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Drechsler Y, Dong C, Clark DE, Kaur G. Canine Atopic Dermatitis: Prevalence, Impact, and Management Strategies. VETERINARY MEDICINE (AUCKLAND, N.Z.) 2024; 15:15-29. [PMID: 38371487 PMCID: PMC10874193 DOI: 10.2147/vmrr.s412570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 01/26/2024] [Indexed: 02/20/2024]
Abstract
Atopic dermatitis (AD) is a common inflammatory and pruritic allergic skin disease in humans and dogs worldwide. The pathogenesis of AD is multifactorial, immunologically complex, and may involve genetic factors, epidermal barrier dysfunction, microbiome changes, immune dysregulation, and allergic sensitization. Across species, prevalence of AD is on the rise. At present, there is no cure for canine AD (CAD). The treatment for CAD is multifaceted and aimed at controlling the pruritus, associated inflammation, and infections, repairing the skin barrier function, and dietary management. This review presents data on prevalence, impact, and complex immunological interactions in AD with a focus on subsequent management of the disease in the canine population. A multimodal approach for management of CAD to address varying clinical signs and responses to therapies is discussed.
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Affiliation(s)
- Yvonne Drechsler
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, CA, USA
| | - Charli Dong
- Animal Dermatology Clinic, Pasadena, CA, USA
| | - David E Clark
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, CA, USA
| | - Gagandeep Kaur
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, CA, USA
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2
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Bruet V, Mosca M, Briand A, Bourdeau P, Pin D, Cochet-Faivre N, Cadiergues MC. Clinical Guidelines for the Use of Antipruritic Drugs in the Control of the Most Frequent Pruritic Skin Diseases in Dogs. Vet Sci 2022; 9:vetsci9040149. [PMID: 35448647 PMCID: PMC9030482 DOI: 10.3390/vetsci9040149] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/13/2022] [Accepted: 03/15/2022] [Indexed: 12/10/2022] Open
Abstract
Pruritus is a common clinical sign in many skin disorders and is currently the main complaint in canine dermatology. Pruritic skin diseases can affect the quality of life of dogs and their owners. Several families of antipruritic drugs are available to help control pruritus in dogs. The aim of this review is to help practitioners select the most appropriate symptomatic treatment in the most frequent situations of dermatological pruritus in dogs. The molecules reviewed here are systemic and topical glucocorticoids, antihistamines, ciclosporin, oclacitinib and lokivetmab. A level of evidence (1, 2 or 3) has been established according to a detailed algorithm for each individual study in the literature published between 1990 and March 2021. The guidelines result from evidence grading using the strength of recommendation taxonomy (SoRT) and clinical recommendations using a thorough methodology.
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Affiliation(s)
- Vincent Bruet
- Veterinary Dermatology Referral Services, 44100 Nantes, France;
| | - Marion Mosca
- Université de Lyon, VetAgro Sup, Interactions Cells Environment, UPSP 2016.A104, 69280 Marcy l’Etoile, France; (M.M.); (D.P.)
| | - Amaury Briand
- Department of Dermatology, Ecole Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France; (A.B.); (N.C.-F.)
| | - Patrick Bourdeau
- Department of Clinical Sciences, ENVN (Oniris) Université de Nantes, 44307 Nantes, France;
| | - Didier Pin
- Université de Lyon, VetAgro Sup, Interactions Cells Environment, UPSP 2016.A104, 69280 Marcy l’Etoile, France; (M.M.); (D.P.)
| | - Noëlle Cochet-Faivre
- Department of Dermatology, Ecole Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France; (A.B.); (N.C.-F.)
- UMR BIPAR, Laboratoire de Santé Animale, 94700 Maisons-Alfort, France
| | - Marie-Christine Cadiergues
- Department of Clinical Sciences, Université de Toulouse, ENVT, 31076 Toulouse, France
- INFINITy, Université de Toulouse, Inserm, CNRS, UPS, 31059 Toulouse, France
- Correspondence: ; Tel.: +33-561-193268
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El-Telbany DFA, El-Telbany RFA, Zakaria S, Ahmed KA, El-Feky YA. Formulation and assessment of hydroxyzine HCL solid lipid nanoparticles by dual emulsification technique for transdermal delivery. Biomed Pharmacother 2021; 143:112130. [PMID: 34560549 DOI: 10.1016/j.biopha.2021.112130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 10/20/2022] Open
Abstract
Hydroxyzine HCL (HHCL) is an antihistamine, used for the treatment of allergic skin conditions. The purpose of this study was to achieve a dual phase drug delivery rate across the intact skin, to enhance HHCL permeation through the stratum corneum, to assess the peripheral H1-antihistaminic activity and the extent to which HHCL was systemically absorbed from transdermal gel loaded with solid lipid nanoparticles (SLNs), as well as to avoid its extreme bitterness. According to 23 factorial design, eight formulations of HHCL-SLNs were prepared by the double emulsification method. Lipid type (XA), surfactant concentration (XB) and co-surfactant concentration (XC) were the independent variables. All formulations were characterized for their surface morphology, particle size, entrapment efficiency and in-vitro drug release study. The optimized formula that provides greater desirability was then incorporated into the transdermal gel. In addition, the efficacy of the developed gel was tested in-vivo using 2,4-Dinitrochlorobenzene induced atopic dermatitis as lesion model in mice. F4 showed an average diameter 111 nm ± 0.03, zeta potential - 30 MV ± 2.4 and EE 75.2% ± 4.4. TEM images showed spherical, smooth morphology with uniform particles distribution. In-vivo study demonstrated potent antipruritic efficacy of transdermal gel in atopic dermatitis such as induced lesions compared to HHCL gel. Hence, HHCL solid lipid nanoparticles transdermal gel may be considered as potential for delivery of HHCL and alternatively to traditional oral use.
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Affiliation(s)
- Dalia Farag A El-Telbany
- Department of Pharmaceutics, Faculty of Pharmacy, Modern University for Technology and Information (MTI), Cairo, Egypt.
| | - Rania Farag A El-Telbany
- Department of Biochemistry, Faculty of Pharmacy, Modern University for Technology and Information (MTI), Cairo, Egypt.
| | - Sherin Zakaria
- Department of Pharmacology and Toxicology, Kafr Elsheikh University, Kafr Elsheikh, Egypt.
| | - Kawkab A Ahmed
- Department of Pathology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt.
| | - Yasmin A El-Feky
- Department of Pharmaceutics, Faculty of Pharmacy, Modern University for Technology and Information (MTI), Cairo, Egypt.
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Saridomichelakis MN, Favrot C, Jackson HA, Bensignor E, Prost C, Mueller RS. A proposed medication score for long-term trials of treatment of canine atopic dermatitis sensu lato. Vet Rec 2021; 188:e19. [PMID: 33666961 DOI: 10.1002/vetr.19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/08/2020] [Accepted: 11/06/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND The use of concurrent medications is necessary in trials of treatment of canine atopic dermatitis. Our aim was to use the best available evidence to construct and then to validate a medication score (MS) formula that will estimate the impact of concurrent medications on trial outcomes. METHODS Trials of 15 interventions were scrutinized to find those that were consistent in terms of specific medication, administration route and dosage regimen. A MS was constructed in five steps, starting from assigning a score of 1 for each day on oral prednisone, prednisolone or methylprednisolone at 0.5-1.0 mg/kg. The MS score was validated using the clinical records of 35 dogs with atopic dermatitis that had been treated for a period of 12 ± 2 weeks with six of these medications and compared with a previously published non-validated MS. RESULTS A MS could be assigned to eight treatments, six of which had been administered to the 35 dogs. A positive correlation was seen with the previously published MS and a negative correlation with changes in lesional and pruritus scores. CONCLUSION This MS may be a useful tool in new studies evaluating the efficacy of treatments in canine atopic dermatitis.
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Affiliation(s)
- Manolis N Saridomichelakis
- Clinic of Medicine, Faculty of Veterinary Science, University of Thessaly, Karditsa, Greece.,'Attiko' Animal Hospital, Paiania, Attiki, Greece
| | - Claude Favrot
- Clinic for Small Animal Internal Medicine, Dermatology Department, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland
| | | | - Emmanuel Bensignor
- Dermatology Referral Service, Clinique Vétérinaire, Rennes-Cesson, France
| | | | - Ralf S Mueller
- Medizinische Kleintierklinik, Centre for Clinical Veterinary Medicine, Ludwig-Maximilian University, Munich, Germany
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Gamperl S, Stefanzl G, Willmann M, Valent P, Hadzijusufovic E. In vitro effects of histamine receptor 1 antagonists on proliferation and histamine release in canine neoplastic mast cells. Vet Med Sci 2020; 7:57-68. [PMID: 32924324 PMCID: PMC7840218 DOI: 10.1002/vms3.336] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 06/12/2020] [Accepted: 07/20/2020] [Indexed: 12/12/2022] Open
Abstract
Canine mastocytomas (MCTs) are characterized by rapid proliferation of neoplastic mast cells (MCs) and clinical signs caused by MC-derived mediators. In dogs suffering from MCT, histamine receptor 1 (HR1) antagonists are frequently used to control mediator-related clinical symptoms. Previous studies have shown that the HR1 antagonists loratadine and terfenadine exert some growth-inhibitory effects on neoplastic MCs. We examined whether other HR1 antagonists used in clinical practice (desloratadine, rupatadine, cyproheptadine, dimetindene, diphenhydramine) affect proliferation and survival of neoplastic MCs. Furthermore, we analysed whether these HR1 antagonists counteract IgE-dependent histamine release from a MC line harbouring a functional IgE-receptor. HR1 antagonists were applied on two canine MC lines, C2 and NI-1, and on primary MCs obtained from three MCT samples. The HR1 antagonists desloratadine, rupatadine and cyproheptadine were found to be more potent in decreasing proliferation of C2 and NI-1 cells when compared with dimetindene and diphenhydramine. Similar effects were seen in primary neoplastic MCs, except for diphenhydramine, which exerted more potent growth-inhibitory effects than the other HR1 antagonists. Drug-induced growth-inhibition in C2 and NI-1 cells was accompanied by apoptosis. Loratadine, desloratadine and rupatadine also suppressed IgE-dependent histamine release in NI-1 cells. However, drug concentrations required to elicit substantial effects on growth or histamine release were relatively high (>10 µM). Therefore, it remains unknown whether these drugs or similar, more potent, HR1-targeting drugs can suppress growth or activation of canine neoplastic MCs in vivo.
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Affiliation(s)
- Susanne Gamperl
- Division of Hematology & Hemostaseology, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Gabriele Stefanzl
- Division of Hematology & Hemostaseology, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Michael Willmann
- Department of Companion Animals and Horses, Clinic for Internal Medicine and Infectious Diseases, University of Veterinary Medicine Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Peter Valent
- Division of Hematology & Hemostaseology, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Emir Hadzijusufovic
- Division of Hematology & Hemostaseology, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria.,Department of Companion Animals and Horses, Clinic for Internal Medicine and Infectious Diseases, University of Veterinary Medicine Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria
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Gamperl S, Stefanzl G, Peter B, Smiljkovic D, Bauer K, Willmann M, Valent P, Hadzijusufovic E. Effects of ibrutinib on proliferation and histamine release in canine neoplastic mast cells. Vet Comp Oncol 2019; 17:553-561. [PMID: 31286638 PMCID: PMC6900099 DOI: 10.1111/vco.12520] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 07/02/2019] [Accepted: 07/03/2019] [Indexed: 01/08/2023]
Abstract
The Bruton's tyrosine kinase (BTK) inhibitor ibrutinib is effective in the treatment of human chronic lymphocytic leukaemia and mantle cell lymphoma. Recent data have shown that ibrutinib also blocks IgE-dependent activation and histamine release in human basophils (BAs) and mast cells (MCs). The aim of this study was to investigate whether BTK serves as a novel therapeutic target in canine mast cell tumours (MCTs). We evaluated the effects of ibrutinib on two canine MC lines, C2 and NI-1 and on primary MCs obtained from canine MCTs (n = 3). Using flow cytometry, we found that ibrutinib suppresses phosphorylation of BTK and of downstream STAT5 in both MC lines. In addition, ibrutinib decreased proliferation of neoplastic MCs, with IC50 values ranging between 0.1 and 1 μM in primary MCT cells and between 1 and 3 μM in C2 and NI-1 cells. In C2 cells, the combination "ibrutinib + midostaurin" produced synergistic growth-inhibitory effects. At higher concentrations, ibrutinib also induced apoptosis in both MC lines. Finally, ibrutinib was found to suppress IgE-dependent histamine release in primary MCT cells, with IC50 values ranging from 0.05 to 0.1 μM in NI-1 cells, and from 0.05 to 1 μM in primary MCT cells. In summary, ibrutinib exerts anti-proliferative effects in canine neoplastic MCs and counteracts IgE-dependent histamine release in these cells. Based on our data, ibrutinib may be considered as a novel therapeutic agent for the treatment of canine MCT. The value of BTK inhibition in canine MCT patients remains to be elucidated in clinical trials.
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Affiliation(s)
- Susanne Gamperl
- Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of Vienna, Vienna, Austria
| | - Gabriele Stefanzl
- Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of Vienna, Vienna, Austria
| | - Barbara Peter
- Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Dubravka Smiljkovic
- Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of Vienna, Vienna, Austria
| | - Karin Bauer
- Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Michael Willmann
- Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria.,Department/Hospital for Companion Animals and Horses, University Clinic for Small Animals, Internal Medicine Small Animals, University of Veterinary Medicine, Vienna, Austria
| | - Peter Valent
- Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Emir Hadzijusufovic
- Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria.,Department/Hospital for Companion Animals and Horses, University Clinic for Small Animals, Internal Medicine Small Animals, University of Veterinary Medicine, Vienna, Austria
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Ekstrand C, Ingvast-Larsson C, Bondesson U, Hedeland M, Olsén L. Cetirizine per os: exposure and antihistamine effect in the dog. Acta Vet Scand 2018; 60:77. [PMID: 30477556 PMCID: PMC6258303 DOI: 10.1186/s13028-018-0431-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 11/20/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cetirizine is an antihistamine used in dogs, but plasma concentrations in relation to effect after oral administration are not well studied. This study investigated cetirizine exposure and the plasma cetirizine concentration-antihistamine response relation in the dog following oral administration of cetirizine. RESULTS Eight Beagle dogs were included in a cross-over study consisting of two treatments. In treatment one, cetirizine 2-4 mg/kg was administered per os once daily for 3 days. The other treatment served as a control. Wheal diameter induced by intra-dermal histamine injections served as response-biomarker. Cetirizine plasma concentration was quantified by UHPLC-MS/MS. Median (range) cetirizine plasma terminal half-life was 10 h (7.9-16.5). Cetirizine significantly inhibited wheal formation compared with the premedication baseline. Maximum inhibition of wheal formation after treatment with cetirizine per os was 100% compared with premedication wheal diameter. The median (range) IC50-value for reduction in wheal area was 0.33 µg/mL (0.07-0.45). The median (range) value for the sigmoidicity factor was 1.8 (0.8-3.5). A behavioral study was also conducted and revealed no adverse effects, such as sedation. CONCLUSION The results indicate that a once-daily dosing regimen of 2-4 mg/kg cetirizine per os clearly provides a sufficient antihistamine effect. Based on this experimental protocol, cetirizine may be an option to treat histamine-mediated inflammation in the dog based on this experimental protocol but additional clinical studies are required.
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Affiliation(s)
- Carl Ekstrand
- Department of Biomedicine and Veterinary Public Health, Division of Pharmacology and Toxicology, Swedish University of Agricultural Sciences, P.O. Box 7028, 750 07 Uppsala, Sweden
| | - Carina Ingvast-Larsson
- Department of Biomedicine and Veterinary Public Health, Division of Pharmacology and Toxicology, Swedish University of Agricultural Sciences, P.O. Box 7028, 750 07 Uppsala, Sweden
| | - Ulf Bondesson
- Department of Chemistry, Environment and Feed Hygiene, National Veterinary Institute, Uppsala, Sweden
- Department of Medicinal Chemistry, Division of Analytical Pharmaceutical Chemistry, Uppsala University, Uppsala, Sweden
| | - Mikael Hedeland
- Department of Chemistry, Environment and Feed Hygiene, National Veterinary Institute, Uppsala, Sweden
- Department of Medicinal Chemistry, Division of Analytical Pharmaceutical Chemistry, Uppsala University, Uppsala, Sweden
| | - Lena Olsén
- Department of Biomedicine and Veterinary Public Health, Division of Pharmacology and Toxicology, Swedish University of Agricultural Sciences, P.O. Box 7028, 750 07 Uppsala, Sweden
- Department of Clinical Sciences, Division of Veterinary Nursing, Swedish University of Agricultural Sciences, Uppsala, Sweden
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Gedon NKY, Mueller RS. Atopic dermatitis in cats and dogs: a difficult disease for animals and owners. Clin Transl Allergy 2018; 8:41. [PMID: 30323921 PMCID: PMC6172809 DOI: 10.1186/s13601-018-0228-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 09/10/2018] [Indexed: 12/13/2022] Open
Abstract
The purpose of this review article is to give an overview of atopic dermatitis in companion animals and of recent developments including knowledge on immunological background, novel treatment options and difficulties in disease management. The prevalence of hypersensitivities seems to be increasing. The pathogenetic mechanisms are not fully understood, yet multiple gene abnormalities and altered immunological processes are involved. In dogs and cats, the diagnosis of atopic dermatitis is based on history, clinical examination and exclusion of other differential diagnoses. Intradermal testing or testing for serum allergen-specific Immunoglobulin E is only used to identify allergens for inclusion in the extract for allergen immunotherapy. Symptomatic therapy includes glucocorticoids, ciclosporin, essential fatty acids and antihistamines. A selective janus kinase 1 inhibitor and a caninized monoclonal interleukin-31 antibody are the newest options for symptomatic treatment, although longterm effects still need to be assessed. The chronic and often severe nature of the disease, the costly diagnostic workup, frequent clinical flares and lifelong treatment are challenging for owners, pets and veterinarians. Patience and excellent communication skills are needed to achieve a good owner compliance and satisfactory clinical outcome for the animal.
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Affiliation(s)
- Natalie Katharina Yvonne Gedon
- Small Animal Medicine Clinic, Centre for Clinical Veterinary Medicine, Ludwig Maximilian University, Veterinaerstraße 13, 80539 Munich, Germany
| | - Ralf Steffen Mueller
- Small Animal Medicine Clinic, Centre for Clinical Veterinary Medicine, Ludwig Maximilian University, Veterinaerstraße 13, 80539 Munich, Germany
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Noli C, Della Valle MF, Miolo A, Medori C, Schievano C. Efficacy of ultra-micronized palmitoylethanolamide in canine atopic dermatitis: an open-label multi-centre study. Vet Dermatol 2015; 26:432-40, e101. [PMID: 26283633 DOI: 10.1111/vde.12250] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND Palmitoylethanolamide is a naturally occurring bioactive lipid, produced on-demand by damage-exposed cells. Palmitoylethanolamide is documented to counteract inflammation, itch and pain. OBJECTIVE The aim of this 8-week study was to evaluate the efficacy of oral ultra-micronized palmitoylethanolamide (PEA-um) in dogs with moderate atopic dermatitis. ANIMALS Clinicians from 39 veterinary clinics enrolled 160 dogs with nonseasonal atopic dermatitis and moderate pruritus. METHODS This was a multi-centre open-label study. On days 0 (D0) and 56 (D56), owners evaluated pruritus with a Visual Analog Scale (VAS) and completed a validated Quality of Life (QoL) questionnaire. Veterinarians assessed the severity of skin lesions using the Canine Atopic Dermatitis Lesion Index (CADLI). RESULTS Mean pruritus VAS score decreased from 5.7 ± 0.08 cm (range 3.8-7.9 cm) to 3.63 ± 0.19 cm (range 0.1-9.2 cm) (P < 0.0001). At D56, 58% of dogs showed a greater than 2 cm reduction from baseline and 30% showed an absent-to-very mild pruritus (VAS ≤ 2 cm). Mean total CADLI at D56 decreased significantly (P < 0.0001); in 62% of dogs this score reached a value in the remission range (≤5). Mean total QoL score was significantly decreased (P < 0.0001) with 45% of dogs reaching QoL values described for healthy animals. Tolerability was good-to-excellent with only four dogs reporting treatment associated reversible adverse events. CONCLUSIONS AND CLINICAL IMPORTANCE PEA-um appears to be effective and safe in reducing pruritus and skin lesions, and in improving QoL in dogs with moderate atopic dermatitis and moderate pruritus.
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Affiliation(s)
- Chiara Noli
- Servizi Dermatologici Veterinari, Strada Bedale della Ressia 2, Peveragno, CN, 12016, Italy
| | - M Federica Della Valle
- CeDIS (Centro di Documentazione e Informazione Scientifica), Innovet Italia Srl, Via Egadi 7, Milan, 20144, Italy
| | - Alda Miolo
- CeDIS (Centro di Documentazione e Informazione Scientifica), Innovet Italia Srl, Via Egadi 7, Milan, 20144, Italy
| | - Cristina Medori
- CeDIS (Centro di Documentazione e Informazione Scientifica), Innovet Italia Srl, Via Egadi 7, Milan, 20144, Italy
| | - Carlo Schievano
- Dipartimento Biomedicina Comparata ed Alimentazione, Università di Padova, Viale dell'Università 16, Legnaro, PD, 35020, Italy
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Olivry T, DeBoer DJ, Favrot C, Jackson HA, Mueller RS, Nuttall T, Prélaud P. Treatment of canine atopic dermatitis: 2015 updated guidelines from the International Committee on Allergic Diseases of Animals (ICADA). BMC Vet Res 2015; 11:210. [PMID: 26276051 PMCID: PMC4537558 DOI: 10.1186/s12917-015-0514-6] [Citation(s) in RCA: 143] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 07/30/2015] [Indexed: 12/11/2022] Open
Abstract
Background In 2010, the International Task Force on Canine Atopic Dermatitis (now International Committee on Allergic Diseases of Animals, ICADA) published the first consensus guidelines for the treatment of atopic dermatitis (AD) in dogs. This is the first 5-year minor update of this document. Results The treatment of acute flares of AD should involve the search for, and then elimination of, the cause of the flares, bathing with mild shampoos, and controlling pruritus and skin lesions with interventions that include topical and/or oral glucocorticoids or oclacitinib. For chronic canine AD, the first steps in management are the identification and avoidance of flare factors, as well as ensuring that there is adequate skin and coat hygiene and care; this might include more frequent bathing and possibly increasing essential fatty acid intake. The medications currently most effective in reducing chronic pruritus and skin lesions are topical and oral glucocorticoids, oral ciclosporin, oral oclacitinib, and, where available, injectable recombinant interferons. Allergen-specific immunotherapy and proactive intermittent topical glucocorticoid applications are the only interventions likely to prevent or delay the recurrence of flares of AD. Conclusions This first 5-year minor update of the international consensus guidelines for treatment of AD in dogs further establishes that the treatment of this disease is multifaceted, and that interventions should be combined for a proven (or likely) optimal benefit. Importantly, treatment plans are likely to vary between dogs and, for the same dog, between times when the disease is at different stages. Electronic supplementary material The online version of this article (doi:10.1186/s12917-015-0514-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Thierry Olivry
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, 27606, NC, USA.
| | - Douglas J DeBoer
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, 2015 Linden Drive, Madison, 53706, WI, USA
| | - Claude Favrot
- Clinic for Small Animal Internal Medicine, Dermatology Department, Vetsuisse Faculty, University of Zürich, Winterthurerstrasse 260, 8057, Zürich, Switzerland
| | - Hilary A Jackson
- Dermatology Referral Services LTD, 528 Paisley Road West, Glasgow, Scotland, G51 1RN, UK
| | - Ralf S Mueller
- Medizinische Kleintierklinik, Centre for Clinical Veterinary Medicine, Ludwig-Maximilian University, Veterinärstrasse 13, 80539, Munich, Germany
| | - Tim Nuttall
- Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush Campus, Roslin, Scotland, EH25 9RG, UK
| | - Pascal Prélaud
- Clinique Advetia, 5 rue Dubrunfaut, Paris, 75012, France
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Abstract
Itch is the most common clinical problem seen in dogs with skin diseases. Although an etiological classification of canine pruritus does not yet exist, most causes would likely fall into the IFSI class I (dermatological) itch. One of the most common causes of canine itch is that associated with atopic dermatitis, and there is randomized controlled trial grade evidence of the efficacy of several antipruritic interventions. At this time, the mainstay of treatment of canine atopic itch relies principally on the use of topical and/or oral glucocorticoids and oral cyclosporine. Type 1 receptor antihistamines are notorious in their inconsistency in reducing pruritus in atopic dogs. A new Janus kinase (JAK)-1 inhibitor has recently been approved for treatment of allergic itch in dogs, and its onset of efficacy is remarkably fast. Modeling itch in dogs can be achieved by allergen sensitization (fleas, house dust mites), and challenges that elicit pruritic manifestation can be used for mechanistic studies as well as for testing of novel anti-itch modalities.
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Affiliation(s)
- Thierry Olivry
- Department of Clinical Sciences, College of Veterinary Medicine, NC State University, Raleigh, NC, USA,
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