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On Topic: Cyclosporine Options

Clinician's Brief (Capsule)

Dermatology

|March 2014

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Oral cyclosporine A (CsA), while efficacious when used to treat canine atopic dermatitis (AD), can be costly and associated with toxic effects, especially with chronic use. This trial evaluated a novel topical preparation of 2.5% CsA intended for moderate and severe nonseasonal AD in dogs (n = 32). Chitosan nanocapsules were used as a mucoadhesive, creating a film on the skin that allowed the lipophobic drug to penetrate. All dogs were treated q12h for 6 weeks with either CsA (n = 17) or placebo (n = 15). Investigators rated erythema, lichenification, and excoriation in selected skin lesions on days 0, 21, and 45. Owners were asked to rate severity of pruritus at these times. AD severity scores were significantly lower than baseline for topical CsA dogs, and most owners reported good response after 2 weeks of treatment. The study’s topical CsA formulation effectively treated AD, was well tolerated, had a relatively quick onset, and lacked the significant adverse effects of traditional oral preparations, although more investigation is needed.

Commentary

The goal of AD treatment is to balance clinical response with financial and medical cost and to minimize systemic steroids that atopic patients receive. Topical therapies are appealing because the drug is applied where needed, avoiding some of the adverse systemic effects. Topical steroids and oral CsA are effective but topical steroids can cause skin atrophy if overused, and oral CsA has been associated with GI disturbance. The topical CsA presented here avoids steroids and may be better tolerated than oral CsA.—William Oldenhoff, DVM 

Source

Efficacy of a new topical cyclosporine A formulation in the treatment of atopic dermatitis in dogs. Puigdemont A, Brazís P, Ordeix L, et al. VET J 197:280-285, 2013.

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