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

Department of Clinical Sciences and Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.
Veterinary Dermatology (Impact Factor: 1.73). 02/2013; 24(1):97-e26. DOI: 10.1111/j.1365-3164.2012.01088.x
Source: PubMed


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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Available from: Thierry Olivry
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    • "Overall results from the trials show that around one- to two-thirds of dogs will show a 50 per cent or more reduction in pruritus and lesion scores within four to eight weeks. A recent systematic review of RCTs for treatments of canine AD concluded that there were now multiple, high-quality RCTs that show the efficacy of oral ME ciclosporin given at a starting dose of 5 mg/kg for the management of canine AD (Olivry and Bizikova 2013). There was no difference demonstrated in efficacy between oral ciclosporin and prednisolone and oral ciclosporin and methylprednisolone for the management of canine AD with both lesional scores and pruritus responding to treatment (Olivry and others 2002a, Steffan and others 2004a, Kovalik and others 2011). "
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