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Drechsler Y, Dong C, Clark DE, Kaur G. Canine Atopic Dermatitis: Prevalence, Impact, and Management Strategies. VETERINARY MEDICINE (AUCKLAND, N.Z.) 2024; 15:15-29. [PMID: 38371487 PMCID: PMC10874193 DOI: 10.2147/vmrr.s412570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 01/26/2024] [Indexed: 02/20/2024]
Abstract
Atopic dermatitis (AD) is a common inflammatory and pruritic allergic skin disease in humans and dogs worldwide. The pathogenesis of AD is multifactorial, immunologically complex, and may involve genetic factors, epidermal barrier dysfunction, microbiome changes, immune dysregulation, and allergic sensitization. Across species, prevalence of AD is on the rise. At present, there is no cure for canine AD (CAD). The treatment for CAD is multifaceted and aimed at controlling the pruritus, associated inflammation, and infections, repairing the skin barrier function, and dietary management. This review presents data on prevalence, impact, and complex immunological interactions in AD with a focus on subsequent management of the disease in the canine population. A multimodal approach for management of CAD to address varying clinical signs and responses to therapies is discussed.
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Affiliation(s)
- Yvonne Drechsler
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, CA, USA
| | - Charli Dong
- Animal Dermatology Clinic, Pasadena, CA, USA
| | - David E Clark
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, CA, USA
| | - Gagandeep Kaur
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, CA, USA
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Bruet V, Mosca M, Briand A, Bourdeau P, Pin D, Cochet-Faivre N, Cadiergues MC. Clinical Guidelines for the Use of Antipruritic Drugs in the Control of the Most Frequent Pruritic Skin Diseases in Dogs. Vet Sci 2022; 9:vetsci9040149. [PMID: 35448647 PMCID: PMC9030482 DOI: 10.3390/vetsci9040149] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/13/2022] [Accepted: 03/15/2022] [Indexed: 12/10/2022] Open
Abstract
Pruritus is a common clinical sign in many skin disorders and is currently the main complaint in canine dermatology. Pruritic skin diseases can affect the quality of life of dogs and their owners. Several families of antipruritic drugs are available to help control pruritus in dogs. The aim of this review is to help practitioners select the most appropriate symptomatic treatment in the most frequent situations of dermatological pruritus in dogs. The molecules reviewed here are systemic and topical glucocorticoids, antihistamines, ciclosporin, oclacitinib and lokivetmab. A level of evidence (1, 2 or 3) has been established according to a detailed algorithm for each individual study in the literature published between 1990 and March 2021. The guidelines result from evidence grading using the strength of recommendation taxonomy (SoRT) and clinical recommendations using a thorough methodology.
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Affiliation(s)
- Vincent Bruet
- Veterinary Dermatology Referral Services, 44100 Nantes, France;
| | - Marion Mosca
- Université de Lyon, VetAgro Sup, Interactions Cells Environment, UPSP 2016.A104, 69280 Marcy l’Etoile, France; (M.M.); (D.P.)
| | - Amaury Briand
- Department of Dermatology, Ecole Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France; (A.B.); (N.C.-F.)
| | - Patrick Bourdeau
- Department of Clinical Sciences, ENVN (Oniris) Université de Nantes, 44307 Nantes, France;
| | - Didier Pin
- Université de Lyon, VetAgro Sup, Interactions Cells Environment, UPSP 2016.A104, 69280 Marcy l’Etoile, France; (M.M.); (D.P.)
| | - Noëlle Cochet-Faivre
- Department of Dermatology, Ecole Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France; (A.B.); (N.C.-F.)
- UMR BIPAR, Laboratoire de Santé Animale, 94700 Maisons-Alfort, France
| | - Marie-Christine Cadiergues
- Department of Clinical Sciences, Université de Toulouse, ENVT, 31076 Toulouse, France
- INFINITy, Université de Toulouse, Inserm, CNRS, UPS, 31059 Toulouse, France
- Correspondence: ; Tel.: +33-561-193268
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Atopic Dermatitis in Domestic Animals: What Our Current Understanding Is and How This Applies to Clinical Practice. Vet Sci 2021; 8:vetsci8070124. [PMID: 34357916 PMCID: PMC8310319 DOI: 10.3390/vetsci8070124] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/25/2021] [Accepted: 06/26/2021] [Indexed: 12/18/2022] Open
Abstract
Atopic dermatitis is a clinical syndrome that affects both people and animals. Dogs closely mimic the complexity of the human skin disease, and much progress has been made in recent years in terms of our understanding of the role of skin impairment and the identification of new treatments. Cats and horses also develop atopic syndromes which include both cutaneous and respiratory signs, yet studies in these species are lagging. It is now recognized that atopic dermatitis is not a single disease but a multifaceted clinical syndrome with different pathways in various subgroups of patients. Appreciating this complexity is clinically relevant as we develop more targeted treatments which may work well in some patients but not in others. Different phenotypes of atopic dermatitis have been described in dogs, and it is possible that phenotypes related to breed and age may exist in other animals similar to how they are described in people. The awareness of different mechanisms of disease leads to the desire to correlate different phenotypes with specific biomarkers and responses to treatment. In this review, the current understanding and updated information on atopic syndrome in animals are described, highlighting opportunities for further studies in the future.
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Saridomichelakis MN, Favrot C, Jackson HA, Bensignor E, Prost C, Mueller RS. A proposed medication score for long-term trials of treatment of canine atopic dermatitis sensu lato. Vet Rec 2021; 188:e19. [PMID: 33666961 DOI: 10.1002/vetr.19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/08/2020] [Accepted: 11/06/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND The use of concurrent medications is necessary in trials of treatment of canine atopic dermatitis. Our aim was to use the best available evidence to construct and then to validate a medication score (MS) formula that will estimate the impact of concurrent medications on trial outcomes. METHODS Trials of 15 interventions were scrutinized to find those that were consistent in terms of specific medication, administration route and dosage regimen. A MS was constructed in five steps, starting from assigning a score of 1 for each day on oral prednisone, prednisolone or methylprednisolone at 0.5-1.0 mg/kg. The MS score was validated using the clinical records of 35 dogs with atopic dermatitis that had been treated for a period of 12 ± 2 weeks with six of these medications and compared with a previously published non-validated MS. RESULTS A MS could be assigned to eight treatments, six of which had been administered to the 35 dogs. A positive correlation was seen with the previously published MS and a negative correlation with changes in lesional and pruritus scores. CONCLUSION This MS may be a useful tool in new studies evaluating the efficacy of treatments in canine atopic dermatitis.
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Affiliation(s)
- Manolis N Saridomichelakis
- Clinic of Medicine, Faculty of Veterinary Science, University of Thessaly, Karditsa, Greece.,'Attiko' Animal Hospital, Paiania, Attiki, Greece
| | - Claude Favrot
- Clinic for Small Animal Internal Medicine, Dermatology Department, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland
| | | | - Emmanuel Bensignor
- Dermatology Referral Service, Clinique Vétérinaire, Rennes-Cesson, France
| | | | - Ralf S Mueller
- Medizinische Kleintierklinik, Centre for Clinical Veterinary Medicine, Ludwig-Maximilian University, Munich, Germany
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Kuroda T, Nagata SI, Tamura N, Mita H, Kusano K, Mizobe F, Takizawa Y, Fukuda K, Kasashima Y. Pharmacokinetics and pharmacodynamics of olopatadine following administration via nasogastric tube to healthy horses. Am J Vet Res 2019; 80:689-695. [PMID: 31246121 DOI: 10.2460/ajvr.80.7.689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate the pharmacokinetics and antihistaminic effects (pharmacodynamics) of olopatadine in a small population of healthy horses after administration via nasogastric tube. ANIMALS 4 healthy adult Thoroughbreds. PROCEDURES Olopatadine (0.1 mg/kg, once) was administered via nasogastric tube. Blood samples were collected at predetermined time points for pharmacokinetic analyses of the drug in plasma. Olopatadine effects were investigated by measurement of cutaneous wheals induced by ID histamine injection (0.1 mL [10 μg]/injection) at predetermined time points. Inhibition effect ratios were calculated on the basis of measured wheal size (area) after versus before olopatadine administration. RESULTS Mean ± SD maximum plasma olopatadine concentration was 48.8 ± 11.0 ng/mL approximately 1.5 hours after administration. Median terminal half-life was 6.11 hours. Mean ± SD maximal effect was 88.2 ± 4.9% inhibition approximately 3.5 hours after drug delivery, and the inhibition effect remained > 80% for 12.5 hours after treatment. No signs of adverse clinical effects were observed. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested olopatadine may have a strong, long-term inhibitory effect against histamine-induced wheals in the skin of horses. Clinical research with a larger number of horses is warranted.
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Ehling S, Bäumer W, Papich MG. Diphenhydramine pharmacokinetics after oral and intravenous administration of diphenhydramine and oral administration of dimenhydrinate to healthy dogs, and pharmacodynamic effect on histamine‐induced wheal formation: a pilot study. Vet Dermatol 2019; 30:91-e24. [DOI: 10.1111/vde.12727] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Sarah Ehling
- Department of Molecular Biomedical Sciences College of Veterinary Medicine North Carolina State University 1052 William Moore Drive Raleigh NC 27606 USA
- Institute of Pharmacology and Toxicology Faculty of Veterinary Medicine Freie Universität Berlin Koserstrasse 20 14195 Berlin Germany
| | - Wolfgang Bäumer
- Department of Molecular Biomedical Sciences College of Veterinary Medicine North Carolina State University 1052 William Moore Drive Raleigh NC 27606 USA
- Institute of Pharmacology and Toxicology Faculty of Veterinary Medicine Freie Universität Berlin Koserstrasse 20 14195 Berlin Germany
| | - Mark G. Papich
- Department of Molecular Biomedical Sciences College of Veterinary Medicine North Carolina State University 1052 William Moore Drive Raleigh NC 27606 USA
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Kammanadiminti SJ, Carter LA, Seewald W, Doucette KP. Comparative study to evaluate the voluntary acceptance of two liquid oral formulations of ciclosporin in dogs. Ir Vet J 2019; 71:27. [PMID: 30619604 PMCID: PMC6310966 DOI: 10.1186/s13620-018-0138-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 12/10/2018] [Indexed: 11/21/2022] Open
Abstract
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.
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Affiliation(s)
| | - Lori A Carter
- Stillmeadow Inc., 12852 Park One Drive, Sugar Land, TX 77478 USA
| | - Wolfgang Seewald
- Elanco Animal Health, Mattenstrasse 24a, 4058 Basel, Switzerland
| | - Kelly P Doucette
- 1Elanco Animal Health, 2500 Innovation Way, Greenfield, IN 26140 USA
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Ekstrand C, Ingvast-Larsson C, Bondesson U, Hedeland M, Olsén L. Cetirizine per os: exposure and antihistamine effect in the dog. Acta Vet Scand 2018; 60:77. [PMID: 30477556 PMCID: PMC6258303 DOI: 10.1186/s13028-018-0431-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 11/20/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cetirizine is an antihistamine used in dogs, but plasma concentrations in relation to effect after oral administration are not well studied. This study investigated cetirizine exposure and the plasma cetirizine concentration-antihistamine response relation in the dog following oral administration of cetirizine. RESULTS Eight Beagle dogs were included in a cross-over study consisting of two treatments. In treatment one, cetirizine 2-4 mg/kg was administered per os once daily for 3 days. The other treatment served as a control. Wheal diameter induced by intra-dermal histamine injections served as response-biomarker. Cetirizine plasma concentration was quantified by UHPLC-MS/MS. Median (range) cetirizine plasma terminal half-life was 10 h (7.9-16.5). Cetirizine significantly inhibited wheal formation compared with the premedication baseline. Maximum inhibition of wheal formation after treatment with cetirizine per os was 100% compared with premedication wheal diameter. The median (range) IC50-value for reduction in wheal area was 0.33 µg/mL (0.07-0.45). The median (range) value for the sigmoidicity factor was 1.8 (0.8-3.5). A behavioral study was also conducted and revealed no adverse effects, such as sedation. CONCLUSION The results indicate that a once-daily dosing regimen of 2-4 mg/kg cetirizine per os clearly provides a sufficient antihistamine effect. Based on this experimental protocol, cetirizine may be an option to treat histamine-mediated inflammation in the dog based on this experimental protocol but additional clinical studies are required.
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Affiliation(s)
- Carl Ekstrand
- Department of Biomedicine and Veterinary Public Health, Division of Pharmacology and Toxicology, Swedish University of Agricultural Sciences, P.O. Box 7028, 750 07 Uppsala, Sweden
| | - Carina Ingvast-Larsson
- Department of Biomedicine and Veterinary Public Health, Division of Pharmacology and Toxicology, Swedish University of Agricultural Sciences, P.O. Box 7028, 750 07 Uppsala, Sweden
| | - Ulf Bondesson
- Department of Chemistry, Environment and Feed Hygiene, National Veterinary Institute, Uppsala, Sweden
- Department of Medicinal Chemistry, Division of Analytical Pharmaceutical Chemistry, Uppsala University, Uppsala, Sweden
| | - Mikael Hedeland
- Department of Chemistry, Environment and Feed Hygiene, National Veterinary Institute, Uppsala, Sweden
- Department of Medicinal Chemistry, Division of Analytical Pharmaceutical Chemistry, Uppsala University, Uppsala, Sweden
| | - Lena Olsén
- Department of Biomedicine and Veterinary Public Health, Division of Pharmacology and Toxicology, Swedish University of Agricultural Sciences, P.O. Box 7028, 750 07 Uppsala, Sweden
- Department of Clinical Sciences, Division of Veterinary Nursing, Swedish University of Agricultural Sciences, Uppsala, Sweden
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