Therapeutic management of canine atopic dermatitis by combination of pentoxifylline and PUFAs

Singh, Sanjay K.; Dimri, Umesh; Saxena, S.; Jadhav, R. K.

doi:10.1111/j.1365-2885.2009.01146.x

Cited by 23 publications

(34 citation statements)

References 28 publications

(29 reference statements)

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“…One RCT selected only dogs with pedal lesions, 21 another selected dogs with at least mild signs, 30 while four studies enrolled dogs with moderate to severe AD (A. Puigdemont, personal communication 2012) 25–27 . Finally, two trials needed dogs to have signs for a minimal duration before selection (6 months 33 and 1 year 22 ).…”

Section: Resultsmentioning

confidence: 99%

“…Of the RCTs that tested the evolution of skin lesions over time, the validated third version of the CADESI score was used in 10 studies, 21–24,26,27,29,30,34,35 while five trials employed the second version of this scale, which had limited validation 25,31,33,36,37 . Four trials employed unvalidated scales modified from the first, second or third versions of the CADESI – the so called ‘modified CADESI’ or ‘mCADESI’– having changed the type of lesions, the body sites and/or the severity rating used (A. Puigdemont, personal communication 2012) 28,38,39 .…”

Section: Resultsmentioning

confidence: 99%

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A systematic review of randomized controlled trials for prevention or treatment of atopic dermatitis in dogs: 2008–2011 update

Olivry

Bizikova

2013

Veterinary Dermatology

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Background -The management of atopic dermatitis (AD) in dogs relies mainly on the use of interventions to reduce pruritus and skin lesions.Objectives -To provide a critical analysis of recent clinical trials reporting the efficacy and safety of interventions for canine AD.Methods -Systematic review of randomized controlled trials (RCTs) published, presented or completed between 2008 and 2011, which enrolled dogs with AD. The search was done using electronic databases, reviewing published meeting abstracts and sending queries to professional email lists. Trials reporting the efficacy of interventions aimed at treating, preventing or reducing glucocorticoid usage in atopic dogs were selected.Results -Twenty-one RCTs were included. We found further moderate-quality evidence of efficacy and safety of oral glucocorticoids and ciclosporin for treatment of canine AD. There was additional moderate-quality evidence of the efficacy of a topical glucocorticoid spray containing hydrocortisone aceponate. Low-quality evidence was found for the efficacy and safety of injectable recombinant interferons, a budesonide leave-on conditioner, a ciclosporin topical nano-emulsion and oral fexofenadine. There is low-quality evidence of efficacy of oral masitinib, with a need for monitoring for protein-losing nephropathy. Finally, we uncovered low-quality evidence of efficacy of a commercial diet as a glucocorticoid-sparing intervention and of a glucocorticoid spray as a flare-delaying measure. Very low-quality evidence was found for the efficacy of other interventions.Conclusions and clinical importance -Topical or oral glucocorticoids and oral ciclosporin remain the interventions with highest evidence for efficacy and relative safety for treatment of canine AD.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

A systematic review of randomized controlled trials for prevention or treatment of atopic dermatitis in dogs: 2008–2011 update

Olivry

Bizikova

2013

Veterinary Dermatology

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“…In clinical veterinary medicine, PTX is used in dogs for the treatment of canine familial dermatomyositis, contact allergy, canine atopic dermatitis, lick granulomas and symmetric lupoid onychodystrophy, and for vasculitis and other vasculopathies (Marsella, ; Marsella & Nicklin, ; Mueller, Rosychuk, & Jonas, ; Singh, Dimri, Saxena, & Jadhav, ). Pentoxifylline has also been used to treat diseases that feature tissue necrosis, such as spider bites (Marsella, ; Singh et al, ). Two PTX pharmacokinetic studies have been published in dogs using the currently available extended‐release oral PTX formulation and an intravenous form prepared by the authors for their studies.…”

Section: Introductionmentioning

confidence: 99%

Effects of pentoxifylline on whole blood IL‐2 and IFN‐gamma gene expression in normal dogs

Kummari

Gibbs

Riggs

et al. 2019

Veterinary Medicine & Sci

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Background Pentoxifylline (PTX) is a methylxanthine phosphodiesterase inhibitor that is used as a hemorrheologic and anti‐inflammatory agent in veterinary and human medicine. In human studies, PTX has been shown to decrease T‐cell production of cytokines such as IL‐2 and IFN‐γ. A RT‐qPCR assay to measure activated T‐cell gene expression of IL‐2 and IFN‐γ has been validated in dogs. Objectives The goal of this study was to utilize this assay to investigate the effects of PTX on in vitro cytokine gene expression in canine whole blood. Methods Whole blood from seven healthy dogs was collected and incubated with various concentrations of PTX for 1 hr before activation. PTX concentrations spanned and exceeded blood concentrations achieved when administered at clinically relevant dosages (1, 2, 10, 50 and 200 μg/ml). Cyclosporine was used at a concentration of 500 ng/ml as a positive control. All blood samples, including untreated activated baseline samples, were then activated with phorbol myristate acetate and ionomycin for 5 hrs. Results Analysis of activated whole blood by RT‐qPCR revealed that there was not a significant suppression of IL‐2 or IFN‐γ gene expression at any concentration of PTX when evaluating ΔCt values. All samples exposed to cyclosporine showed significant changes from untreated activated baseline samples, demonstrating marked suppression as the positive control. Cytokine expression, presented as a percentage of untreated activated baseline samples, was also evaluated. After exposure to the highest concentration of PTX (200 μg/ml), median percentage cytokine expression was suppressed to just below 50% of baseline values. This concentration, however, is much higher than blood concentrations reported to be achieved at standardly used pentoxifylline doses. Conclusions PTX does not appear to significantly suppress T‐cell cytokine production in samples from most dogs at clinically relevant drug concentrations. Further testing is needed to establish the full effects of PTX on the immune system in dogs.

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“…4 Yet, a more recent study 25 using this medication at higher doses (20 mg/kg three times daily versus 10 mg/kg twice daily of the original studies 26 ) and in combination with essential fatty acids showed a marked beneficial effect. In this study, dogs receiving the combination of pentoxifylline and essential fatty acids revealed 56.75% and 47.76% reduction in clinical scores and pruritus scores on day 30, while the corresponding reduction on day 60 was 90.92% and 92.59%, respectively.…”

Section: Long-term Approach To Chronic Casesmentioning

confidence: 99%

An update on the treatment of canine atopic dermatitis

Marsella¹

2012

VMRR

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Remarkable progress has been made in recent years concerning our understanding of the pathogenesis of canine atopic dermatitis (AD). As our understanding improves, the therapeutic approach evolves. Of utmost importance is the documentation of skin barrier impairment in canine AD: ceramides deficiency leads to increased permeability and increased allergen penetration and sensitization. It is currently unknown whether this dysfunction is primary and genetically inherited or secondary to inflammation but it is accepted that skin barrier deficiency plays an important role in either starting or minimally exacerbating canine AD. Thus, the therapeutic approach has changed from focusing on the control of the inflammation to a combined approach that includes therapies aimed at skin barrier repair. The issue of skin barrier repair has been addressed both with oral administration of essential fatty acids and the topical application of products containing a combination of ceramides and fatty acids. These strategies are most helpful as adjunctive treatments and would be best used in young patients that have not developed chronic skin changes. Importantly, treatment for canine AD is multimodal and tailored to the individual patient, the age, and the duration of the disease. Client education plays an important role in explaining the importance of a long-term approach to minimize flare-ups and, in this context, topical therapy to correct skin barrier can be of great benefit. This is an area still in infancy and much work is needed to identify the best formulation. In human medicine, long-term use of moisturizers can have a profound effect on skin barrier and gene expression of proteins involved in skin barrier. This effect is variable depending on the formulation used. It is reasonable to speculate that the same may be true in dogs; thus, it is very important to identify the correct ingredients and formulation to use.

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Therapeutic management of canine atopic dermatitis by combination of pentoxifylline and PUFAs

Cited by 23 publications

References 28 publications

A systematic review of randomized controlled trials for prevention or treatment of atopic dermatitis in dogs: 2008–2011 update

A systematic review of randomized controlled trials for prevention or treatment of atopic dermatitis in dogs: 2008–2011 update

Effects of pentoxifylline on whole blood IL‐2 and IFN‐gamma gene expression in normal dogs

An update on the treatment of canine atopic dermatitis

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