Abstract
Long-term remission between flares of canine atopic dermatitis (CAD) can be difficult to achieve. Therefore, additional strategic forms of treatment are needed in order to target flare prevention. The concept of proactive therapy is recommended in the European guidelines for the treatment of human atopic eczema. To evaluate the efficacy of a proactive treatment regimen with a 0.0584% hydrocortisone aceponate (HCA) spray for CAD. Client-owned dogs with spontaneous atopic dermatitis (AD) (n = 41). This pilot study was conducted as a randomised, placebo-controlled, double-blinded clinical trial with an end-point of treatment failure. Dogs were treated once daily to remission, then randomly assigned to receive either the HCA spray (n = 21) or a placebo (n = 20) spray on two consecutive days each week. All dogs were on appropriate flea control. No topical or systemic anti-inflammatory or antimicrobial agents were permitted. Intention-to-treat analysis was used. At Day 0, all the dogs were in remission or had mild AD based on their Canine Atopic Dermatitis Extent and Severity Index, version 3 (CADESI-03) scores. The time to relapse was significantly higher in the HCA group (median 115 d; range 31-260 d) compared to the placebo group (median 33 d; range 15-61 d) (P < 0.0001). No adverse events were attributable to the HCA spray. Four dogs were lost to follow-up and four were withdrawn after receiving prohibited medication. These results indicate that proactive long-term therapy of CAD with an HCA spray administered on two consecutive days each week is effective and well-tolerated.
Highlights
Canine atopic dermatitis (CAD) is a common, highly pruritic disease characterized by a waxing and waning course with frequent flares of inflammation
From the group initially enrolled (n = 41), four dogs were lost to follow-up. Three of these were from the hydrocortisone aceponate (HCA) group; one died from an unrelated cause and the other two were excluded due to lack of compliance
There were no significant differences in clinical or demographic baseline values between the two groups (HCA and placebo) at the beginning of treatment
Summary
Canine atopic dermatitis (CAD) is a common, highly pruritic disease characterized by a waxing and waning course with frequent flares of inflammation. Treatment of severe and chronic cases can be challenging, and CAD is often associated with diminished quality of life in dogs and an economic burden for their owners.[1,2]. There are several treatment options for acute flares and chronic disease, which are well described in the liter-. Accepted 22 July 2015 Source of funding: Cortavanceâ and placebo bottles were provided by Virbac SA, France. Apart from C.A.R., none of the authors has any direct or indirect financial interests in the products used in this study 1Ana M.
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