BackgroundOclacitinib (Apoquel®) inhibits the function of a variety of pro-inflammatory, pro-allergic and pruritogenic cytokines that are dependent on Janus kinase enzyme activity. Oclacitinib selectively inhibits Janus kinase 1.Hypothesis/ObjectivesWe aimed to evaluate the safety and efficacy of oclacitinib for the control of pruritus associated with allergic dermatitis in a randomized, double-blinded, placebo-controlled trial.MethodsClient-owned dogs (n = 436) with moderate to severe owner-assessed pruritus and a presumptive diagnosis of allergic dermatitis were enrolled. Dogs were randomized to either oclacitinib at 0.4–0.6 mg/kg orally twice daily or an excipient-matched placebo. An enhanced 10 cm visual analog scale (VAS) was used by the owners to assess the severity of pruritus from day 0 to 7 and by veterinarians to assess the severity of dermatitis on days 0 and 7. Dogs could remain on the study for 28 days.ResultsPretreatment owner and veterinary VAS scores were similar for the two treatment groups. Oclacitinib produced a rapid onset of efficacy within 24 h. Mean oclacitinib Owner Pruritus VAS scores were significantly better than placebo scores (P < 0.0001) on each assessment day. Pruritus scores decreased from 7.58 to 2.59 cm following oclacitinib treatment. The day 7 mean oclacitinib Veterinarian Dermatitis VAS scores were also significantly better (P < 0.0001) than placebo scores. Diarrhoea and vomiting were reported with similar frequency in both groups.Conclusions and clinical importanceIn this study, oclacitinib provided rapid, effective and safe control of pruritus associated with allergic dermatitis, with owners and veterinarians noting substantial improvements in pruritus and dermatitis VAS scores.

In human beings, intrarenal blood flow impedance, expressed as the resistive index (RI) and obtained by duplex Doppler ultrasonography, has been used to aid in diagnosis and prognosis of renal failure. Higher than normal values for RI were obtained in 3 of 4 dogs with acute tubular necrosis (ATN) and in 5 of 10 dogs with glomerulonephrosis (GNI.Normalization of RI was observed in 2 dogs with ATN evaluated serially during treatment. Increased RI values were obtained in 9 of 10 cats with nonobstructive renal disease and in 2 of 5 cats with obstructive renal disease. Normalization of RI was observed in 3 cats with renal failure in which treatenal failure is an important cause of morbidity and mor-R tality in dogs and cats.'.' Often, renal biopsy is needed for further clarification of cause and ~everity,'.~ but this procedure is relatively invasive and potentially is associated with complication^.^^^ Additional noninvasive methods to aid in the diagnosis and prognosis of renal diseases in dogs and cats would be beneficial.B-mode ultrasonography provides noninvasive morphologic evaluation of organs without use of ionizing radiation. It has become a widely accepted diagnostic technique in veterinary practice and has proved useful in the evaluation of patients with renal d i~e a s e ?~~*~ Duplex Doppler ultrasonography adds noninvasive real-time quantitative determination of organ blood flow in addition to morphologic evaluation. Diseases that alter organ blood flow have the potential to be further characterized by duplex Doppler ultrasonograIn human patients, intrarenal blood flow values obtained with duplex Doppler ultrasonography have been used to aid in diagnosis of renal disease and to monitor therapeutic response and p r o g n o s i~.~~'~ In human patients, duplex Doppler evaluation of intrarenal blood flow commonly is performed using resistive index (RI) (also known as Pourcelot index," resistivity index,I2 and resistance indexI3), an expression of intrarenal blood flow impedance." In human beings, the upper limit of normal for intrarenal RI is 0.70; values above 0.70 are considered a b n~r m a l . '~~'~ In human beings, in- creased intrarenal RI has been used as an aid in the diagnosis of renal disease, and normalization of RI after effective treatment has been used to monitor therapeutic response.9Intrarenal RI values for normal dogs have been described as 0.62 i 0.05 (mean t standard deviation [SD]) for the right kidney and 0.63 t 0.05 (mean i SD) for the left kidney, with no statistically significant difference observed between the right and left kidney.15 Intrarenal RI values for normal cats have been described as 0.59 t 0.05 (mean 5 SD) for the right kidney and 0.56 i 0.06 (mean i SD) for the left kidney, with no statistically significant differences observed between right and left kidney.16 Mean intrarenal RI vaIue plus 2 SD has been used to describe the upper limit of normal in human beings." Based on the aforementioned value^,'^.'^ 0.73 is proposed as the upper limit for intrarenal RI in normal dogs and...

Background -Oclacitinib is safe and effective for treating dogs with pruritus associated with allergic and atopic dermatitis, based on randomized clinical trials of up to 4 months duration.Hypothesis/Objectives -This study assessed long-term safety, efficacy and quality of life of oclacitinib-treated dogs enrolled in a compassionate use programme.Animals -Two hundred and forty-seven client-owned dogs with allergic skin disease that had previously benefited from oclacitinib therapy.Methods -Dogs were enrolled in an open-label study at 26 veterinary clinics. Dogs received 0.4-0.6 mg/kg oclacitinib twice a day for 14 days, then once a day for up to 630 days. Assessments were performed at~90 day intervals. Owners completed a quality-of-life survey and assessed pruritus using a Visual Analog Scale (VAS) at each clinic visit. Veterinarians assessed dermatitis using a similar VAS. Abnormal health events, concomitant medication and clinical pathology results were summarized.Results -Visual Analog Scale scores showed improvement from baseline at all time points. The percentage of dogs showing ≥50% reduction from baseline on day 90 was 63.9% for pruritus and 66.4% for dermatitis. Owners saw a positive impact on quality of life in >91% of all dogs. Urinary tract infection/cystitis, vomiting, otitis, pyoderma and diarrhoea were the most frequently reported (>5% of dogs) abnormal clinical signs. Haematology and serum chemistry means remained within the normal reference ranges. Concomitant medications were well tolerated.Conclusions and clinical importance -Results indicated that oclacitinib was safe and efficacious for long-term use and improved the quality of life for dogs in this study.

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BackgroundCiclosporin is approved for the treatment of atopic dermatitis (AD) in dogs and has been shown to be safe and effective. Placebo-controlled studies suggest that oclacitinib is a safe and effective alternative therapy.Hypothesis/ObjectivesTo evaluate the efficacy and safety of oclacitinib, in comparison to ciclosporin, for the control of AD in a blinded, randomized clinical trial, incorporating a noninferiority test at day 28.AnimalsA total of 226 client-owned dogs with a history of AD from eight sites were enrolled.MethodsEnrolled animals were randomized to receive oral oclacitinib (0.4–0.6 mg/kg twice daily for 14 days, then once daily) or oral ciclosporin (3.2–6.6 mg/kg once daily) for 12 weeks. Owners assessed pruritus using an enhanced visual analog scale (VAS), and veterinarians assessed dermatitis using the Canine Atopic Dermatitis Extent and Severity Index (CADESI)-02.ResultsOn days 1, 2, 7, 14, 28, 56 and 84, the percentage reduction from baseline for owner-assessed pruritus changed from 25.6 to 61.0% in the oclacitinib group compared with 6.5 to 61.5% in the ciclosporin group; differences were significant at all time points up to day 28. On day 56, ciclosporin-treated dogs showed a similar decrease in pruritus to oclacitinib-treated dogs. On day 14, the percentage reduction from baseline CADESI-02 was significantly greater in the oclacitinib group (58.7%) than in the ciclosporin group (43.0%). Three times as many adverse events attributed to gastrointestinal signs were reported in the ciclosporin group compared with the oclacitinib group.Conclusions and clinical importanceIn this study of treatment for canine AD, oclacitinib had a faster onset of action and a lower frequency of gastrointestinal side effects compared with ciclosporin.