I have hunting dogs that will pickup hundreds of ticks if not protected. I use Bravcto (Fluralaner) on them now, which is extremely effective. Hopefully lotilaner is similar with humans.
Most of the older generation of anti-tick meds have pretty substantial side effects and poor efficacy.
I've been using Bravecto and Nexgard for the past 4 years and it really should be emphasized how much of a seismic shift these meds have been.
I've had dogs all my life and live in a very tick-prone area. Nothing ever really worked, to be honest. It was a constant battle of attrition. I had to spray the house with nasty chemicals every few months cause that was pretty much the only thing that kind of tipped the balance against the ticks. I frankly don't know how we didn't get Lyme disease, we were exposed for decades.
Since these new meds appeared, ticks have completely disappeared from our property. They only provide 1-3 months of protection, but they're so effective at eradicating the parasite population that I've only had to use 3 pills in the past 4 years.
There might be external effects happening at the same time here.
I grew up on a island with a lot of ticks. Being a kid and spending time on fields and in forests, we constantly had to remove ticks before heading home.
But now 2 decades later, visiting the island again as an adult and expecting having to do the same after walking around the forest, we didn't find a single tick on ourselves, when it would easily have been a couple of ticks each in the before-days.
So many parameters being different though, so hard to reach any conclusion, maybe my blood is less attractive, maybe we weren't physically intensive enough, maybe the wrong season, but maybe there are other chemicals at play too that wasn't there before.
The consolidated FDA, Project Jake and EMA findings (Table 8) showed notable differences between survey populations regarding the percentage of neurological toxicity and serious AE, and fatal effects. Statistical analysis of these serious AE showed highly significant differences between the findings of the Project Jake survey and those reported by the FDA and EMA. While the number of death and seizure AE reported by the EMA was 7 to 10 times higher than those reported to the FDA, the reported responses for the Project Jake survey for death and seizures fell in between those of the FDA and EMA but aligned more closely with the EMA results. Furthermore, the number of reported death and seizure AE for lotilaner and spinosad were considerably higher than suggested with respect to their product labelling for potential neurological effects (Table 2 and and8).8).
But yes, the drug is "generally" safe for use. It's still worth being aware of the potential risks.
The link you posted has a notice right at the top saying the article has been corrected.
It links to a corrigendum adding a conflict of interest disclosure stating
> A Class Action lawsuit related to the use and safety of isoxazoline parasiticides was filed on December 27, 2019 in New Jersey, while this manuscript was undergoing peer review. One of the article's co‐authors, Valerie Palmieri, is the Plaintiff. [PALMIERI, et al. v. INTERVET INC, Case No. .2:19‐cv‐22024‐JMV‐AME (D. N. J.).]”
#1: Authorship is a big one, and the conflict of interest developing during the review process shows that these are not disinterested researchers.
#2: The type of study is a nearly worthless type, in that it has no real statistical control and is just asking people to report on things on the internet. What ends up happening with these studies is that people self-recruit by word of mouth. Survey respondents may have been asked by other participants to register adverse events, and survey respondents may have never given the medication to a pet or seen an adverse event. There is no controlling for that apparent in the study.
#3: The survey instrument is supposed to be in the appendix and it is not, yet it is not described. Their recruitment process is described only as "distributed electronically by mail throughout the United States to veterinarians, veterinary clients, pet caregivers/owners, kennel club groups and on social media sites between August 1 and 31, 2018." There are lots of complaints about the adverse-event reporting system, the worst is that adverse events are merely enumerated from reports and there is no real way to put them into a statistical study. This is just getting another enumeration of events and putting a different denominator under them.
In my prescribing I have seen only one adverse event worth reporting: a dog was heartworm positive and received ivermectin, doxycycline and afoxolaner at the same time. It had a transient episode of low blood pressure treated with fluids. For a drug that, in their denominator, gives 80+% adverse reactions, that is very surprising. So, the study doesn't really pass the smell test.
There have been other drugs that have caused adverse reactions in significant numbers of patients. We stop using them immediately. The difference is very noticeable.
OMG, I went down the rabbit hole on this paper and it is bonkers. Their methodology is amateur hour. It's just an uncontrolled non-validated survey sent out by an activist group. What is their list of survey recipients based on? What were the demographic differences between responders and nonresponders? It's the science equivalent of a political push-poll (https://en.wikipedia.org/wiki/Push_poll)
The first author is a business executive who launched a huge class-action against Merck without disclosing it in this paper, the only veterinarian in the authors has been cited for practicing without a license (https://www.ocregister.com/2021/10/26/founder-of-hemopet-in-...) and the senior author is an orthopedic surgeon with no relation to the field and has maybe one other publication.
If you browse around pet forums, or go wild with Google, you'll find all sorts of anecdotal reports of people who claim their pets died (with all sorts of terrifying symptoms etc) soon after taking these kinds of drugs.
Take from that what you want. It's anecdotal and non-scientific. But it concerns me enough that we keep our dogs on Nexgard only during the peak of tick season and not year round like the vets seem to want to push.
There are also known genetic differences in dogs that cause some to find various anti-parasiticals (esp heartworm) to be toxic to some herding breeds (border collies, aus. sheperds). We had our border collies tested for this before putting them on medications. (https://vcacanada.com/know-your-pet/multidrug-resistance-mut...)
That said, genetic diversity is higher in dogs than it is in humans.
Sorry to hear. Yeah this weird winter is super unusually warm where I am too, though we've fallen back into seasonal normals in the last week. I've been keeping an eye out for ticks, but so far nothing.
I've only ever seen deer ticks here, never black legged, but they're definitely in the area.
They are absolutely not safe at normal doses. They killed my 2 year old dog. There are thousands of dogs out there that experienced seizures from this class of drugs.
She had seizures within hours of giving her the stuff, and was dead within 48 hours.
I'll happily die on this hill of looking like an internet crank ranting about drug companies, but it was a traumatizing experience for my wife and I, and even worse for our dog.
It's weird that regardless of how many different ways you try to tell this to people they're still more than happy to give the benefit of the doubt to $307 billion dollar pharma company.
It’s about risk assessment. It would be awful to have one of the small percent of dogs that have bad reactions to those medicines. It’s also bad to have dogs crawling with ticks.
Where I grew up, having dogs get sick from tick bites was fairly common. Ever seen a collie with its ears packed with swollen ticks? That has to be miserable. The risk of the medicine was less than the risk of the bites in our case.
Most of the older generation of anti-tick meds have pretty substantial side effects and poor efficacy.