1
|
Affiliation(s)
- Da Bin Lee
- Dentistry and Oral Surgery Service, William R. Pritchard Veterinary Medical Teaching Hospital, University of California - Davis, 1 Garrod Drive, Davis, CA 95616, USA
| | - Frank J M Verstraete
- Dentistry and Oral Surgery Service, William R. Pritchard Veterinary Medical Teaching Hospital, University of California - Davis, 1 Garrod Drive, Davis, CA 95616, USA; Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California - Davis, 1 Garrod Drive, Davis, CA 95616, USA
| | - Boaz Arzi
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California - Davis, 1 Garrod Drive, Davis, CA 95616, USA.
| |
Collapse
|
2
|
|
3
|
Colombo S, Sartori R. Ciclosporin and the cat: Current understanding and review of clinical use. J Feline Med Surg 2018; 20:244-255. [PMID: 29478396 PMCID: PMC10816290 DOI: 10.1177/1098612x17748718] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Practical relevance: Ciclosporin (CsA) is a systemic immuno-modulatory drug widely used to treat immune-mediated diseases in humans and veterinary species. CsA was registered for use in cats in the USA and Europe in 2011, and is indicated for the treatment of chronic allergic dermatitis at a recommended daily dose of 7 mg/kg PO. AUDIENCE This review will be of interest to all veterinarians working with cats, given the wide range of potential applications of CsA and its safety profile. Although the drug is currently only licensed to treat chronic allergic dermatitis in cats, a small number of reports describe its use in non-dermatological conditions. Evidence base: This article reviews the mechanism of action, pharmacokinetics, drug interactions, adverse effects and clinical use of CsA, both for the licensed indication and for off-label use in the feline patient. Information presented has been summarised from the existing literature on CsA, with specific interest in studies carried out in cats. For its licensed indication, chronic allergic dermatitis, evidence provided includes randomised, placebo or prednisolone-controlled studies (EBM grade I) and prospective or retrospective open trials.
Collapse
Affiliation(s)
- Silvia Colombo
- Servizi Dermatologici Veterinari, via Felice Musazzi 24, Legnano (MI), 1–20025, Italy
| | - Roberta Sartori
- Servizi Dermatologici Veterinari, via Felice Musazzi 24, Legnano (MI), 1–20025, Italy
| |
Collapse
|
4
|
TREATMENT SUCCESS IN THREE ANDEAN BEARS (TREMARCTOS ORNATUS) WITH ALOPECIA SYNDROME USING OCLACITINIB MALEATE (APOQUEL®). J Zoo Wildl Med 2017; 48:818-828. [DOI: 10.1638/2016-0239.1] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
|
5
|
Nafe LA, Leach SB. Treatment of feline asthma with ciclosporin in a cat with diabetes mellitus and congestive heart failure. J Feline Med Surg 2015; 17:1073-6. [PMID: 25527351 PMCID: PMC10816346 DOI: 10.1177/1098612x14563342] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A 5-year-old domestic shorthair cat that had been previously diagnosed with diabetes mellitus was presented for episodes of coughing and respiratory distress. Diagnostic testing revealed congestive heart failure secondary to hypertrophic cardiomyopathy and concurrent asthma. All clinical signs and eosinophilic airway inflammation resolved with oral ciclosporin while the cat was concurrently receiving medications for treatment of heart failure (furosemide and enalapril). Ciclosporin should be considered for treatment of feline asthma in patients with concurrent diseases (eg, diabetes mellitus, severe heart disease) that may contraindicate use of oral glucocorticoid therapy.
Collapse
Affiliation(s)
- Laura A Nafe
- Department of Veterinary Clinical Sciences, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Stacey B Leach
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| |
Collapse
|
6
|
Archer TM, Boothe DM, Langston VC, Fellman CL, Lunsford KV, Mackin AJ. Oral cyclosporine treatment in dogs: a review of the literature. J Vet Intern Med 2013; 28:1-20. [PMID: 24341787 PMCID: PMC4895546 DOI: 10.1111/jvim.12265] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 09/02/2013] [Accepted: 10/28/2013] [Indexed: 11/30/2022] Open
Abstract
Cyclosporine is an immunomodulatory drug used to treat an increasing spectrum of diseases in dogs. Cyclosporine is a calcineurin inhibitor, ultimately exerting its inhibitory effects on T-lymphocytes by decreasing production of cytokines, such as interleukin-2. Although, in the United States, oral cyclosporine is approved in dogs only for treatment of atopic dermatitis, there are many other indications for its use. Cyclosporine is available in 2 oral formulations: the original oil-based formulation and the more commonly used ultramicronized emulsion that facilitates oral absorption. Ultramicronized cyclosporine is available as an approved animal product, and human proprietary and generic preparations are also available. Bioavailability of the different formulations in dogs is likely to vary among the preparations. Cyclosporine is associated with a large number of drug interactions that can also influence blood cyclosporine concentrations. Therapeutic drug monitoring (TDM) can be used to assist in attaining consistent plasma cyclosporine concentrations despite the effects of varying bioavailability and drug interactions. TDM can facilitate therapeutic success by guiding dose adjustments on an individualized basis, and is recommended in cases that do not respond to initial oral dosing, or during treatment of severe, life-threatening diseases for which a trial-and-error approach to dose adjustment is too risky. Pharmacodynamic assays that evaluate individual patient immune responses to cyclosporine can be used to augment information provided by TDM.
Collapse
Affiliation(s)
- T M Archer
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS
| | | | | | | | | | | |
Collapse
|
7
|
Roberts ES, Vanlare KA, Strehlau G, Peyrou M, Roycroft LM, King S. Safety, tolerability, and pharmacokinetics of 6-month daily dosing of an oral formulation of cyclosporine (ATOPICA for cats®) in cats. J Vet Pharmacol Ther 2013; 37:161-8. [PMID: 24134659 PMCID: PMC4282489 DOI: 10.1111/jvp.12081] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 08/23/2013] [Indexed: 11/28/2022]
Abstract
Cyclosporine was proven efficacious in the treatment of feline hypersensitivity dermatitis. This target animal study was conducted to evaluate the safety, tolerability, and pharmacokinetics of ATOPICA for Cats® (cyclosporine oral solution, USP) MODIFIED following 6-month daily dosing in cats. Forty healthy cats (four cats/sex/group) received 0, 8 (1×), 16 (2×), 24 (3×), or 40 (5×) mg/kg cyclosporine once daily for 6 months (183 days). Body weight, food consumption, ophthalmoscopic, physical examinations including neurological assessments, blood pressure, electrocardiography, clinical pathology (hematology, coagulation, clinical chemistry, urinalysis), organ weights, and macroscopic and microscopic examinations were performed and assessed. In addition, blood concentrations of cyclosporine were measured at the pretreatment trough on Days 1, 2, 7, 14, 31, 91, 154, and 182, and post-treatment on Days 1, 31, and 182. Adverse effects possibly related to treatment included prolonged APTT and one report each of bone marrow hypocellularity and lymphoma; all occurred in cats treated with doses more than 16 mg/kg. There was no significant accumulation of cyclosporine beyond the first week of treatment. Results confirm that ATOPICA for Cats is safe and well tolerated in cats without unexpected accumulation beyond the first week of treatment when administered as directed.
Collapse
Affiliation(s)
- E S Roberts
- Novartis Animal Health US, Inc, Greensboro, NC, USA
| | | | | | | | | | | |
Collapse
|
8
|
Wang A, Smith JR, Creevy KE. Treatment of canine idiopathic immune-mediated haemolytic anaemia with mycophenolate mofetil and glucocorticoids: 30 cases (2007 to 2011). J Small Anim Pract 2013; 54:399-404. [DOI: 10.1111/jsap.12107] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- A. Wang
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine; University of Georgia; Athens GA
| | - J. R. Smith
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine; University of Georgia; Athens GA
| | - K. E. Creevy
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine; University of Georgia; Athens GA
| |
Collapse
|
9
|
Lommer MJ. Efficacy of Cyclosporine for Chronic, Refractory Stomatitis in Cats: A Randomized, Placebo-Controlled, Double-Blinded Clinical Study. J Vet Dent 2013; 30:8-17. [DOI: 10.1177/089875641303000101] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sixteen cats with chronic stomatitis, that had previously undergone premolar-molar or full-mouth extractions, were randomly assigned a group to receive 2.5 mg/kg cyclosporine or placebo orally twice daily. Neither the clinician nor the clients were aware of the group assignments. Cats were evaluated prior to treatment and every 2 weeks for 6 weeks using a 30 point Stomatitis Disease Activity Index (SDAI) score. Mean improvement in SDAI scores among cats in the treatment group after 6 weeks was 52.7 %. This was significantly different from the mean improvement (12.2 %) of cats in the placebo group. During the 6 week study period, 7 of the 9 cats in the treatment group (77.8 %) showed a > 40 % improvement in SDAI score, while 1 of 7 cats in placebo group (14.3 %) showed a > 40 % improvement in SDAI score. This difference was statistically significant. Individual variability in the absorption of orally-administered cyclosporine was high. Trough whole-blood cyclosporine levels ranged from 32.1 ng/ml to 1,576.2 ng/ml. At the end of the 6 week observation period, there was a statistically significant difference among cats with trough whole-blood cyclosporine levels > 300 ng/ml (72.3 % improvement) compared with cats with cyclosporine levels < 300 ng/ml (28.2 % improvement). Whole-blood cyclosporine levels > 300 ng/ml were associated with significant improvement in oral inflammation in cats with chronic stomatitis that had previously undergone premolar-molar or full-mouth extraction.
Collapse
Affiliation(s)
- Milinda J. Lommer
- From Aggie Animal Dental Center, 487 Miller Avenue, Mill Valley, CA 94941
| |
Collapse
|
10
|
Prednisolone and cyclosporine A: Effects on an experimental model of ancylostomiasis. Exp Parasitol 2013; 133:80-8. [PMID: 23142084 DOI: 10.1016/j.exppara.2012.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Revised: 09/20/2012] [Accepted: 10/19/2012] [Indexed: 10/27/2022]
|
11
|
Irwin KE, Beale KM, Fadok VA. Use of modified ciclosporin in the management of feline pemphigus foliaceus: a retrospective analysis. Vet Dermatol 2012; 23:403-e76. [DOI: 10.1111/j.1365-3164.2012.01069.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
12
|
Kovalik M, Thoday KL, van den Broek AHM. The use of ciclosporin A in veterinary dermatology. Vet J 2012; 193:317-25. [PMID: 22609151 DOI: 10.1016/j.tvjl.2012.03.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Revised: 03/14/2012] [Accepted: 03/29/2012] [Indexed: 11/18/2022]
Abstract
Ciclosporin A (CsA) has potent immunosuppressive and immunomodulatory activity that has been exploited in human medicine to prevent the rejection of transplanted organs and to manage atopic dermatitis and psoriasis. Over the past decade, CsA has been employed more frequently in veterinary dermatology and its value in the management of several canine and feline dermatoses is now well established. CsA inhibits calcineurin phosphatase, suppressing T cell activation and the synthesis of T cell cytokines consequently impairing the activity of B cells, antigen-presenting cells, mast cells, basophils and eosinophils. The pharmacokinetics of CsA are similar in humans, dogs and cats and the drug has a wide safety margin in dogs, cats and rabbits. Adverse effects, principally transient vomiting and soft faeces/diarrhoea, may be seen shortly after instituting treatment but often resolve despite continuing treatment. Gingival hyperplasia and cutaneous effects such as hirsutism may occur after prolonged treatment.
Collapse
Affiliation(s)
- Marcel Kovalik
- The University of Edinburgh, Division of Veterinary Clinical Sciences, Dermatology Unit, The Royal (Dick) School of Veterinary Studies, The Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian EH25 9RG, Scotland, UK.
| | | | | |
Collapse
|
13
|
Peterson AL, Torres SMF, Rendahl A, Koch SN. Frequency of urinary tract infection in dogs with inflammatory skin disorders treated with ciclosporin alone or in combination with glucocorticoid therapy: a retrospective study. Vet Dermatol 2012; 23:201-e43. [PMID: 22409401 DOI: 10.1111/j.1365-3164.2012.01044.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Few studies have investigated the frequency of urinary tract infection (UTI) in dogs receiving long-term ciclosporin therapy. HYPOTHESIS/OBJECTIVES The goal of the study was to investigate the frequency of UTI in dogs receiving ciclosporin with or without glucocorticoids. A secondary goal was to determine whether bacteriuria, pyuria and urine specific gravity were good predictors of UTI, and if ciclosporin dose, concurrent ketoconazole therapy, sex or duration of therapy affected the frequency of UTI. Animals - Eighty-seven dogs with various inflammatory skin disorders and 59 control dogs with inflammatory skin conditions that had not received glucocorticoids or ciclosporin for 6 months were enrolled. METHODS This study was retrospective. The first urine culture from dogs receiving ciclosporin was compared with control dogs using Fisher's exact test. A logistic mixed model was used to test for association between a positive bacterial culture and duration of treatment, dose of ciclosporin, concurrent ketoconazole therapy and sex. The sensitivities and specificities for bacteriuria, pyuria and urine specific gravity were determined. RESULTS Twenty-six of 87 (30%) ciclosporin-treated dogs had at least one positive culture. Compared with 3% positive control samples, 15% were positive in treated dogs (P=0.027). The sensitivity and specificity were, respectively, 64.1 and 98.1% for bacteriuria, 74.4 and 70.9% for pyuria, and 56.4 and 65.3% for urine specific gravity. All other analysed parameters were not significantly different. CONCLUSIONS AND CLINICAL IMPORTANCE The results suggest that routine urine cultures and assessment of bacteriuria by cystocentesis should be part of the monitoring for dogs on long-term ciclosporin with and without glucocorticoids.
Collapse
Affiliation(s)
- Andrea L Peterson
- Department of Veterinary Clinical Sciences, University of Minnesota, St Paul, MN 55108, USA
| | | | | | | |
Collapse
|
14
|
Grundon RA, Hardman C, O’Reilly A, Stanley RG. Repair of a scleral defect with an autogenous fascia lata graft in a dog. Vet Ophthalmol 2011; 14:271-4. [DOI: 10.1111/j.1463-5224.2011.00894.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
15
|
Santoro D, Campbell KL. Use of ciclosporin in a dog with canine juvenile sterile granulomatous dermatitis and lymphadenitis. Vet Dermatol 2011; 22:287-8. [DOI: 10.1111/j.1365-3164.2010.00953.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
16
|
Kovalik M, Thoday KL, Handel IG, de C. Bronsvoort BM, Evans H, van den Broek AHM, Mellanby RJ. Ciclosporin A therapy is associated with disturbances in glucose metabolism in dogs with atopic dermatitis. Vet Dermatol 2010; 22:173-80. [DOI: 10.1111/j.1365-3164.2010.00935.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
17
|
Loeffelbein DJ, Nieberler M, Steinstraesser L, Boeckmann R, Hoelzle F, Wolff KD, Kesting MR. Effects of ciclosporin therapy on xylazine/ketamine anaesthesia in a rat model. J Vet Pharmacol Ther 2010; 33:100-2. [PMID: 20444032 DOI: 10.1111/j.1365-2885.2009.01067.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- D J Loeffelbein
- Department of Oral and Maxillofacial Surgery, Technische Universität München, München, Germany.
| | | | | | | | | | | | | |
Collapse
|
18
|
Oliveira AM, Obwolo MJ, van den Broek AHM, Thoday KL. Focal metatarsal sinus tracts in a Weimaraner successfully managed with ciclosporin. J Small Anim Pract 2007; 48:161-4. [PMID: 17355608 DOI: 10.1111/j.1748-5827.2006.00147.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Focal metatarsal sinus tracts ('fistulation') are, to the authors knowledge, reported for the first time in a Weimaraner. The six-year-old, entire male had a five-month history of two symmetrical, well-demarcated sinuses on the plantar aspect of each metatarsus. The area surrounding each pair of sinuses was slightly fluctuant and a serosanguineous discharge could be expressed. Cytological examination of the discharge was characteristic of pyogranulomatous inflammation. Bacterial culture showed the material to be sterile. Examination of a skin biopsy revealed a severe inflammatory reaction involving the dermal collagen, with an infiltrate of neutrophils, macrophages, lymphocytes, plasma cells and multi-nucleated giant cells, with some micro-pustule formation. Treatment with ciclosporin induced total remission. Reduction of the dose of ciclosporin resulted in recurrence of the physical signs with further remission on re-introduction of the original dosage. This is the first report of the use of ciclosporin to control this condition.
Collapse
Affiliation(s)
- A M Oliveira
- University of Edinburgh, Dermatology Unit, Division of Veterinary Clinical Sciences, The Royal (Dick) School of Veterinary Studies, The Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian EH25 9RG, UK
| | | | | | | |
Collapse
|
19
|
Noli C, Scarampella F. Prospective open pilot study on the use of ciclosporin for feline allergic skin disease. J Small Anim Pract 2006; 47:434-8. [PMID: 16911110 DOI: 10.1111/j.1748-5827.2006.00110.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the efficacy of ciclosporin in cats with allergic skin disease. METHODS Ten cats with signs of allergic skin disease were administered ciclosporin daily at a dose of 3.6 to 8.3 mg/kg for one month. None of these cats had previously responded to a hypoallergenic diet trial, and all animals had previously been treated with endectoparasiticidal drugs, with no improvement two weeks before entering the trial. On days 0 and 30, owners assessed pruritus with a visual analogue scale, and veterinarians evaluated cutaneous lesions. RESULTS All the cats had pruritus and erythema, five had alopecia, two had an eosinophilic plaque, one had miliary dermatitis and two had both alopecia and an eosinophilic plaque. Good or excellent improvement was observed in 40 per cent of cats for pruritus, 57 per cent of cats for alopecia and 60 per cent of cats for erythema. A significant decrease in mean scores was observed for pruritus only, while for erythema and alopecia, it was close to being significant (P < 0.052). CLINICAL SIGNIFICANCE Ciclosporin may be helpful in symptomatically treating signs of feline allergic skin disease. However, it is important to remember that ciclosporin is not licensed for use in cats.
Collapse
Affiliation(s)
- C Noli
- Ospedale Veterinario Cuneese, Via Cuneo 52/N, 12011 Borgo S. Dalmazzo (CN), Italy
| | | |
Collapse
|
20
|
Brazís P, Barandica L, García F, Clough GF, Church MK, Puigdemont A. Dermal microdialysis in the dog: in vivo assessment of the effect of cyclosporin A on cutaneous histamine and prostaglandin D2 release. Vet Dermatol 2006; 17:169-74. [PMID: 16674731 DOI: 10.1111/j.1365-3164.2006.00511.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Dermal microdialysis, a relatively noninvasive technique, allows investigation of the changes in cellular mediators released during cutaneous allergic responses. This technique was used to evaluate the effect of cyclosporin A, an immunosuppressive drug used for treatment of canine atopic dermatitis, on the cutaneous release of two pro-inflammatory mediators following intradermal allergen challenge. Four beagle dogs spontaneously sensitized to Ascaris suum were treated for 1 month with oral cyclosporin A. At days 0, 15 and 30 of the treatment, dialysis probes were inserted into the skin of the back, and 20 microL of A. suum antigen was injected intradermally at each site. At timed intervals, dialysate was collected and assayed for histamine and prostaglandin D(2) and the wheal area was measured. Mean histamine concentration and wheal area were significantly lower at days 15 and 30 of treatment, compared with day 0. However, prostaglandin D(2) concentration was not significantly reduced. The inhibition in histamine release after intradermal challenge, by cyclosporin, confirms its anti-inflammatory action in the dog. Dermal microdialysis provides a useful tool for investigating canine allergic reactions and their modulation by drugs.
Collapse
Affiliation(s)
- Pilar Brazís
- UNIVET Servicio de Diagnostico Veterinario SL, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | | | | | | | | | | |
Collapse
|
21
|
Abstract
Cyclosporin is currently considered a new and interesting drug in veterinary dermatology for the treatment of immune-mediated skin diseases, and a safe and effective alternative to immunosuppressive therapy with glucocorticoids. The authors report a case of granulomatous folliculitis and furunculosis and of sebaceous adenitis in two cats and a case of alopecia areata in a dog, successfully controlled with cyclosporin.
Collapse
Affiliation(s)
- Chiara Noli
- Ospedale Veterinario Cuneese, Via Cuneo 52/N, 12011 Borgo S. Dalmazzo (CN), Italy.
| | | |
Collapse
|
22
|
Abstract
Gingivostomatitis (GS) with various patterns of disease may require antiviral therapy, steroids, laser fulguration, immunomodulation drugs, or nonsteroidal anti-inflammatory drugs. The use of cyclosporine as an immunomodulation drug has long-term benefits in reduction of the immunologic events that contribute to GS. Whole-mouth extraction or partial extraction (premolars and molars), with radiographic conformation that all root remnants have been removed, may be the most viable option in nonresponsive and or intractably painful stomatitis in noncompliant cats or dogs. Oral inflammation subsided after extraction without the need for further medication in approximately 70% of the cats from two studies with previous chronic unrelenting oral disease. The combination of immunomodulation with cyclosporine together with laser resection of proliferative tissue should be recommended if extraction of teeth is not desired. Removal of proliferative oral tissues by lasing (carbon dioxide laser) removes the tissue that maybe producing tissue antigens and the area where bacteria are sequestered. The use of anti-inflammatory medications is recommended in the management of GS. Therapeutic success is achieved when there is elimination of proliferative tissue and inflammation.
Collapse
Affiliation(s)
- Kenneth F Lyon
- Arizona Veterinary Dentistry and Oral Surgery, 86 West Juniper Avenue, Gilbert, AZ 85233, USA.
| |
Collapse
|
23
|
Linek M, Boss C, Haemmerling R, Hewicker-Trautwein M, Mecklenburg L. Effects of cyclosporine A on clinical and histologic abnormalities in dogs with sebaceous adenitis. J Am Vet Med Assoc 2005; 226:59-64. [PMID: 15646573 DOI: 10.2460/javma.2005.226.59] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the effects of cyclosporine A in the treatment of sebaceous adenitis in dogs. DESIGN Open-label clinical trial. ANIMALS 12 dogs with sebaceous adenitis. PROCEDURE Dogs were treated with cyclosporine A at a dosage of 5 mg/kg/d (2.3 mg/lb/d), PO, for 12 months and reevaluated every 4 months. A clinical score was calculated by grading the extent of alopecia and severity of follicular casts as absent, mild, moderate, or severe in each of 17 body regions. Biopsy specimens were obtained and examined histologically and by means of immunohistochemical staining. RESULTS Mean clinical score was significantly decreased, compared with baseline score, after 4 months of treatment and remained low after 8 and 12 months. Histologically, the severity of inflammation was significantly decreased, as were numbers of macrophages, CD3+ T cells, and major histocompatibility complex class II-expressing cells. The percentage of hair follicles with sebaceous glands increased, suggesting regeneration of sebaceous glands. Clinical signs recurred when cyclosporine administration was discontinued. CONCLUSIONS AND CLINICAL RELEVANCE Results suggest that administration of cyclosporine A at a dosage of 5 mg/kg/d may reduce the inflammation associated with sebaceous adenitis in dogs. Long-term treatment appears to be neccessary to control the disease.
Collapse
Affiliation(s)
- Monika Linek
- Veterinary Clinic Linek, Brunnenkoppel 1, 22041 Hamburg, Germany
| | | | | | | | | |
Collapse
|
24
|
Steffan J, Strehlau G, Maurer M, Rohlfs A. Cyclosporin A pharmacokinetics and efficacy in the treatment of atopic dermatitis in dogs. J Vet Pharmacol Ther 2004; 27:231-8. [PMID: 15305852 DOI: 10.1111/j.1365-2885.2004.00587.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
A series of experiments was conducted to study cyclosporin A (CsA) pharmacokinetics in dogs and the factors influencing variability of blood concentrations. In a first study, influence of feeding on drug absorption and blood profile was evaluated. Administration of CsA as micro-emulsion (ME) formulation with food decreased the bioavailability by 22% and increased the individual variability of drug absorption. In a second study, pharmacokinetic profiles from laboratory fasted beagle dogs receiving orally CsA ME formulation were analyzed. CsA was measured in blood samples by high-performance liquid chromatography (HPLC, 34 profiles) and fluorescent polarization immunoassay (FPIA, 16 profiles). A two-compartment model with first-order absorption was used to calculate the pharmacokinetic parameters. Using FPIA, blood concentrations were 1.5 to 1.7 times higher than when using HPLC, but elimination half-life and MRT were similar. The coefficient of variation of key pharmacokinetic parameters ranged from 27 to 34% following HPLC assay. The same range of variation was obtained after FPIA assay. In a third study, in a clinical trial evaluating CsA for the treatment of canine atopic dermatitis, a single blood sample was collected in dogs which had received CsA for 28 days. No significant correlation was found between clinical improvement and CsA blood concentrations. Considering the large margin of safety of CsA in dogs, the limited inter-individual variability and the lack of correlation between blood concentrations and clinical response, routine monitoring of blood CsA does not appear necessary in dogs with atopic dermatitis.
Collapse
Affiliation(s)
- J Steffan
- Novartis Animal Health, WRO-1032 2.50, CH-4002 Basle, Switzerland.
| | | | | | | |
Collapse
|