Interventions for atopic dermatitis in dogs: a systematic review of randomized controlled trials

Abstract

The objective of this systematic review, which was performed following the guidelines of the Cochrane collaboration, was to assess the effects of interventions for treatment of atopic dermatitis (AD) in dogs. Citations identified from three databases (MEDLINE, Thomson’s Science Citation Index Expanded and CAB Abstracts) and trials published by December 2007 were selected. Proceedings books from the major veterinary dermatology international congresses were hand searched for relevant citations. The authors selected randomized controlled trials (RCTs), published from January 1980 to December 2007, which reported the efficacy of topical or systemic interventions for treatment or prevention of canine AD. Studies had to report assessments of either pruritus or skin lesions, or both. Studies were selected and data extracted by two reviewers, with discrepancies resolved by a third arbitrator. Missing data were requested from study authors of recently published trials. Pooling of results and meta‐analyses were performed for studies reporting similar interventions and outcome measures. A total of 49 RCTs were selected, which had enrolled 2126 dogs. This review found some evidence of efficacy of topical tacrolimus (3 RCTs), topical triamcinolone (1), oral glucocorticoids (5), oral ciclosporin (6), subcutaneous recombinant γ‐interferon (1) and subcutaneous allergen‐specific immunotherapy (3) to decrease pruritus and/or skin lesions of AD in dogs. One high‐quality RCT showed that an oral essential fatty acid supplement could reduce prednisolone consumption by approximately half. Additional RCTs of high design quality must be performed to remedy previous flaws and to test interventions for prevention of flares of this disease.

Three Cases of Idiopathic Sterile Pyogranulomatous Inflammation of Epidural Fat in Miniature Dachshunds

“…In human medicine, cyclosporine is an immunosuppressant drug used for organ transplant patients to decrease the risk of organ rejection [6]. In veterinary medicine, cyclosporine has been widely used for dermatologic diseases and other systemic immune-mediated diseases [1,2,13,16]. Recent reviews and a meta-analysis of prospective clinical trials concluded that cyclosporine was highly effective compared with placebo and was as effective as prednisolone for treatment of atopic dermatitis in the dog [13,16].…”

“…In veterinary medicine, cyclosporine has been widely used for dermatologic diseases and other systemic immune-mediated diseases [1,2,13,16]. Recent reviews and a meta-analysis of prospective clinical trials concluded that cyclosporine was highly effective compared with placebo and was as effective as prednisolone for treatment of atopic dermatitis in the dog [13,16]. Some reports have suggested that cyclosporine is an effective therapeutic option for CNS inflammation in dogs [1,2].…”

An update on the treatment of canine atopic dermatitis

“…4 Yet, a more recent study 25 using this medication at higher doses (20 mg/kg three times daily versus 10 mg/kg twice daily of the original studies 26 ) and in combination with essential fatty acids showed a marked beneficial effect. In this study, dogs receiving the combination of pentoxifylline and essential fatty acids revealed 56.75% and 47.76% reduction in clinical scores and pruritus scores on day 30, while the corresponding reduction on day 60 was 90.92% and 92.59%, respectively.…”

“…4 Of these options, some are used for the management of the acute flare-up and others are best suited for the long-term approach.…”

“…The same concept applies to essential fatty acids, which also were not found to be effective as monotherapy in the systematic review of treatments for canine AD. 4 Yet, in clinical practice, they are frequently used as adjunctive therapy. The benefit of essential fatty acids in canine AD may be due to a multitude of properties ranging from modulation of the inflammation to the repair of skin barrier.…”