Open Access Research article

Concurrent short-term use of prednisolone with cyclosporine A accelerates pruritus reduction and improvement in clinical scoring in dogs with atopic dermatitis

Ramiro Dip12*, James Carmichael3, Ingrid Letellier4, Guenther Strehlau1, Elizabeth Roberts3, Emmanuel Bensignor5 and Wayne Rosenkrantz6

Author Affiliations

1 Novartis Animal Health Inc., Schwarzwaldallee 215, CH-4058 Basel, Switzerland

2 Institute of Pharmacology and Toxicology, University of Zurich-Vetsuisse, Winterthurerstrasse 260, CH-8057 Zurich, Switzerland

3 Novartis Animal Health US, Inc., 3200 Northline Ave., Ste 300, NC 27408 Greensboro, USA

4 Novartis Animal Health S.A.S., 14 Boulevard Richelieu, Boite Postale 430F-92845 Rueil-Malmaison Cedex, France

5 Veterinary Dermatology Referral Service, 6 rue de la Mare Pavée, F-35510 Cesson Sevigne, France

6 Animal Dermatology Clinic, 2965 Edinger Ave., CA 92780 Tustin, USA

For all author emails, please log on.

BMC Veterinary Research 2013, 9:173  doi:10.1186/1746-6148-9-173

Published: 3 September 2013

Abstract

Background

A randomized, unmasked, multicenter study was conducted to evaluate the rate of pruritus reduction and improvement in clinical scoring by cyclosporine A (5 mg/kg orally, once daily for 28 days) either alone (n = 25 dogs) or with concurrent prednisolone (1 mg/kg once daily for 7 days, followed by alternate dosing for 14 days; n = 23 dogs) for the treatment of atopic dermatitis in dogs. Dogs were included in the study after exclusion of other causes of pruritic dermatitis, and were assessed by dermatologists on days 0, 14 ± 1 and 28 ± 2. Assessments included: general physical examination, CADESI-03 lesion scoring, overall clinical response, evaluation of adverse events (AEs), body weight and clinical pathology (hematology, clinical chemistry and urinalysis). Owner assessments, including pruritus (visual analogue scale, VAS) and overall assessment of response were conducted every 3–4 days, either during visits to the clinic or at home. Owners reported AEs to the investigator throughout the study.

Results

By day 28 ± 2 both treatment groups resulted in a significant improvement of the atopic dermatitis. Both investigators and owners agreed that concurrent therapy resulted in a quicker improvement of the dogs ‘overall’ skin condition and of pruritus (significant reduction of pruritus by day 3–4, 72.8% improvement by day 14 ± 1), when compared to cyclosporine A alone (significant reduction of pruritus by day 7–8, 24.7% improvement by day 14 ± 1). CADESI-03 scores significantly improved in both groups by day 14 ± 1 onwards, and there were no significant differences in the scores between treatment groups at any time points. A total of 56 AEs (cyclosporine A alone = 34; concurrent therapy = 22) were reported in 33 dogs. No dogs died or stopped treatment due to an AE. The most commonly reported AEs in the cyclosporine A group were associated with the digestive tract, whilst systemic disorders were reported more frequently observed following concurrent therapy. Evaluation of body weight change and clinical pathology indices showed no overall clinically significant abnormalities.

Conclusions

In dogs with atopic dermatitis, a short initiating course of prednisolone expedited the efficacy of cyclosporine A in resolving pruritus and associated clinical signs. The observed adverse events were consistent with those expected for the individual veterinary medicinal products.

Keywords:
Cyclosporine; Ciclosporine; Atopic dermatitis; Pruritus; Prednisolone; Clinical safety; Atopica