Single-dose pharmacokinetics of mycophenolic acid following administration of immediate-release mycophenolate mofetil in healthy Beagle dogs

Pharmacology of drugs used in autoimmune dermatopathies in cats and dogs: A narrative review

Immunosuppressive drugs are the mainstay of treatment for many feline and canine autoimmune skin diseases, either as monotherapy or in combination with other drugs. Treatment with these drugs is often lifelong and may have long-term consequences on the affected animal's overall quality-of-life. Clinicians need to understand the pharmacology of immunosuppressants in planning and executing the treatment regimen for the best possible clinical outcome, as well as reducing the risk of adverse effects. This review paper will focus on the mechanism of action, pharmacokinetics and pharmacodynamics, clinical uses and adverse effects of immunosuppressive drugs used to treat autoimmune dermatoses in cats and dogs. These include glucocorticoids, ciclosporin A, azathioprine, chlorambucil, mycophenolate mofetil, oclacitinib and Bruton's tyrosine kinase inhibitors.

A retrospective evaluation of the steroid sparing effects of oral mycophenolate mofetil (MMF) as an adjunct immunosuppressant for the treatment of canine pemphigus foliaceus

BACKGROUND

Oral mycophenolate mofetil (MMF) is currently considered a low-risk steroid-sparing therapeutic option the management of canine pemphigus foliaceus (PF).

OBJECTIVES

This retrospective study evaluates the therapeutic outcomes of dogs with PF treated with the combination of oral MMF and GC. Clinical outcomes and side effects are reported.

ANIMALS

Eleven dogs diagnosed with PF.

METHODS AND MATERIALS

Retrospective review of medical records from dogs presented with PF to the dermatology service of a veterinary teaching hospital 2015-2020.

RESULTS

Eleven dogs were identified which had received concurrent GCs and MMF. The MMF dose range was 19.8-45 mg/kg/day. Only two dogs (2/11) treated with a mean MMF dosage of 39 mg/kg/day along with oral prednisone or dexamethasone achieved complete remission (CR). Partial remission (PR) was achieved in 4/11 dogs who received either prednisone, prednisolone or dexamethasone along with MMF (mean dosage 26 mg/kg/day). Four dogs (4/11) showed poor response to MMF given at 28.5 mg/kg/day along with prednisone or dexamethasone. In one dog (1/11) MMF was discontinued due to severe GI upset; transient vomiting and diarrhea was observed in 4/11 dogs. The median duration of MMF therapy in conjunction with GC for all groups was 70.5 days. Tapering of oral GCs while continuing MMF administration at the same dosage and frequency led to recurrence of lesions in all PF patients.

CONCLUSION

Oral MMF combined with GC achieved CR in 2 out of 11 PF dogs included in this study. Further research of MMF efficacy in PF may need to be performed.