Voluntary acceptance and consumption of two oral ciclosporin formulations in dogs: two randomised, controlled studies

Comparative study to evaluate the voluntary acceptance of two liquid oral formulations of ciclosporin in dogs

Background

The purpose of this study was to determine and compare the voluntary acceptance of two oral liquid formulations of ciclosporin, investigational Atopica® oral solution (Elanco Animal Health) and Cyclavance® Oral Solution (Virbac), when given orally via syringe or offered freely after mixing with food to dogs.

Twenty-five adult mixed breed dogs were selected for this two-phase study. In Phase 1, 12 (Group I) and 13 (Group II) dogs received Atopica® oral solution and Cyclavance® Oral Solution, respectively, daily for 7 days via an oral syringe. After a 3-day washout period, the dosing was switched for a further 7 days. For Phase 2, dosing was by acceptance from freely offered test article mixed in a small amount of food, approximately 6 h after the routine morning feeding. During the first part of this phase, normal daily ration of food offered in the morning was continuously left in the cage. Group I was offered Atopica® oral solution and Group II was offered Cyclavance® Oral Solution mixed with ~ 25 g of food for 3 days. After another 2-day washout period, the test articles were switched for another 3 days but the animals received food for only 1 h in the morning. Five hours after the food was removed, the test articles with food were offered in the same manner as in the first part of Phase 2. Animals were also monitored for adverse events (AEs).

Results

During Phase I, voluntary acceptance rates of 100 and 98.9% were noted for Atopica® oral solution and Cyclavance® Oral Solution, respectively. The corresponding immediate prehension rates during Phase 2 (Period 1) were 61.1 and 56.4%, respectively. During Phase 2 (Period 2), the immediate prehension rates were 69.2, 69.4 and 92.0% for Atopica® oral solution, Cyclavance® Oral Solution and the positive control (DYNE®; High Calorie Liquid Dietary Supplement), respectively. Two adverse events of diarrhea and vomiting, with a probable relationship to the test articles, were reported.

Conclusion

There was no significant difference in acceptance of the two oral ciclosporin solutions, the investigational Atopica® oral solution (Elanco) and Cyclavance® (Virbac) for dogs.

Electronic supplementary material

The online version of this article (10.1186/s13620-018-0138-9) contains supplementary material, which is available to authorized users.

Bioequivalence study between two formulations of ciclosporin A (Cyclavance® oral solution and Atopica® soft capsules) following a single oral administration to dogs

Background

Ciclosporin is a selective immunomodulator used for the treatment of atopic dermatitis in dogs. A new 100 mg/ml oral solution formulation (Cyclavance®, Virbac) was developed as a pharmaceutical equivalent to the marketed capsule formulations (Atopica®, Novartis Animal Health) containing 25, 50 mg, or 100 mg of ciclosporin A. The aim of this study was to assess and compare the pharmacokinetic profiles and bioequivalence of the two formulations following a single oral administration to dogs. This randomised, two-period, two-sequence, crossover bioequivalence study was conducted in 40 healthy dogs under fasting conditions. Each dog received either one 50 mg capsule of Atopica® or 0.5 ml of Cyclavance®. After dosing, blood samples were collected during a 48-h time period at 0, 0.5, 1, 2, 4, 6, 12, 24, 36 and 48 h. Blood ciclosporin A concentrations were measured by using an HPLC-MS/MS method. Cmax, Tmax, t1/2, AUC0-t, AUC0-∞ and Kel were determined for the two ciclosporin formulations. Bioequivalence was to be concluded if the 90 % confidence intervals were within the range of 80 % to 125 % for Cmax and AUC0-t. Dogs were monitored once daily throughout the study period for adverse effects.

Results

The 90 % confidence intervals for Cyclavance®/Atopica® mean ratios of the log-transformed pharmacokinetic variables Cmax and AUC0-t were within the conventional bioequivalence range of 80 % to 125 % (Point estimate: 101.2 % and 101.4 % respectively). Except for salivation reported after administration of both products, or vomiting and diarrhoea reported after Atopica® administration, both formulations were well tolerated in the 40 healthy dogs over the 48-h study period.

Conclusions

The two ciclosporin oral formulations demonstrated similar pharmacokinetic profiles and were found to be bioequivalent, and therefore, interchangeable.

Treatment of canine atopic dermatitis: 2015 updated guidelines from the International Committee on Allergic Diseases of Animals (ICADA)

Background

In 2010, the International Task Force on Canine Atopic Dermatitis (now International Committee on Allergic Diseases of Animals, ICADA) published the first consensus guidelines for the treatment of atopic dermatitis (AD) in dogs. This is the first 5-year minor update of this document.

Results

The treatment of acute flares of AD should involve the search for, and then elimination of, the cause of the flares, bathing with mild shampoos, and controlling pruritus and skin lesions with interventions that include topical and/or oral glucocorticoids or oclacitinib. For chronic canine AD, the first steps in management are the identification and avoidance of flare factors, as well as ensuring that there is adequate skin and coat hygiene and care; this might include more frequent bathing and possibly increasing essential fatty acid intake. The medications currently most effective in reducing chronic pruritus and skin lesions are topical and oral glucocorticoids, oral ciclosporin, oral oclacitinib, and, where available, injectable recombinant interferons. Allergen-specific immunotherapy and proactive intermittent topical glucocorticoid applications are the only interventions likely to prevent or delay the recurrence of flares of AD.

Conclusions

This first 5-year minor update of the international consensus guidelines for treatment of AD in dogs further establishes that the treatment of this disease is multifaceted, and that interventions should be combined for a proven (or likely) optimal benefit. Importantly, treatment plans are likely to vary between dogs and, for the same dog, between times when the disease is at different stages.

Electronic supplementary material

The online version of this article (doi:10.1186/s12917-015-0514-6) contains supplementary material, which is available to authorized users.