Introduction:

Oclacitinib is a Janus kinase inhibitor with activity against IL-31 used for canine atopic dermatitis. Despite a high level of owner satisfaction with this treatment, the drug’s cost represents a concern for 75%, with 42.5% mentioning that they had to limit other expenses to afford the treatment of their dog.

Objectives:

To evaluate the possibility of adopting an alternative therapeutic protocol with oclacitinib on alternate days, and whether there is an advantage in administering oral glucocorticoids at the beginning.

Methods:

This prospective study was conducted as a randomised, placebo-controlled, double‑blinded clinical trial, and included 16 private-owned dogs diagnosed with atopic dermatitis, allocated in group P (n=7; Placebo) and G (n=9; Glucocorticoids). Dogs were evaluated for skin lesions (CADESI-04) and pruritus (PVAS) at Day -30, Day 0 and end-point (whether relapse or Day 30). This study comprised two distinct and successive phases. In the first phase, oclacitinib was given orally to both groups (0,4 mg/kg, twice a day [BID] for 14 days and once a day [SID] for 16 days). However, in the first 7 days, group G was given oral prednisolone (1 mg/kg SID) and group P was given a placebo following the same regimen. In the second phase, all animals underwent the same protocol with oclacitinib, only given every other day, until the disease’s relapse.

Results:

It was possible to adopt the alternate days’ protocol for at least 30 days in 71.43% of the animals. There were no significant differences between the mean values of CADESI-04 and pruritus at Day 0 and end-point. There were also no significant differences between the average alternate days’ treatment times of the two groups.

Conclusions:

The alternate days’ treatment protocol has the potential in allowing monthly costs to be reduced by half, giving greater access to this innovative, safe, and very effective, but also expensive, therapeutic tool. There seems to be no benefit, in matters of reducing the oclacitinib dose, in adding prednisolone at the beginning of the treatment.

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