Rush sublingual immunotherapy in canine atopic dermatitis: a prospective pilot study

Abstract

Twenty dogs with canine atopic dermatitis (CAD) were treated with rush sublingual immunotherapy (SLIT), with a 48 hour build-up phase and 6 months maintenance phase (treated by antigen once every 3-4 weeks). The canine atopic dermatitis extent and severity index (CADESI)-4 was evaluated before treatment (baseline) and after 6 months. An open, non-controlled, non-randomized pilot trial was conducted to assess the effectiveness and safety of rush SLIT for environmental allergen extracts (Dematophagoides pteronyssinus and D.farinae mix and other). Three dogs dropped out and 17 dogs finished the trial. CADESI-4 at baseline was 60.6±27.1 (range 17-107, n=17). After 6 months of SLIT treatment, CADESI-4 was 37.4±36.0 (range 5-152, n=17) (p <0.01), which was a 38.3% reduction. A significant improvement, defined as a CADESI-4 reduction of > 30%, was observed in 13 out of 17 dogs (76%). A moderate improvement, defined as a CADESI-4 reduction of < = 30%, was observed in 2 dogs (12%). In the other 2 dogs (12%), CADESI-4 worsened or showed no change. However, no severe adverse effects were observed during the trial.Therefore, rush SLIT against environmental allergen extract for CAD showed effectiveness and safety as evidenced by the reduction of CADESI-4 after 6 months SLIT without severe adverse effects.

The safety of rush immunotherapy in the management of canine atopic dermatitis—230 cases

“…In another study, 10 injections of increasing amounts of allergy extract were injected subcutaneously every 30 min to 10 dogs and no AE were reported. 9 In a sublingual RIT conducted in 20 dogs, 11 doses-at least 60 min apart-were given over a period of 26 h. 8 Mild pruritus was seen in 10 of 20 (50%) and vomiting in 2 of 20 (10%) dogs. 8 In another study, severe pruritus also was noted in 7 of 30 (23%) dogs, and generalised wheals and swollen eyelids in one patient, when administering most injections during intradermal RIT .…”

“…9 In a sublingual RIT conducted in 20 dogs, 11 doses-at least 60 min apart-were given over a period of 26 h. 8 Mild pruritus was seen in 10 of 20 (50%) and vomiting in 2 of 20 (10%) dogs. 8 In another study, severe pruritus also was noted in 7 of 30 (23%) dogs, and generalised wheals and swollen eyelids in one patient, when administering most injections during intradermal RIT . 16 As a result of the severe pruritus, RIT was discontinued in the affected patients.…”

“…[3][4][5] Less information is available on rush, sublingual and intralymphatic immunotherapies. [6][7][8][9][10][11][12] A recent study showed a low risk of AE using a protocol with a shortened induction phase for subcutaneous AIT of approximately four weeks. 13 With rush immunotherapy (RIT), the maintenance dose is reached within one or few days.…”

Shortened immunotherapy dose‐escalation saves time, but is it safe? A case‐control study comparing the rates of adverse reactions between conventional and fast‐escalation subcutaneous immunotherapy protocols during the induction phase

“…1,2 Immunotherapy has been reported as beneficial in over two-thirds of treated dogs with atopic dermatitis (AD). [3][4][5][6][7][8][9][10][11][12] In atopic dogs, as in humans, conventional AIT protocols consist of a slow and progressive dose-escalation (i.e. an "induction" period) before reaching the maintenance phase.…”

“…Allergen immunotherapy (AIT) is currently the only specific therapy of allergic diseases believed to modify and change their course 1,2 . Immunotherapy has been reported as beneficial in over two‐thirds of treated dogs with atopic dermatitis (AD) 3–12 . In atopic dogs, as in humans, conventional AIT protocols consist of a slow and progressive dose‐escalation (i.e.…”