Clinical Efficacy of Oclacitinib and Lokivetmab in Dogs with Canine Atopic Dermatitis

Abstract

Canine atopic dermatitis (CAD) is a genetically predisposed inflammatory and pruritic skin disease presenting characteristic clinical features in dogs. Despite oclacitinib and lokivetmab being commonly used, no study has compared their efficacies in CAD. This study aimed to compare the efficacy, safety, and control of CAD-associated pruritus and skin lesions between oclacitinib and lokivetmab. It also investigated whether switching to lokivetmab from oclacitinib or prednisolone had any benefits. Twenty-five client-owned dogs, newly diagnosed with CAD, were allocated to the oclacitinib (n = 20) and lokivetmab (n = 5) groups and administered oclacitinib (0.4-0.6 mg/kg orally, twice daily for 14 days, then once daily) and lokivetmab (2 mg/kg subcutaneously, every month) for 8 weeks, respectively. The switching group included five dogs previously administered with oclacitinib (n = 4) or prednisolone (n = 1) who were switched to lokivetmab directly at the start of the study. The pruritus visual analog scale (PVAS) and Canine Atopic Dermatitis Extent and Severity Index (CADESI-04) values were surveyed at weeks 0, 4, and 8. Oclacitinib and lokivetmab significantly reduced the PVAS and CADE-SI-04 scores. Switching from oclacitinib or prednisolone to lokivetmab maintained the severity of pruritus (4 weeks: p = 0.068; 8 weeks: p = 0.068) and dermatitis (4 weeks: p = 0.144; 8 weeks: p = 0.068) at the levels measured at baseline. Thus, both oclacitinib and lokivetmab reduced CAD-associated pruritus by a similar degree. Switching to lokivetmab maintained the severity of pruritus and dermatitis at the same level as the previous treatment.

Alternative clinical approaches to the treatment of pruritus related with canine atopic dermatitis

“…In another study evaluating its safety, no abnormal health findings associated with lokivetmab were observed as a result of its use for 6 months (Moyaert et al, 2017). In a study comparing lokivetmab and oclacitinib, no significant difference was found between their antipruritic effects (Lee et al, 2021).…”

Is Vitamin D3 a Worthy Supplement Protecting against Secondary Infections in Dogs with Atopic Dermatitis?

“…This therapy is effective in CAD, except for otitis externa which seems to be resistant to Lokivetmab and only glucocorticoids sufficiently reduce inflammation of the ear canal. Moreover, side effects of Lokivetmab have also been described, and they include drowsiness, vomiting, diarrhea, lack of appetite, pain at the injection site, dermatitis, and pruritus [ 27 , 28 ].…”

Cytokine transcriptome profiling in acute experimental canine atopic dermatitis skin lesions afterIL‐31 inhibition with lokivetmab

“…Interleukin (IL)‐31 is now known to represent one of the key cytokines of human and canine AD 3–5 . In dogs with AD, a significant reduction in pruritus has been seen following injections of lokivetmab (LKV, Cytopoint; Zoetis), a therapeutic monoclonal antibody (mAb) targeting canine IL‐31, thus confirming that this cytokine plays a pivotal role in the genesis of pruritus associated with this disease 6–12 …”

“…[3][4][5] In dogs with AD, a significant reduction in pruritus has been seen following injections of lokivetmab (LKV, Cytopoint; Zoetis), a therapeutic monoclonal antibody (mAb) targeting canine IL-31, thus confirming that this cytokine plays a pivotal role in the genesis of pruritus associated with this disease. [6][7][8][9][10][11][12] Despite documented therapeutic success in clinical trials, increasing evidence suggests that IL-31 is not required for the induction of acute allergic skin…”