Determination of the efficacy rate and time‐to‐efficacy of subcutaneous immunotherapy in dogs with atopic dermatitis

Abstract

Background -Allergen-specific immunotherapy (ASIT) is reported to have a success rate of 50-70% when given for up to 12 months to dogs with atopic dermatitis (AD). How soon ASIT is clinically effective is unclear.Objectives -To compare the efficacy rate (ER) and time-to-efficacy (TTE) of various types of subcutaneous immunotherapy (SCIT) administered using conventional dosing regimens using the methodology of a critically appraised topic.Methods and materials -Three databases were searched to extract information on the ER and TTE of SCIT in dogs with AD. Herein, "efficacy" was defined as a ≥50% reduction in pruritus and/or skin lesions, and the TTE as the time needed to achieve such a reduction.Results -We selected 12 publications including 194 dogs. The ER was significantly higher with the polymerised allergoids coupled with nonoxidized mannan than for the "classic" aqueous and alum-precipitated SCIT types. A TTE of three months or shorter was seen in a significantly higher proportion of dogs receiving mannan-couple allergoids, pullulan-conjugated Der f 2 or tyrosine-adjuvanted than aqueous or alum-precipitated SCIT; with the latter two formulations, the TTE might be nine months or longer in ≤20% of atopic dogs.Conclusions and clinical relevance -In spite of the low number of articles available for review and small number of enrolled dogs, novel SCIT regimens appear to have a fasterand possibly higherefficacy than the currently available aqueous or alum-precipitated formulations. A standardisation of outcome measures for ASIT clearly is needed to allow a more meaningful comparison between SCIT types.

Quality of Life of Allergic Dogs Treated with Allergen-Specific Immunotherapy—A Retrospective Study

“…Regular measures to improve skin and coat hygiene are mandatory, as is the use of antipruritic medications when necessary [ 7 ]. Allergen-specific immunotherapy is unique among available therapies in that it interferes with the immune response of the allergic dog in that it can provide longer-term symptomatic relief compared with symptomatic treatments [ 15 , 16 , 17 , 18 ]. Our results show that dogs treated with ASIT have a better quality of life than dogs not treated with ASIT and may help to convince owners and clinicians of this type of treatment, which is very effective and safe in most cases [ 15 , 19 , 20 , 21 , 22 , 23 ].…”

Efficacy of short‐term combination of intralymphatic allergen immunotherapy and lokivetmab treatment in canine atopic dermatitis: A double‐blinded, controlled, randomised study

“…15 Clinical efficacy of SCIT is estimated at 50%-70% in cAD and may take up to nine or 12 months. [15][16][17][18][19] Attempts have been made to increase the efficacy and to decrease the time of onset to clinical effectiveness. In this regard, sublingual immunotherapy, subcutaneous immunotherapy with conjugated immunomodulatory compounds and allergen-specific rush immunotherapy have been studied in atopic dogs.…”

“…In cAD the induction phase using alum‐precipitated subcutaneous allergen‐specific immunotherapy (SCIT) is usually three months and thereafter the maintenance dose is administered 15 . Clinical efficacy of SCIT is estimated at 50%–70% in cAD and may take up to nine or 12 months 15–19 . Attempts have been made to increase the efficacy and to decrease the time of onset to clinical effectiveness.…”

New Treatments and Validations for Atopic Dermatitis in Humans After Comparative Approach With Canine Models

“…As a result, there is a wide range of protocols and doses being used without strong evidence to support one over the other. When efficacy and speed to reach effect with allergen specific immunotherapy in dogs, it was found that efficacy was significantly higher with the polymerized allergoids coupled with non-oxidized mannan than for the "classic" aqueous and alum-precipitated subcutaneous IT types [56]. Allergoids improve safety and formulations using nanoparticles or microparticle packed with the allergen are considered with vehicles that protect immunogenicity to be suitable for oral immunotherapy rather than injectable.…”