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

Abstract

BackgroundOral glucocorticoids are widely used to reduce pruritus and dermatitis associated with allergic dermatitis. Data suggest that oclacitinib, a Janus kinase inhibitor, is a safe and effective alternative.Hypothesis/ObjectivesTo evaluate the efficacy and safety of oclacitinib compared with prednisolone for the control of pruritus associated with allergic dermatitis in a single-masked, controlled clinical trial with a randomized complete block design.AnimalsClient-owned dogs (n = 123) with a presumptive diagnosis of allergic dermatitis and moderate to severe pruritus as assessed by the pet owner were enrolled.MethodsDogs were randomized to treatment with either oclacitinib (0.4–0.6 mg/kg orally twice daily for 14 days, then once daily) or prednisolone (0.5–1.0 mg/kg once daily for 6 days, then every other day) for 28 days. An enhanced visual analog scale (VAS) was used by owners to assess pruritus and by veterinarians to assess dermatitis, at all time points assessed.ResultsBoth treatments produced a rapid onset of efficacy within 4 h. The mean reductions in pruritus and dermatitis scores were not significantly different between the treatments except on day 14, when reductions were more pronounced for oclacitinib than prednisolone (P = 0.0193 for owner pruritus scores; P = 0.0252 for veterinarian dermatitis scores). Adverse events were reported with similar frequency in both groups.Conclusion and clinical importanceIn this study, both oclacitinib and prednisolone provided rapid, effective and safe control of pruritus associated with allergic dermatitis, with substantial improvement in pruritus, reported by owners, and dermatitis, reported by veterinarians.

The frequency of urinary tract infection and subclinical bacteriuria in dogs with allergic dermatitis treated with oclacitinib: a prospective study

“…Only two of these studies excluded dogs with abnormal urinalysis findings prior to study enrolment . Urinalysis as a means of monitoring changes within the urinary tract during the course of oclacitinib therapy was performed in four of the studies . Two studies did not describe any results from the urinalyses .…”

“…Previous studies of oclacitinib‐treated dogs described clinical signs of haematuria in two of 61 (3.3%) dogs and transient haematuria as a urinalysis finding in four of 247 (0.8%) dogs, all of which resolved spontaneously . None of the dogs in the present study exhibited clinical signs of haematuria, however, microscopic haematuria was detected in seven of 55 (12.7%) dogs in the absence of urinary clinical signs and with an otherwise normal urinalysis.…”

STAT3 Expression and Activity are Up‐Regulated in Diffuse Large B Cell Lymphoma of Dogs

“…Multiple small molecule JAK inhibitors currently are under investigation in clinical trials for treating myeloproliferative disease and leukemia in humans . In veterinary medicine, the JAK1/2 inhibitor oclacitinib (Apoquel) was approved by the Food and Drug Administration in 2013 for treating dogs with atopic dermatitis . Our finding that the STAT3 pathway is up‐regulated in canine DLBCL is encouraging because it supports further exploration of the potential therapeutic effect of JAK2 inhibitors in canine patients with DLBCL.…”

Comparative efficacy of topical oclacitinib 0.1% and tacrolimus 0.01% in canine keratoconjunctivitis sicca

“…The advantage of topical administration of JAK inhibitors is that they are small molecules that easily penetrate skin barriers and are well tolerated by human patients . In mice, topical administration resulted in a reduction in the skin swelling that was not seen in animals treated orally, with a reduction in epidermal hyperplasia, parakeratosis, dermal edema, and inflammatory cells infiltration . In dogs topical oclacitinib and tofatinib reduce dermal cellular infiltrates, especially eosinophils and mast cells .…”