Efficacy of a 0.0584% hydrocortisone aceponate spray in the management of canine atopic dermatitis: a randomised, double blind, placebo‐controlled trial

Abstract

This study evaluated a 0.0584% hydrocortisone aceponate (HCA) spray (Cortavance; Virbac SA, Carros, France) in canine atopic dermatitis (AD). Initially, dogs with a canine AD extent and severity index (CADESI-03) >or= 50 were randomly allocated to receive HCA (n = 15) or placebo (n = 13) (two sprays from 10 cm away to treat an area of 100 cm(2)) once daily for 28 days. Twenty-one of the dogs then received HCA spray once daily, reducing to every other day or twice weekly over 42 days if improvement was maintained. CADESI, pruritus (14 cm visual-analogue-scale) and owner satisfaction (5-point scale) were recorded every 14 days. Haematology, biochemistry and adrenocorticotrophic hormone stimulation were performed at baseline, d28 and d70 (HCA n = 9; placebo n = 7). Intention-to-treat data were analysed. HCA spray significantly decreased CADESI (-61.4% versus -13.4%, P = 0.0069) and pruritus (-38.8% versus +57.6%, P = 0.0015) at d28 compared to placebo. Scores were significantly decreased at d14 (CADESI -50.5%, P < 0.0021) and d28 (CADESI P < 0.0001; pruritus P = 0.018) compared to baseline following HCA but not placebo. At d28 11 of 15 and 7 of 15 HCA dogs had >or= 50% reductions in CADESI and pruritus compared to 3 of 13 (P = 0.02) and 1 of 13 (P = 0.04) placebo dogs. Owner satisfaction scores were significantly higher in the HCA group (d28 P = 0.0001). Daily 3 of the 21 dogs required daily maintenance therapy, 7 every other day, 6 twice weekly and 5 dogs required additional therapy. Coat length did not influence the results. No adverse effects or changes to blood parameters were noted. HCA spray proved safe and effective up to 70 days. It is not, however, licensed for long-term treatment.

An update on the treatment of canine atopic dermatitis

“…In a placebo-controlled clinical trial, topical 0.0584% hydrocortisone aceponate spray was shown to be rapidly effective in controlling pruritus in dogs with AD. 9 In this study, clinical scores and pruritus were significantly decreased after 2 weeks of therapy and no adverse effects were reported. In another study comparing topical hydrocortisone aceponate spray with oral cyclosporine, no significant difference was found between treatments in terms of clinical efficacy.…”

Evaluation of the effect of a 0.0584% hydrocortisone aceponate spray on clinical signs and skin barrier function in dogs with atopic dermatitis

“…HCA has been show to exert potent anti-inflammatory effects in the skin with few adverse side effects [5,20,32]. HCA, which is derived from the esterification of C21-acetate and C17-propionate, has increased hydrophilicity and lipophilicity compared to the parent drugs.…”

“…These compounds are widely used for treating atopic dermatitis and other forms of eczema in humans [3,30]. Recently, a new generation of topical glucocorticoids with excellent pharmacological activities and low benefit-risk ratios was developed for use in veterinary dermatology [4,20]. The purpose of this study was to evaluate the effects of a topical diester formula spray containing 0.0584% hydrocortisone aceponate (HCA) on canines with CAD, and to evaluate skin barrier function during the treatment of CAD by measuring transepidermal water loss (TEWL).…”

Antipruritic application of ovocystatin in atopic dermatitis in dogs - preliminary study

“…hydrocortisone aceponate, but their application is limited to the cases of localised pruritus of possibly hairless areas. Despite high level of safety of the medicament in case of its long term use it may lead to skin thinning (4,9,16). In the conducted studies, hydrocortisone aceponate was used for 70 d. Positive and rapid therapeutic effect was described as partial clinical improvement by 14 d with further improvement on day 28.…”