Prolonged twice‐daily administration of oclacitinib for the control of canine atopic dermatitis: a retrospective study of 53 client‐owned atopic dogs

Abstract

Background -Oclacitinib administered at the licensed dose twice daily for two weeks and then once daily as required is recommended for the treatment of atopic dogs. In some cases, the once-daily regimen is insufficient to control the clinical signs.Objectives -To provide preliminary safety and efficacy data on the prolonged twice-daily administration of oclacitinib in atopic dogs.Animals -Fifty-three client-owned atopic dogs.Methods and materials -The medical records of dogs with atopic dermatitis treated with oclacitinib twice daily for more than two weeks were reviewed retrospectively. Animal details, treatment dose and duration, concurrent diseases, adjunctive medications and possible adverse events were recorded. Treatment efficacy was assessed retrospectively and, when available, the selected blood parameters before and during the treatment were compared. Statistical analyses of the collected data were performed.Results -The median treatment duration was 113 days. Excellent-to-good efficacy was observed in 38 dogs (72%), including 24 of 33 dogs that failed to respond to the once-daily regimen. Eight dogs showed a poor response despite the addition of systemic glucocorticoids. Pyoderma, gastrointestinal signs and otitis externa were the most frequent adverse events recorded whilst on treatment. Blood tests performed in 35 dogs showed slightly decreased leucocyte, neutrophil, eosinophil and monocyte counts that remained within the reference ranges in most cases. Three dogs developed hypercholesterolemia.Conclusions and clinical relevance -Prolonged twice-daily administration of oclacitinib generally was welltolerated and was effective in most of the treated dogs. Regular clinical evaluation and blood tests are advisable for this treatment regimen.

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

“…These observations are supported by two recent studies that suggest that the long‐term oral administration of oclacitinib at dosages approved for treatment of canine atopic dermatitis generally is not associated with the development of adverse effects 12,13 . Nevertheless, the monitoring of blood counts is important when using oclacitinib off‐label, especially when given twice daily in the long term, because of its potential inhibition of JAK2 that could impact haematopoiesis 14 …”

“…Blood samples were taken every 2-3 weeks at the beginning of oclacitinib therapy, and then with a reduced frequency, to evaluate possible changes in haematological parameters, as suggested by a recent publication on the prolonged twice-daily treatment with oclacitinib. 14 The response to treatment was evaluated subjectively following a a physical examination and recording of the examining veterinarians perception of the reduction in clinical signs. 'Complete remission', CR, represented the disappearance of all active skin lesions.…”

“…All dogs received oclacitinib monotherapy at the approved (0.4–0.6 mg/kg) or higher dosages (Table 1). Blood samples were taken every 2–3 weeks at the beginning of oclacitinib therapy, and then with a reduced frequency, to evaluate possible changes in haematological parameters, as suggested by a recent publication on the prolonged twice‐daily treatment with oclacitinib 14 …”

Is oclacitinib a suitable alternative to oral glucocorticoids for the control of pruritus in cats?

“…Oclacitinib is licensed in the UK for ‘the treatment of pruritus associated with allergic dermatitis and the clinical manifestations of atopic dermatitis in dogs’ 6 . It has been used widely in veterinary practice for canine allergic skin disease, and there are reports of it being used for other canine skin diseases such as pemphigus 7,8 . There are also several reports of the off‐label use of oclacitinib in cats with allergic skin disease, including cats with feline atopic skin syndrome – where there are presumed to be allergic reactions to environmental allergens associated with the presence of immunoglobulin E antibodies 9 …”

Canine atopic dermatitis: systemic immunomodulatory protocol based on clinical phenotype

“…Oclacitinib is a drug recently introduced in veterinary medicine for the treatment of allergic pruritus in dogs. Its mechanism of action involves the inhibition of Janus Kinase (JAK) receptors (GONZALES et al, 2014;DENTI et al, 2022). In mammalian cells there are 4 JAK groups that play important pathophysiological roles.…”