Pilot evaluation of Enterococcus faecium SF68 as adjunctive therapy for oclacitinib‐responsive adult atopic dermatitis in dogs

Abstract

Objective To evaluate the adjunctive effect of supplementation with Enterococcus faecium SF68 (FortiFlora; Purina Pro Plan Veterinary Diets) on oclacitinib (Apoquel, Zoetis) dose reduction, while maintaining or reducing the Pruritus Visual Analog Score and Canine Atopic Dermatitis Extent and Severity Index values in client‐owned adult dogs with environmental atopic dermatitis. Materials and Methods Enrolled dogs had exhibited control of atopic dermatitis on oclacitinib for at least 6 months before, and continuing throughout, the study. Dogs with non‐seasonal pruritus were blindly randomised to receive either SF68 (1×108 colony forming units/g orally twice daily) or placebo for 12 weeks. After 8 weeks of supplementation, oclacitinib dose was decreased by approximately 25%, aiming to maintain and reduce the clinical disease scores. Results Supplementation with SF68 was associated with no difference in oclacitinib dose reduction versus placebo in 21 client‐owned dogs with atopic dermatitis. Clinical disease scores were not different between groups at study completion. Clinical Significance Further larger‐scale studies are warranted to investigate optimal strain(s), dosing and duration of probiotic supplementation as an adjunctive strategy in management of canine atopic dermatitis.

Impact of Nutritional Supplementation on Canine Dermatological Disorders

“…A body of research is directed toward the evaluation of heat-killed bacteria registered strains. The hypothesized mechanisms by which these bacteria may potentially influence AD symptoms is the modulation of the gastrointestinal microbiome, even if it is not fully elucidated [86,87]. Moreover, there are no data on the possible presence of a cutaneous-intestinal microflora axis and if this can be mutually influenced.…”

Evidence‐base for the beneficial effect of nutraceuticals in canine dermatological immune‐mediated inflammatory diseases — A literature review

“…No significant adjunctive effect of the probiotic on reduction in the medication score of concurrent drugs was found 69 . Twelve weeks of supplementation with a commercial product containing E. faecium SF68 (1 × 10 8 cfu/g twice daily) had no significant effect on the required oclacitinib dose in 11 dogs compared with the placebo dose ( n = 10) 85 . By contrast, reduction in required medication was reported after 12 weeks of treatment with Lactobacillus paracasei K71 in 20 dogs with mild‐to‐moderate AD compared with antihistamine‐treated dogs ( n = 21) 70 …”

“…Four studies (three Category I 68,69,85 and one Category II 70 ) were found on the use of probiotics for treatment of cAD. A combined total of 77 dogs were treated with different types of probiotics for a duration of eight to 12 weeks compared with 59 control dogs treated with placebo ( n = 38) or antihistamine ( n = 21).…”

“…Disease Category of evidence a with reference Biotin SLO IV [81] EFAs Superficial pemphigus b IV [40] CLE IV [94,95] and V [90] SA IV [102][103][104] Enterococcus faecium SF68 c cAD I [85] Enterococcus faecalis FK-23 c cAD I [69] Niacinamide (with tetracycline) cAD III [86] MCLE IV [77] and V [100] ECLE IV [77,94] and V [96] VCLE IV [77,97] and V [98] Retinoids CLE IV [94] and V [96] Vitamin A CLE IV [94] and V [96] SA IV [102][103][104] Vitamin B complex (B1, B2 and B6) SLO V [83] Vitamin E CLE IV [91,94,95] and V [96] Zinc CLE IV [94] SLO IV [81] and V [83] SA III [84] Based on the results on the use of EFAs in general, no evidence was found for its use in dogs with superficial pemphigus and CLE variants. In comparison, treatment with omega-3 FAs in humans with autoimmune conditions shows conflicting results 129 and no specific reports on the use of EFAs in humans with pemphigus or CLE have been found.…”

Polyphenols and Cannabidiol Modulate Transcriptional Regulation of Th1/Th2 Inflammatory Genes Related to Canine Atopic Dermatitis

“…Of relevance, the transcriptional regulation of many of these markers was modulated by the nutraceutical exposure. It is well-established that the regular use of dietary supplements, such as essential fatty acids (EFAs), polyphenols, probiotics, or vitamins, has benefits for atopic animals (28)(29)(30)(31)(32). Their mechanisms of action in canine AD are not completely elucidated but may involve binding of toll-like receptors and downregulation of the predominately Th2mediated allergic response (3,33,34).…”