The effect of pegbovigrastim on early-lactation disease, production, and reproduction in dairy cows

The objective of this randomized, double-blind, controlled trial was to evaluate the effect of pegbovigrastim (pegylated recombinant bovine granulocyte colony-stimulating factor) on early-lactation disease, milk yield, and reproduction on commercial dairy farms. A total of 1,607 Holstein cows from 6 farms in Ontario and Québec, Canada, were randomly assigned to receive two 2.7-mL subcutaneous injections of either 15 mg of pegbovigrastim (n = 798; Imrestor, Elanco) or sterile physiological saline (placebo; n = 809). The first injection was administered by investigators 1 wk before expected calving, and the second by farm personnel within 24 h after calving, according to the product label. Producers inspected cows daily and using standardized disease definitions, recorded cases of retained placenta, metritis, displaced abomasum, and clinical mastitis until 63 d in milk. Progesterone concentration was measured in serum at wk 3, 5, 7, and 9 postpartum. Cows were examined for purulent vaginal discharge using the Metricheck (Simcro) device and endometritis using the cytobrush method at wk 5 postpartum. Milk production and reproduction data were obtained from farm management software and the national milk recording database. Disease and culling outcomes were assessed with logistic regression, milk production with linear regression, and time-to-event outcomes with proportional hazards regression. All analyses considered parity and pre-treatment body condition score and their interaction with treatment, and accounted for clustering of cows within farm. In a subset of 246 cows, the effect of treatment on metabolic markers (serum concentrations of glucose, β-hydroxybutyrate, nonesterified fatty acids, cholesterol, haptoglobin, albumin, and calcium) was assessed in wk 1 and 2 postpartum. Pegbovigrastim had no significant effects on the incidence of retained placenta, metritis, displaced abomasum, clinical or subclinical mastitis, purulent vaginal discharge, or endometritis. Treatment reduced the serum concentration of glucose, slightly reduced the concentration of albumin, and slightly increased concentrations of β-hydroxybutyrate and nonesterified fatty acids, with no effect on the other markers. There were no differences between treatments in culling risk, time to first insemination, pregnancy at first insemination, or time to pregnancy. Milk yield over the first 3 test days of lactation was 1.0 kg per day lower in the pegbovigrastim group, although a mechanism for