July 2019

Today’s VETgirl online veterinary continuing education sponsored blog is written by Dr. Michele Rosenbaum VMD DACVD, Medical Lead, Dermatology Zoetis. Thanks to Zoetis for sponsoring this blog. Please note the opinions in this blog are the expressed opinion of the author, and not directly endorsed by VETgirl.

Summer is here, and allergy season is in full swing! Summer fun comes with the misery of allergies for many dogs who are scratching, chewing and licking up a storm. Your days are full of seeing itchy dogs and their pet parents all wanting fast relief from the suffering of allergic itch. Don’t pull your own hair out, help is on the way. APOQUEL® gives your patients fast and effective relief from allergic itch and inflammation while CYTOPOINT® provides targeted long-lasting relief. CYTOPOINT® has recently received an expanded label claim so you can use it in even more itchy allergic dogs.

As you recall, APOQUEL is proven to be effective in rapidly relieving itch in dogs with allergic dermatitis due to its inhibition of IL-31 activity, an important itch-causing cytokine. A recent study demonstrated that the monoclonal antibody CYTOPOINT also significantly reduces allergic itch due its ability to target and neutralize canine IL-31 in a laboratory dog model of pruritus.(1) A single 2 mg/kg subcutaneous injection of CYTOPOINT was demonstrated to be effective in reducing clinical signs of allergic dermatitis or just reducing pruritus following intravenous IL-31 challenge within one day of administration, and for 28 days following administration. The mean pruritus scores for CYTOPOINT-treated dogs were significantly lower than for placebo-treated dogs at Days 1 and 28. CYTOPOINT was well tolerated. Thus, the USDA approved an expanded label for CYTOPOINT to include allergic dermatitis. This includes flea, food, and contact allergies.

Further support of this allergic dermatitis claim came from an independent retrospective study of client-owned dogs with atopic dermatitis, food allergy, or allergic dermatitis of undetermined cause, completed by Colorado State University and published in the journal Veterinary Dermatology.(2) Treatment success was defined as >2 cm reduction in an owner-completed 10 cm pruritus visual analog score (PVAS).

• 135 dogs were included: 80 with atopic dermatitis (AD), 10 with food allergy (with AD) and 45 with allergic dermatitis of undetermined cause (ADUC). Three dogs were lost to follow-up. There were no flea allergic dogs, as the
study was completed in Colorado.

• 116/132 (87.8 %) dogs were treatment successes.

• Mean PVAS pre-CYTOPOINT® decreased from 6.5 to 1.5. PVAS reduction ≥50% was achieved in 104/132 (77%) of dogs.

• All 10 food allergic/AD dogs responded to CYTOPOINT.

• In ADUC dogs 37/45 (82%) were treatment successes.

The study authors concluded that CYTOPOINT® was a safe and effective therapy for the control of pruritus in dogs with allergic dermatitis.

Both APOQUEL and CYTOPOINT are indicated for allergic dermatitis, so now you can tailor treatment to suit the individual needs of each pet and their owner. You can provide relief for your patients from the first time they present with allergic itch and throughout the course of your diagnostic workup. Refer to the streamlined diagnostic approach below:

 

APOQUEL is a great choice for:
• Rapid itch and inflammation relief you can start and stop(3-5)
• First-line treatment: APOQUEL’s ability to start reducing allergic itch within 4 hours(3) and to control itch within 24 hours(4) makes APOQUEL ideal to use when you first see your
patient, to protect the bonds that matter most
• Use during the diagnostic work-up: allows flexibility to stop and start treatment making it an ideal “precision” tool to turn on/off itch control during flea control or food trials
• Dogs at least 12 months of age
• Short and long-term management of allergic itch and inflammation by inhibiting cytokine activity(5)
• Flare relief, where dog is otherwise controlled by CYTOPOINT

CYTOPOINT is an ideal choice for:
• Sustained, long-lasting relief: Begins relieving allergic itch within 24 hours and lasts for 4-8 weeks, giving the skin time to heal(6)
• Dogs who are difficult to pill
• Where owner compliance is a concern
• Dogs with serious infections
• Owners who seek non-drug therapy
• Dogs of all ages including under 12 months
• Allergic itch relief during diagnostic trials in the unique situations above: The diagnostic trial needs to be extended beyond CYTOPOINT’s anticipated duration of efficacy for that patient
• Dogs requiring lasting, lifelong disease management
• When dogs have recurrence of previously well-controlled allergic itch: When a known flea or food allergic dog needs sustained itch control while returning to a lapsed restricted diet or regular flea control
and/or with a flare of allergy due to high pollen levels
• Flare relief, where dog is otherwise controlled by APOQUEL

By understanding how to tailor your approach to itchy dogs using the two best in class anti-pruritic medications for canine allergic disease, you have more options than ever in choosing the treatment that best fits the pet owner and dog’s preferences and life style. Use the streamlined diagnostic approach to identify the all-important cause of the patient’s itch. The goal is for all our allergic patients to have a fun and itch-free summer!

IMPORTANT SAFETY INFORMATION
Do not use APOQUEL in dogs less than 12 months of age or those with serious infections. APOQUEL may increase the chances of developing serious infections, and may cause existing parasitic skin infestations or pre-existing cancers to get worse. APOQUEL has not been tested in dogs receiving some medications including some commonly used to treat skin conditions such as corticosteroids and cyclosporines. Do not use in breeding, pregnant, or lactating dogs. Most common side effects are vomiting and diarrhea. APOQUEL has been used safely with many common medications including parasiticides, antibiotics and vaccines.

See full Prescribing Information at https://www.apoqueldogs.com/apoquel_pi.pdf

References
1. Study Report No. C166R-US-17-180, Zoetis LLC.
2. Souza CP, Rosychuk RAW, Contrerras E, Schissler JR Simpson C. A retrospective analysis of the use of lokivetmab in the management of allergic pruritus in a referral population of 135 dogs in the western USA. Vet Dermatol 2018;29: 489–e164.
3. Gadeyne C, Little P, King VL, Edwards N, Davis K, Stegemann MR. Efficacy of oclacitinib (Apoquel®) compared with prednisolone for the control of pruritus and clinical signs associated with allergic dermatitis in client-owned dogs in Australia. Vet Dermatol. 2014 Dec;25(6):512–e86.
4. Cosgrove SB, Wren JA, Cleaver DM, Martin DD, Walsh KF, Harfst JA, Follis SL, King VL, Boucher JF, Stegemann MR. Efficacy and safety of oclacitinib for the control of pruritus and associated skin lesions in dogs with canine allergic dermatitis. Vet Dermatol. 2013 Oct:24(5): 479–e114.
5. Gonzales AJ, Bowman J, Fici G, Zhang M, Mann DW. Oclacitinib (Apoquel®; Zoetis) is a novel Janus kinase inhibitor that has activity against canine pro-allergic and proinflammatory cytokines (abstract). Vet Dermatol. 2013 Aug;24:384-385.
6. Data on file, Study Report No. C863R-US-12-018 Zoetis, Inc.

  3. Rachelle Gonzalez says:

    My vet just prescribed Apoquel for 14 days to my breeding 2 yr old stud Goldendoodle, Sawyer. My next bitch will be ready for breeding in August. Will this affect his ability to impregnate her? Should I ask my vet for Cytopoint instead? Thank you

    • VETgirl says:

      If your dog has allergies severe enough to use these drugs, I wouldn’t honestly breed her, a it’s inherited. Also, Apoquel has not be tested in pregnant, breeding, or lactating bitches, so for that reason it is labeled as “Do not use in breeding, pregnant, or lactating dogs.”

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