Evidence-based veterinary dermatology: a systematic review of the pharmacotherapy of canine atopic dermatitis

Authors

  • T. Olivry,

    Corresponding author
    1. Department of Clinical Sciences, North Carolina State University, College of Veterinary Medicine, 4700 Hillsborough Street, Raleigh, NC 27606, USA
    2. Department of Dermatology, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
    Search for more papers by this author
  • R. S. Mueller,

    1. Department of Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
    Search for more papers by this author
  • THE INTERNATIONAL TASK FORCE ON CANINE ATOPIC DERMATITIS

    Search for more papers by this author
    • §

      International Task Force on Canine Atopic Dermatitis: Thierry Olivry, NC State University, Raleigh, North Carolina, USA (Chair); Didier N. Carlotti, Cabinet de Dermatologie Vétérinaire, Bordeaux-Mérignac, France; Douglas J. DeBoer, University of Wisconsin-Madison, Madison, Wisconsin, USA; Craig E. Griffin, Animal Dermatology Clinic, San Diego, California, USA; Richard E.W. Halliwell, University of Edinburgh, Edinburgh, UK; Bruce Hammerberg, NC State University, Raleigh, North Carolina, USA; Peter B. Hill, University of Edinburgh, Edinburgh, UK; Andrew Hillier, The Ohio State University, Columbus, Ohio, USA; Toshiroh Iwasaki, Tokyo University of Agriculture & Technology, Tokyo, Japan; Hilary A. Jackson, NC State University, Raleigh, North Carolina, USA; Rosanna Marsella, University of Florida, Gainesville, Florida, USA; Ralf S. Mueller, Colorado State University, Fort Collins, Colorado, USA; Timothy Nuttal, University of Liverpool, Liverpool, UK; Pascal Prélaud, Centre d’Etude et de Recherche en Immunologie, Paris, France; Edmund J. Rosser, Jr, Michigan State University, East Lansing, Michigan, USA; Candace A. Sousa, Animal Dermatology Clinic, Sacramento, California, USA; Ton Willemse, University of Utrecht, Utrecht, the Netherlands.


T. Olivry, Department of Clinical Sciences, North Carolina State University, College of Veterinary Medicine, 4700 Hillsborough Street, Raleigh, NC 27606, USA. E-mail: Thierry_Olivry@ncsu.edu

Abstract

Abstract The efficacy of pharmacological interventions used to treat canine atopic dermatitis, excluding fatty acid supplementation and allergen-specific immunotherapy, was evaluated based on the systematic review of prospective clinical trials published between 1980 and 2002. Studies were compared with regard to design characteristics (randomization generation and concealment, masking, intention-to-treat analyses and quality of enrolment of study subjects), benefit (improvement in skin lesions or pruritus scores) and harm (type, severity and frequency of adverse drug events) of the various interventions. Meta-analysis of pooled results was not possible because of heterogeneity of the drugs evaluated. Forty trials enrolling 1607 dogs were identified. There is good evidence for recommending the use of oral glucocorticoids and cyclosporin for the treatment of canine atopic dermatitis, and fair evidence for using topical triamcinolone spray, topical tacrolimus lotion, oral pentoxifylline or oral misoprostol. Insufficient evidence is available for or against recommending the prescription of oral first- and second-generation type-1 histamine receptor antagonists, tricyclic antidepressants, cyproheptadine, aspirin, Chinese herbal therapy, an homeopathic complex remedy, ascorbic acid, AHR-13268, papaverine, immune-modulating antibiotics or tranilast and topical pramoxine or capsaicin. Finally, there is fair evidence against recommending the use of oral arofylline, leukotriene synthesis inhibitors and cysteinyl leukotriene receptor antagonists.

Ancillary