In cats which treatment, meloxicam or prednisolone, most quickly reduces clinical signs of feline interstitial cystitis?

TL;DR

This paper compares meloxicam and prednisolone for treating feline interstitial cystitis but finds no strong evidence for either's effectiveness over a placebo.

Contribution

The study evaluates the effectiveness of meloxicam versus prednisolone in treating feline interstitial cystitis using available clinical trials.

Findings

Meloxicam and prednisolone show no significant difference in reducing clinical signs of FIC compared to a placebo.

No direct comparison between meloxicam and prednisolone was found in available studies.

The evidence suggests weak support for either drug's efficacy in treating FIC.

Abstract

PICO question

In cats with feline interstitial cystitis, which therapy brings a faster resolution of clinical signs: meloxicam or prednisolone?

Clinical bottom line

Category of research question

Treatment

The number and type of study designs reviewed

Two papers evaluated as relevant to the PICO question were critically reviewed. Both were double-blinded randomised controlled trials.

One paper not related to the PICO question, a single-blinded randomised controlled trial, was also reviewed as it is touched upon in the discussion section

Strength of evidence

Appraisal of the literature reveals weak evidence that meloxicam and prednisolone are of equivalent effectiveness when treating feline interstitial cystitis, also known as feline idiopathic cystitis (FIC)

Outcomes reported

There is no statistically significant difference in the reduction of clinical signs when meloxicam is compared with a placebo for the treatment of FIC. There is no statistically significant difference in reduction of clinical signs when prednisolone is compared with a placebo for the treatment of FIC. No studies were available for review which directly compared meloxicam against prednisolone as treatment options for FIC

Conclusion

In cats with FIC, insufficient evidence exists to truly conclude whether meloxicam or prednisolone is the most efficacious therapy for the reduction of clinical signs. Two double-blinded randomised controlled trials were evaluated – one compared the efficacy of meloxicam against a placebo; the other compared the efficacy of prednisolone against a placebo. Neither study found a statistically significant difference between the assessed treatment modality and the placebo used in reducing the clinical signs of FIC. As such, weak evidence exists that there is no significant difference between the use of meloxicam and a placebo, and prednisolone and a placebo in the reduction of clinical signs of FIC. Additionally, it could therefore be hypothesised that no significant difference exists in the reduction of clinical signs when comparing meloxicam against prednisolone as treatments for FIC however, no study was discoverable which was able to substantiate this claim