Efficacy of oclacitinib for the control of feline atopic skin syndrome: correlating plasma concentrations with clinical response.

OBJECTIVES: The aim of this study was to assess the efficacy of a new therapeutic regimen of oclacitinib for the control of feline atopic skin syndrome (FASS) and to correlate plasma levels of this drug with clinical effects. METHODS: Twenty-eight client-owned cats with a clinical diagnosis of FASS were recruited. Oclacitinib was administered at 1 mg/kg q12h for 2 weeks and then at 1 mg/kg q24h for a further 2 weeks. At the study outset (D0), and 7 (D7) and 28 (D28) days after starting treatment, clinical lesions were assessed using a validated scoring system (SCORing Feline Allergic Dermatitis [SCORFAD]) and pruritus was graded via an adapted visual analogue scale (PVAS). At the same time points, plasma oclacitinib levels and haematological variables were measured. RESULTS: Among 18 cats completing the study, PVAS and SCORFAD improved by ⩾50% in 61% and 88% of animals, respectively. Mean PVAS decreased significantly between D0 and D7 and between D0 and D28 (both P <0.001) but not between D7 and D28. Likewise, mean SCORFAD values decreased significantly between D0 and D7 and between D0 and D28 (both P <0.001) but not between D7 and D28. On D7 and D28, plasma oclacitinib concentrations varied widely from 0 to 1443.2 ng/ml and from from 0 to 1177.7 ng/ml, respectively. Oclacitinib concentrations showed no correlation with clinical effects (SCORFAD and PVAS). CONCLUSIONS AND RELEVANCE: Oclacitinib emerged as being safe and effective to control clinical signs of FASS. A mean dose of 1 mg/kg, even without extending twice-daily treatment beyond the first 2 weeks, could be a suitable therapeutic regimen. Plasma drug levels did not seem useful to predict clinical response during treatment.

Beneficial effect of oclacitinib in a case of feline pemphigus foliaceus.

Pemphigus foliaceous (PF) is a pustular, immune-mediated skin disease characterised by acantholytic cells and commonly treated with high doses of glucocorticoids. This report describes one case of feline PF successfully controlled using oral oclacitinib, suggesting a possible therapeutic alternative to glucocorticoids in some cases.

Le pemphigus foliacé (PF) est une dermatose à médiation immune pustuleuse caractérisée par des cellules acantholytiques et traitée fréquemment par des doses élevées de corticoïdes. Cet article décrit un cas de PF félin contrôlé avec succès par de l'oclacitinib orale, suggérant une alternative thérapeutique possible aux corticoïdes dans certains cas.

El pénfigo foliáceo (PF) es una enfermedad cutánea pustular, inmunomediada, caracterizada por células acantolíticas y comúnmente tratada con altas dosis de glucocorticoides. Este informe describe un caso de PF El pénfigo foliáceo (PF) es una enfermedad cutánea pustulosa, inmunomediada, caracterizada por células acantolíticas y comúnmente tratada con altas dosis de glucocorticoides. Este informe describe un caso de FP felino controlado con éxito con oclacitinib oral, lo que sugiere una posible alternativa terapéutica a los glucocorticoides en algunos casos. felino controlado con éxito con oclacitinib oral, lo que sugiere una posible alternativa terapéutica a los glucocorticoides en algunos casos.

O pênfigo foliáceo (PF) é uma dermatopatia pustular, imunomediada caracterizada por células acantolíticas e comumente tratado com altas doses de glicocorticoides. Este relato descreve um caso de PF felino satisfatoriamente controlado utilizando oclacitinib por via oral, sugerindo uma possível alternativa terapêutica aos glicocorticoides em alguns casos.

Clinical efficacy of sublingual allergen-specific immunotherapy in 22 cats with atopic dermatitis.

BACKGROUND: Sublingual immunotherapy (SLIT) has been deployed in humans and dogs; to the best of the authors' knowledge, there are no published studies about the use of SLIT in cats. OBJECTIVES: Evaluate the clinical efficacy of SLIT in atopic cats sensitized to dust and storage mites, assessing immunological changes associated with SLIT treatment. ANIMALS: Twenty-two client-owned cats with clinical signs compatible with feline atopic dermatitis (fAD) and serum allergen-specific immunoglobulin (Ig)E against house dust and storage mites. METHODS AND MATERIALS: Prospective, multicentre, open-label clinical trial. Individualized mite-specific SLIT was administered orally for 12 months. All cats underwent clinical examination to record SCORing feline allergic dermatitis (SCORFAD), pruritus Visual Analog Scale (pVAS) and serum allergen-specific IgE and IgG, every three months for 12 months. RESULTS: Sixteen of 22 cats (73%) completed the study and three of six cats withdrawn from the study were included in an intention-to-treat analysis. SCORFAD and pVAS values decreased significantly from baseline (T0) to the third month of treatment (P = 0.0004 and P = 0.0013, respectively), with median total values ranging from 19 (6-44) (T0) to 2.5 (0-17) (T12) (P = 0.0001), and from 8 (6-10) (T0) to 2.3 (0-8) (T12) (P = 0.0001), respectively. Allergen-specific IgE values decreased significantly from the ninth month (T9) of treatment (P = 0.0032), with median scores decreasing from 56 (12-729) (T0) to 34 (0-158) (T12) (P = 0.0208). No significant differences in allergen-specific IgG values were observed throughout the study. No adverse effects related to the use of SLIT were reported. CONCLUSIONS AND CLINICAL IMPORTANCE: Sublingual immunotherapy should be considered a rapid, effective, safe and well-tolerated treatment in cats with feline atopic dermatitis fAD.

A pharmacokinetic study of oclacitinib maleate in six cats.

BACKGROUND: Oclacitinib is a Janus kinase (JK)1 inhibitor that has been shown to be effective and safe for the treatment of allergic dermatitis in dogs. Its use in cats has been limited by the absence of pharmacokinetic data. OBJECTIVE: To determine the pharmacokinetic parameters of oclacitinib in cats after oral and intravenous administration. ANIMALS: Six adult domestic short hair cats. METHODS AND MATERIALS: A two period, two treatment design was used in which cats received oclacitinib maleate i.v. and p.o., at a dose of 0.5 mg/kg and 1 mg/kg, respectively. There was a one-week interval of washout between the two treatments. Cats received each treatment only once. The plasma concentration of oclacitinib was determined by high-performance liquid chromatography at 0 min, 5 min, 15 min, 30 min, 1 h, 4 h, 6 h, 10 h and 24 h after intravenous.v administration, at 0 min, 15 min, 30 min, 1 h, 2 h, 4 h, 6 h, 10 h and 24 h after p.o. administration. RESULTS: After p.o. administration, oclacitinib was absorbed rapidly and almost completely, as shown by an absolute bioavailability of 87% and a Tmax of 35 min. The elimination of the drug also was very rapid as shown by a half-life of 2.3 h and a clearance calculated as 4.45 mL/min/kg (after i.v. administration). CONCLUSIONS AND CLINICAL IMPORTANCE: The pharmacokinetic parameters of oclacitinib in the cat are similar to those described for the dog, although absorption and elimination are somewhat faster and variability between individuals is somewhat greater. Larger doses and/or shorter dosing intervals would be recommended in cats to achieve similar blood concentrations to those in dogs.

Topical polyhydroxy acid treatment for autosomal recessive congenital ichthyosis in the golden retriever: a prospective pilot study.

BACKGROUND: Autosomal recessive congenital ichthyosis (ARCI) in golden retrievers is due to a PNPLA1 gene mutation, which plays a role in epidermal lipid organization and metabolism. Topical therapies are used to reduce scaling; however, there are few published efficacy studies. OBJECTIVES: To examine the efficacy of topical treatment based on gluconolactone, a polyhydroxy acid with known beneficial effects on stratum corneum structure. ANIMALS: Sixteen golden retriever dogs with clinical signs of ARCI and PCR-confirmed PNPLA1 gene mutation. METHODS: This was a prospective, multicentre, noncontrolled study. Dogs were treated with a shampoo and lotion containing gluconolactone and other hydroxyl acids. Treatments were administered initially twice weekly for two weeks, then once weekly for two weeks and finally once monthly. Examinations were performed prior to and at 14 and 30 days of treatment to assess scaling, presence of other skin lesions and pruritus. In two dogs, pre- and 30 day post-treatment, skin biopsies were obtained. RESULTS: The extent and size of the scales were reduced by 60% and 75% after 14 and 30 days of treatment, respectively (P < 0.001). In 20% of the dogs, scaling was no longer observed after the first 30 days of treatment. No other skin lesions or pruritus were observed in any dog. Post-treatment biopsies showed normalization of the stratum corneum morphology and reduced hyperpigmentation. CONCLUSION AND CLINICAL IMPORTANCE: The frequent use of a shampoo and lotion containing gluconolactone may be an effective measure to improve skin scaling in golden retrievers with ARCI.