Cyclosporine decreases skin lesions and pruritus in dogs with atopic dermatitis: a blinded randomized prednisolone‐controlled trial*

Abstract

During the last decade, oral cyclosporin (CsA) has proven to be effective, in randomized controlled trials, for the treatment of atopic dermatitis (AD) in human patients. The purpose of this blinded randomized controlled trial was to test the hypothesis that CsA was successful in reducing the gravity of clinical signs of AD in dogs. Thirty dogs with nonseasonal AD were randomly allocated to receive an oral solution of either NEORAL CsA (5 mg kg-1) or prednisolone (0.5 mg kg-1) once daily for 6 weeks. Before, and 3 and 6 weeks after therapy, skin lesions were graded by clinicians using the Canine AD Extent and Severity Index (CADESI). Pruritus was assessed by the owners using a visual analog scale (PVAS). In both groups, CADESI and PVAS values were significantly lower at 6 weeks post treatment than before the initiation of therapy (Friedman test, P < 0.0004). The percentage reductions in CADESI and PVAS values from baseline were not statistically different between groups (Mann-Whitney test, P > 0.3). In this experiment, the tolerability and safety of oral CsA and prednisolone appeared similar. One-fifth of dogs given oral CsA occasionally developed diarrhoea or soft stools. One dog that was given CsA developed a generalized papillomatous skin eruption during the second half of the trial. Our study provides randomized controlled trial evidence that CsA reduces the severity of clinical signs in dogs with nonseasonal AD. Moreover, the anti-allergic efficacy of CsA appears comparable with that of prednisolone. We propose that oral CsA should be considered as a valuable alternative to glucocorticoid therapy in dogs with AD.

The evaluation of Canine Atopic Dermatitis Extent and Severity Index (CADESI) test in dogs with Atopic Dermatitis (AD) treated with cyclosporine or prednisone

“…Other publications reports the similar efficacy of both drugs, although there are differences between authors. Olivry et al (2002) and Steffan et al (2003) were unanimous, that clinical efficacy of both glucocorticosteroids and cyclosporine administered orally at dosage mentioned earlier were comparable.…”

“…Olivry et al (1997) published the first version of CA-DESI 01 test for veterinary medicine, which proposed the assessment of skin lesions (erythema, excoriations, lichenification) in 23 body regions. Modification of this test was published by Olivry et al (2002) as CA-DESI 02. Currently in veterinary dermatology several versions of CADESI test are used, from which two are the most popular.…”

Cyclosporine A Inhibits Transcription of Cytokine Genes and Decreases The Frequencies of IL-2 Producing Cells in Feline Mononuclear Cells

“…Classically, CsA has been used as an immunosuppressive agent in organ transplantation in humans and cats [2,3,12,36]. Recently, CsA has been reported as an effective drug for the long-term management of pruritus in human and canine atopic dermatitis (AD) [10,11,22,30]. In addition, several clinical trials have revealed that CsA is also effective for controlling pruritus in feline skin diseases [21,34].…”

The study of canine atopic dermatitis involving the isolation of dogs

“…A pruritus liners score (Olivry et al 2002) was recorded on ascale of 0 to 5 as follows: 0 absence of pruritus. 1 almost no pruritus, 2 mild pruritus, 3 moderate pruritus, 4 severe pruritus, 5 extremely severe pruritus.…”