Canine atopic dermatitis (cAD) is a chronic inflammatory and pruritic dermatopathy requiring a multimodal therapeutic approach. To assess the effectiveness, safety and cost of oclacitinib and prednisolone treatment in dogs with AD. Twenty-three client-owned dogs with cAD. Dogs were randomly assigned to one of two groups: Group 1 received prednisolone (0.5 mg/kg every 24 h) for 7 days, then oclacitinib (0.5 mg/kg) and prednisolone (0.5 mg/kg), were administered alternately with a 1 day pause between each drug, for 7 additional weeks. Group 2 received oclacitinib (0.5 mg/kg every 12 h for 14 days, then every 24 h) for 8 weeks. Assessments included the Canine Atopic Dermatitis Extent and Severity Index, 4th iteration (CADESI-04) and pruritus Visual Analog Scale (PVAS) on Day (D)0, D7, D14, D30, D45 and D60. Both groups showed significant CADESI and PVAS reductions on D7 (p < 0.001). From D14 to D60, mean scores remained stable compared to D7, with no significant differences between groups. Adverse events included two dogs with polyuria and polydipsia, and three with polyphagia in Group 1, all of which resolved by D14. In Group 2, one dog experienced polyphagia, and two had self-limiting vomiting. Three dogs in Group 1 and one dog in Group 2 had mild increases in liver enzyme concentrations. The combined protocol was effective and safe for managing itch and inflammation over a 60 day period. It had a 73.3% lower cost compared to oclacitinib alone.
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