On episode 115 of The Derm Vet podcast, Valerie Fadok, DVM, PhD, Dip ACVD joins to discuss canine allergic and atopic dermatitis. She is a boarded veterinary dermatologist and consultant with a PhD in immunology.
We’ve come a long way in our ability to manage allergic skin diseases in dogs. Due to our increased knowledge based on research, there are better therapeutics available. We have learned that several T- helper type 2 cell-produced cytokines such as IL-2, IL-4, IL-6, IL-13, and IL-31 are major players in mediating allergic pruritus and inflammation. These cytokines mediate their action primarily through Janus kinase-1 signaling pathway and appear early in the allergic inflammation cascade.
The more we have learned, the less we believe histamine is a main mediator of allergic and atopic pruritus and dermatitis in dogs. Environmental allergies are different in dogs compared to people. We need to focus on treating our canine patients by applying what we have learned about the pathogenesis of allergic pruritus and inflammation. In dogs, IL-31 promotes a pruritogenic and pro-inflammatory cytokine response from T helper 2 cells.1 Like the other JAK-1 dependent cytokines, it is also important in the skin barrier. Elevated levels of pro-inflammatory cytokines like IL-4, IL-13, and IL-31 appear to drive some of the skin barrier defects seen in atopic dermatitis.2
In addition to reducing allergic pruritus, Apoquel also decreases inflammation due to allergic and atopic dermatitis. One study3 compared Apoquel to prednisolone in reducing pruritus and skin dermatitis scores in dogs with allergic dermatitis. It showed that the reduction in allergic pruritus, as assessed by the owners, was no different between Apoquel and prednisolone. Dermatitis scores were assessed by the veterinarians and there was no statistically significant difference between these two medications.
The impact of Cytopoint on inflammation was also discussed. This therapy specifically neutralizes canine IL-31. Another study4 showed comparable effects of Cytopoint compared to cyclosporine for controlling pruritus and inflammation due to atopic dermatitis over a course of three months. Reduction in CADESI scores (a measure of skin inflammation in dogs with atopic dermatitis) was similar in both Cytopoint and cyclosporine, with close to a 60% decrease from baseline scores.
It is so important with the management of allergic and atopic dogs that we continue to have published studies showing the effect of therapies on pruritus and inflammation. Check out this episode of the podcast to learn more!
This podcast was sponsored by Zoetis, the makers of treatments including Apoquel® (oclacitinib tablet), Apoquel® Chewable (oclacitinib chewable tablet) and Cytopoint®. Zoetis is dedicated to changing the way we approach canine pruritus to benefit the pet, the owner and the veterinary team. Visit Apoquel.com and Cytopoint.com for more information.
APOQUEL-IMPORTANT SAFETY INFORMATION
Do not use Apoquel in dogs less than 12 months of age or those with serious infections. Apoquel may increase the chances of developing serious infections, and may cause existing parasitic skin infestations or pre-existing cancers to get worse. Consider the risks and benefits of treatment in dogs with a history of recurrence of these conditions. New neoplastic conditions (benign and malignant) were observed in clinical studies and post-approval. Apoquel has not been tested in dogs receiving some medications including some commonly used to treat skin conditions such as corticosteroids and cyclosporines. Do not use in breeding, pregnant, or lactating dogs. Most common side effects are vomiting and diarrhea. Apoquel has been used safely with many common medications including parasiticides, antibiotics and vaccines. For more information, please see the full Prescribing Information at apoquelpi.com.
Apoquel Indications: Control of pruritus (itching) associated with allergic dermatitis and control of atopic dermatitis in dogs at least 12 months of age.
Cytopoint Indications: Cytopoint has been shown to be effective for the treatment of dogs against allergic dermatitis and atopic dermatitis.
References
1. Gonzales AJ, Humphrey WR, Messamore JE, Fleck TJ, Fici GJ, Shelly JA, Teel JF, Bammert GF, Dunham SA, Fuller TE, McCall RB. Interleukin-31: its role in canine pruritus and naturally occurring canine atopic dermatitis. Vet Dermatol. 2013 Feb;24(1):48-e12.
2. Hanel KH, Cornelissen C, Luscher B et al. Cytokines and the skin barrier. Int J Mol. Sci.2013;14:6720-6745. doi:10.3390/ijms14046720.
3.Gadeyne C, Little P, King VL, Edwards N, Davis K, Stegemann MR. Efficacy of oclacitinib (Apoquel®) compared with prednisolone for the control of pruritus and clinical signs associated with allergic dermatitis in client-owned dogs in Australia. Vet Dermatol. 2014 Dec;25(6):512-8, e86. doi: 10.1111/vde.12166.
4. Little PR, King VL, Davis KR, Cosgrove SB, Stegemann MR. A blinded, randomized clinical trial comparing the efficacy and safety of oclacitinib and ciclosporin for the control of atopic dermatitis in client-owned dogs. Vet Dermatol. 2015 Feb;26(1):23-30, e7-8. doi: 10.1111/vde.12186
5. Van Brussel L, Moyaert H, Escalada M, Mahabir SP, Stegemann. A masked, randomised clinical trial evaluating the efficacy and safety of lokivetmab compared to saline control in client-owned dogs with allergic dermatitis. Vet Dermatol. 2021; 32: 477-e131.
