Comparison of various treatment options for canine atopic dermatitis: a blinded, randomized, controlled study in a colony of research atopic beagle dogs

Abstract

BackgroundNo study has directly compared the various treatment options for canine atopic dermatitis and their effects on skin barrier.Hypothesis/ObjectivesTo compare prednisone, oclacitinib, ciclosporin and lokivetmab treatment of atopic dermatitis.AnimalsNineteen atopic beagle dogs.Methods and materialsControlled, blinded study. Dogs were challenged with allergen twice weekly and randomized to oclacitinib, ciclosporin, lokivetmab, prednisone or no treatment for four weeks. Dermatitis and pruritus were assessed at baseline and after each challenge. Transepidermal water loss (TEWL) and hydration were measured at baseline, Day (D)14 and D28 (pinnae, axilla, groin). Area under the curve (AUC) was calculated for Canine Atopic Dermatitis Extent and Severity Index, 3rd iteration (CADESI‐03), pruritus, TEWL and hydration. For CADESI, the AUC of the first two weeks was compared to that of the last two weeks.ResultsFor CADESI, restricted maximum‐likelihood ANOVA showed effect of time (P = 0034) and group x time interaction (P = 0.0169). In the first two weeks, prednisone and oclacitinib were significantly lower than controls (P = 0.019 and P = 0.015, respectively). Lokivetmab prevented flares. Due to variability, no significance differences in pruritus were observed among groups. The TEWL increased with time in controls (P = 0.0237) and ciclosporin (P = 0.04, axilla, D28 versus D0) but not in the oclacitinib and lokivetmab groups. CADESI‐03 correlated with TEWL (P = 0.0043) and pruritus (P = 0.0283). Hydration did not correlate with any parameters. Hydration decreased in controls and prednisone group (axilla, D14 versus D0, P = 0.004 and P = 0.027, respectively). AUC for hydration, over time, was higher for lokivetmab and oclacitinib than controls (P = 0.014 and P = 0.04, respectively).Conclusions and clinical importanceLokivetmab prevented flares when given before challenge. Oclacitinib and lokivetmab have some positive effects on skin barrier parameters.

Local and Systemic Changes in Lipid Profile as Potential Biomarkers for Canine Atopic Dermatitis

“…CADESI-4 and PVAS correlated at the baseline, but that correlation was lost after treatment. The inconsistency of CADESI and PVAS, also reported in other studies [ 33 ], highlights the fact that these scoring systems are not robust enough to be used across studies.…”

“…All atopic dogs treated with oclacitinib or lokivetmab had a significantly improved skin condition after 4 weeks of treatment, consistent with previous reports [ 30 , 31 , 32 ]. The therapeutic response to oclacitinib and lokivetmab appears to be similar, although lokivetmab was more effective than oclacitinib as a preventive treatment in a challenge model of CAD [ 33 ]. CADESI-4 and PVAS correlated at the baseline, but that correlation was lost after treatment.…”

“…It is important to note that the changes in lipid fingerprint composition and the movement of the pattern towards the “healthy” fingerprint do not necessarily correlate with the change in the CADESI score or the pruritus score. Similarly, increased skin hydration after treatment with oclacitinib and lokivetmab did not correlate with the clinical score [ 33 ]. Transepidermal water loss and skin hydration have been linked to the ability of the lipid matrix of the stratum corneum to maintain adequate water levels within the epidermis [ 75 , 76 , 77 ].…”

Weekly topical therapy based on plant extracts combined with lokivetmab in canine atopic dermatitis

“…In another study, lokivetmab was suggested to have a positive effect on hydration. The effects on TEWL were variable and no definitive conclusions could be made 12 . It is therefore unlikely that lokivetmab by itself is directly responsible for the correction of the defective skin barrier in cAD.…”

The use of local glucocorticosteroids in veterinary practice - An overview

“…The main route of penetration of TGCS is transepidermal. The penetration of TGCS through the skin depends on six main factors: the place of application of the drug, the age of the pet (patient), the properties of the active ingredients, the basis of the drug, the method of its application, the stage of the disease (a skin condition) [18,19]. The pharmacological response to TGCS is determined by four main points: 1.…”