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Oral cyclosporine treatment of canine idiopathic sebaceous adenitis
PAG E 4
A D VA N C E S
(ISA) is a non-infectious inflammatory reaction of sebaceous glands which can lead to the complete destruction of the glands. It is considered a T-cell immunemediated disease, but its precise pathogenesis is still unknown. Topical treatment with oil soaks, humectants, and shampoos is effective for the skin changes caused by ISA but is also labor intensive. Cyclosporine A (CsA), an immunomodulatory drug, has recently been shown to ameliorate the clinical picture of ISA. It is, however, an expensive treatment option.
Objectives To evaluate the efficacy of cyclosporine A, either alone or with topical therapy, in treating ISA compared to conventional topical treatment alone.
Procedure Thirty-four dogs with an established diagnosis of ISA were treated for 4 to 6 months and were evaluated before, during, and after therapy. Twenty-nine dogs were randomly assigned to 1 of 3 treatment groups. The “CsA” group was treated with 5 mg/ kg/day of cyclosporine. The “CsA/Top” was treated likewise with cyclosporine, plus topically with shampooing, baby oil, and propylene glycol. The “Placebo/Top” group was treated with a placebo and the same topical treatments as “CsA/Top” group.
Results Both CsA and topical therapy demonstrated efficacy in this study. Differences between the treatment protocols were marginal. Topical treatment, both alone and in combination with CsA, appeared to reduce scaling more effectively than CsA alone. Both therapies reduced alopecia.
Author Conclusion There is a synergistic benefit on both scaling and alopecia, if both orally administered CsA and topical treatments are combined. There is evidence that regeneration of sebaceous glands is best achieved by CsA, either given alone or in combination with topical treatment.
ORAL CYCLOSPORINE TREATMENT OF CANINE IDIOPATHIC SEBACEOUS ADENITIS
Inclusions
Background
Editor Annotation
Canine idiopathic sebaceous adenitis
Sebaceous adenitis is a chronic disease
Five figures, 2 tables, 34 references.
A D VA N C E S
associated with inflammation and eventual destruction of sebaceous glands. Affected dogs develop scaly skin and hair loss, and many are prone to recurrent skin infections. Many therapeutic options have been proposed, including topical treatments and oral vitamin A, retinoids, tetracycline, niacinamide, corticosteroids, and cyclosporine. This study evaluated the effectiveness of topical treatment and oral cyclosporine. Interestingly, there was very little difference in the clinical outcomes of dogs treated with either topical therapy or oral cyclosporine. Both therapies resulting in improved hair coats and decreased inflammation, although topical therapy was more effective than oral cyclosporine in decreasing scaling. The combination of topical therapy plus oral cyclosporine had the greatest effect in decreasing both scaling and alopecia Cyclosporine had the greatest effect in suppressing inflammation and enabling regeneration of sebaceous glands. The primary limitation for use of topical therapy is willingness of the caregiver to spend the time required to soak the dog in oil and bathe spray it on a regular basis. The greatest limitation for the use of cyclosporine is the cost. Additional studies are needed to compare the efficacy of cyclosporine to vitamin A, retinoids, tetracycline, and niacinamide. For now, however, owners of dogs with sebaceous adenitis desiring the best outcome for their dog should be encouraged to use a combination of topical and systemic therapy. (KLC) Note: This study was funded in part by Novartis which produces Atopica, the form of cyclosporine used in the study. Lortz J, Favrot C, Mecklenburg L, et al. A multicentre placebo-controlled clinical trial on the efficacy of oral ciclosporin A in the treatment of canine idiopathic sebaceous adenitis in comparison with conventional topical treatment. Vet Dermatol 2010;21:593-601.
PAG E 5
A D VA N C E S
(ISA) is a non-infectious inflammatory reaction of sebaceous glands which can lead to the complete destruction of the glands. It is considered a T-cell immunemediated disease, but its precise pathogenesis is still unknown. Topical treatment with oil soaks, humectants, and shampoos is effective for the skin changes caused by ISA but is also labor intensive. Cyclosporine A (CsA), an immunomodulatory drug, has recently been shown to ameliorate the clinical picture of ISA. It is, however, an expensive treatment option.
Objectives To evaluate the efficacy of cyclosporine A, either alone or with topical therapy, in treating ISA compared to conventional topical treatment alone.
Procedure Thirty-four dogs with an established diagnosis of ISA were treated for 4 to 6 months and were evaluated before, during, and after therapy. Twenty-nine dogs were randomly assigned to 1 of 3 treatment groups. The “CsA” group was treated with 5 mg/ kg/day of cyclosporine. The “CsA/Top” was treated likewise with cyclosporine, plus topically with shampooing, baby oil, and propylene glycol. The “Placebo/Top” group was treated with a placebo and the same topical treatments as “CsA/Top” group.
Results Both CsA and topical therapy demonstrated efficacy in this study. Differences between the treatment protocols were marginal. Topical treatment, both alone and in combination with CsA, appeared to reduce scaling more effectively than CsA alone. Both therapies reduced alopecia.
Author Conclusion There is a synergistic benefit on both scaling and alopecia, if both orally administered CsA and topical treatments are combined. There is evidence that regeneration of sebaceous glands is best achieved by CsA, either given alone or in combination with topical treatment.
ORAL CYCLOSPORINE TREATMENT OF CANINE IDIOPATHIC SEBACEOUS ADENITIS
Inclusions
Background
Editor Annotation
Canine idiopathic sebaceous adenitis
Sebaceous adenitis is a chronic disease
Five figures, 2 tables, 34 references.
A D VA N C E S
associated with inflammation and eventual destruction of sebaceous glands. Affected dogs develop scaly skin and hair loss, and many are prone to recurrent skin infections. Many therapeutic options have been proposed, including topical treatments and oral vitamin A, retinoids, tetracycline, niacinamide, corticosteroids, and cyclosporine. This study evaluated the effectiveness of topical treatment and oral cyclosporine. Interestingly, there was very little difference in the clinical outcomes of dogs treated with either topical therapy or oral cyclosporine. Both therapies resulting in improved hair coats and decreased inflammation, although topical therapy was more effective than oral cyclosporine in decreasing scaling. The combination of topical therapy plus oral cyclosporine had the greatest effect in decreasing both scaling and alopecia Cyclosporine had the greatest effect in suppressing inflammation and enabling regeneration of sebaceous glands. The primary limitation for use of topical therapy is willingness of the caregiver to spend the time required to soak the dog in oil and bathe spray it on a regular basis. The greatest limitation for the use of cyclosporine is the cost. Additional studies are needed to compare the efficacy of cyclosporine to vitamin A, retinoids, tetracycline, and niacinamide. For now, however, owners of dogs with sebaceous adenitis desiring the best outcome for their dog should be encouraged to use a combination of topical and systemic therapy. (KLC) Note: This study was funded in part by Novartis which produces Atopica, the form of cyclosporine used in the study. Lortz J, Favrot C, Mecklenburg L, et al. A multicentre placebo-controlled clinical trial on the efficacy of oral ciclosporin A in the treatment of canine idiopathic sebaceous adenitis in comparison with conventional topical treatment. Vet Dermatol 2010;21:593-601.
PAG E 5