Effective treatment of canine chronic cutaneous lupus erythematosus variants with oclacitinib: Seven cases

Abstract

Background The treatment of canine chronic cutaneous lupus erythematosus (CCLE) variants generally requires immunosuppression, which often results in potentially severe adverse effects. Janus kinase inhibitors, like oclacitinib, might be a valuable treatment option due to their rapid inhibition of the action of interferons known to be relevant in the pathogenesis of CCLE. Objectives To report the efficacy and safety of oral oclacitinib for the treatment of canine CCLE variants. Animals Seven dogs were diagnosed with CCLE based on clinical signs and compatible histopathological findings. Materials and methods Oclacitinib was administered at the induction dosage of 0.45 mg/kg twice daily to 1.8 mg/kg once daily. The response to treatment was graded as ‘good’ when there was ≥50% lesion reduction, or as ‘complete remission’ if all active lesions had resolved. Complete blood counts were performed at variable intervals. Results A complete remission of all lesions was obtained in the dog with exfoliative cutaneous lupus erythematosus, both dogs with mucocutaneous lupus erythematosus and three of four dogs with facial discoid lupus erythematosus (FDLE); a good response was seen in the remaining dog with FDLE. The first visible improvement of signs was seen within 2‐to‐3 weeks, while the time to complete remission was around 2 months. Clinical adverse effects were not seen, and haematological parameters remained within the reference range. Conclusions and Clinical Relevance Oclacitinib may be considered an effective treatment option for different variants of canine CCLE.

Successful treatment of perianal fistulas in two dogs with oclacitinib

“…It has the potential to inhibit the activation of receptors for several cytokines involved in autoimmunity, such as IL‐2, IL‐15, interferon (IFN)‐α and IFN‐γ. At higher doses 11 (equivalent to approximately 3–4 mg/kg), oclacitinib has immunomodulatory effects on T‐cell proliferation in addition to cytokines. It has been reported to be effective in a number of immune‐mediated dermatoses, such as hyperkeratotic erythema multiforme, cutaneous lupus erythematosus and pemphigus vulgaris 7–9 …”

Successful treatment of sebaceous adenitis with oclacitinib and low‐dose prednisolone in a dog

“…Individual case reports and small case series have documented oclacitinib to be effective for several nonallergic (and immune-mediated) diseases at doses ranging from 0.2-1.8 mg/kg once daily to 0.5-0.9 mg/kg twice daily. [5][6][7][8][9] This suggests a highly individualised response rate for nonallergic diseases. Although the exact pathogenesis of the sebaceous gland destruction in ISA remains unknown, current theories attribute it to a T-cell-mediated immunological targeting of the glands.…”

“…Owing to the potential for oclacitinib to inhibit the activation of receptors for some cytokines involved in autoimmunity, such as interleukin (IL)-2 and IL-15 and interferon (IFN)-α and IFN-γ, there are now several published case reports on the usefulness of oclacitinib for the treatment of canine autoimmune subepidermal blistering dermatosis, 5 generalised ischaemic vasculopathies, 6 pemphigus vulgaris, 7 hyperkeratotic erythema multiforme 8 and chronic cutaneous lupus erythematosus variants. 9 The present work describes the use of oclacitinib and low-dose prednisolone for the treatment of a case of canine ISA.…”

The use of oclacitinib compared to azathioprine in the management of canine pemphigus foliaceus: A retrospective analysis

“…22,23 Several off-label reports have deemed OC successful for the management of autoimmune diseases such as erythema multiforme, cutaneous lupus erythematosus and pemphigus vulgaris. [24][25][26] The offlabel doses of OC used in these case reports ranged…”

“…Oclacitinib has immunomodulatory activity with a high affinity towards JAK1 and JAK2 and inhibits interleukins (IL)‐2, IL‐4, IL‐6, IL‐13 and IL‐31 22,23 . Several off‐label reports have deemed OC successful for the management of autoimmune diseases such as erythema multiforme, cutaneous lupus erythematosus and pemphigus vulgaris 24–26 . The off‐label doses of OC used in these case reports ranged from 0.6 to 1.0 mg/kg twice daily.…”