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Utilização clínica de oclacitinib no maneio da dermatite atópica canina : avaliação da resposta ao tratamento na perspetiva dos tutores
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Authors
Abstract(s)
O oclacitinib (Apoquel®) é um inibidor seletivo da enzima Janus cinase (JAK), utilizado no controlo do prurido em cães com dermatite de origem alérgica, incluindo a dermatite atópica. Visto ser um fármaco recente, as informações relativas à sua utilização na prática clínica poderão complementar os conhecimentos sobre a sua eficácia e segurança a curto e longo prazo. Também é importante averiguar a opinião e o grau de satisfação dos tutores dos animais com esta nova opção terapêutica.
No presente estudo, realizado no serviço de Dermatologia e Imunoalergologia do Hospital Escolar Veterinário, da Faculdade de Medicina Veterinária, da Universidade de Lisboa, avaliou-se a resposta de uma amostra de cães com dermatite atópica (DAc) ao tratamento com oclacitinib, tendo em consideração a perceção dos seus tutores. A avaliação foi realizada através da determinação do grau de prurido antes e 28 dias após o início do tratamento e da realização de um questionário aos tutores referente à resposta ao tratamento e à qualidade de vida durante o mesmo.
O oclacitinib foi utilizado no âmbito de uma terapêutica multimodal e revelou ser bastante eficaz no controlo do prurido. Foram avaliados 40 cães, nos quais o grau de prurido médio passou de um valor inicial de 6,6 (prurido moderado) para 3,2 (prurido ligeiro), com 85% dos animais (34/40) a apresentarem um prurido ligeiro a muito ligeiro na fase de manutenção do tratamento. Para 90% dos tutores (36/40) o seu animal melhorou muito, 77,5% (31/40) concordaram que o tratamento com oclacitinib é eficaz e um igual número (77,5%, 31/40) discordou que este fármaco causou efeitos secundários ao seu cão. No entanto, 3 a 7 meses após o início do tratamento registou-se o aparecimento de nódulos cutâneos ou subcutâneos em 15% dos animais (6/40). O grau de satisfação dos tutores com esta terapêutica foi notório, com 92,5% (37/40) a revelarem-se satisfeitos ou muito satisfeitos com o oclacitinib. Porém, o custo do medicamento é um aspeto que os preocupa. O impacto negativo da DAc na qualidade de vida dos animais afetados e dos seus tutores continuou a estar presente durante o tratamento, mas pareceu ser atenuado por influência do oclacitinib, sugerindo uma melhoria na qualidade de vida.
Tanto quanto sabemos, este é o primeiro estudo sobre a utilização clínica do oclacitinib realizado em Portugal. Neste estudo, demonstrámos a eficácia e segurança deste tratamento a curto prazo e a satisfação dos tutores com o mesmo.
ABSTRACT - Oclacitinib (Apoquel®) is a selective inhibitor of the Janus kinase (JAK) enzyme and it’s used for pruritus control in dogs with allergic dermatitis, including atopic dermatitis. As a new drug, information on its use in clinical practice may complement knowledge of its efficacy and safety in short and long term. It’s also important to assess the owner’s opinion and level of satisfaction with this new therapeutic option. In the present study, carried out by the Department of Dermatology and Immunoallergology from Hospital Escolar Veterinário, Faculdade de Medicina Veterinária, Universidade de Lisboa, dogs with atopic dermatitis (cAD) were evaluated regarding their response to oclacitinib treatment, considering owners’ perception. This was achieved through the determination of pruritus scores before and 28 days after starting the therapy and by an owner’s survey regarding dogs’ response to treatment and the quality of life during the same. Oclacitinib was used in a multimodal approach and shown to be very effective for pruritus reduction. Forty dogs were evaluated and initially the sample’s mean degree of pruritus was 6.6 (moderate itching), which decreased to 3.2 (mild itching), with 85% of the animals (34/40) presenting a mild to very mild itching in the maintenance phase of the treatment. For 90% of the owners (36/40) their animal improved greatly, 77.5% (31/40) agreed that oclacitinib is effective and an equal number (77.5%, 31/40) disagreed that this drug caused side effects to their dog. However, 3 to 7 months after starting the treatment, skin nodules appeared in 15% of the animals (6/40). Owners’ level of satisfaction with therapy was also evident, with 92.5% of them (37/40) being satisfied or very satisfied with oclacitinib. However, drug’s cost is an aspect that worries owners. During treatment, negative impact of cAD on the quality of life of affected animals and their owners was still present, but it appeared to be attenuated by oclacitinib, suggesting an improvement in the quality of life. To our knowledge, this is the first study on the clinical use of oclacitinib in Portugal. We have demonstrated the efficacy and safety of this treatment in the short-term and the overall owner's satisfaction.
ABSTRACT - Oclacitinib (Apoquel®) is a selective inhibitor of the Janus kinase (JAK) enzyme and it’s used for pruritus control in dogs with allergic dermatitis, including atopic dermatitis. As a new drug, information on its use in clinical practice may complement knowledge of its efficacy and safety in short and long term. It’s also important to assess the owner’s opinion and level of satisfaction with this new therapeutic option. In the present study, carried out by the Department of Dermatology and Immunoallergology from Hospital Escolar Veterinário, Faculdade de Medicina Veterinária, Universidade de Lisboa, dogs with atopic dermatitis (cAD) were evaluated regarding their response to oclacitinib treatment, considering owners’ perception. This was achieved through the determination of pruritus scores before and 28 days after starting the therapy and by an owner’s survey regarding dogs’ response to treatment and the quality of life during the same. Oclacitinib was used in a multimodal approach and shown to be very effective for pruritus reduction. Forty dogs were evaluated and initially the sample’s mean degree of pruritus was 6.6 (moderate itching), which decreased to 3.2 (mild itching), with 85% of the animals (34/40) presenting a mild to very mild itching in the maintenance phase of the treatment. For 90% of the owners (36/40) their animal improved greatly, 77.5% (31/40) agreed that oclacitinib is effective and an equal number (77.5%, 31/40) disagreed that this drug caused side effects to their dog. However, 3 to 7 months after starting the treatment, skin nodules appeared in 15% of the animals (6/40). Owners’ level of satisfaction with therapy was also evident, with 92.5% of them (37/40) being satisfied or very satisfied with oclacitinib. However, drug’s cost is an aspect that worries owners. During treatment, negative impact of cAD on the quality of life of affected animals and their owners was still present, but it appeared to be attenuated by oclacitinib, suggesting an improvement in the quality of life. To our knowledge, this is the first study on the clinical use of oclacitinib in Portugal. We have demonstrated the efficacy and safety of this treatment in the short-term and the overall owner's satisfaction.
Description
Dissertação de Mestrado Integrado em Medicina Veterinária
Keywords
oclacitinib Janus cinase prurido cães dermatite atópica terapêutica Janus kinase pruritus dogs atopic dermatitis therapy
Pedagogical Context
Citation
Martins, A.S. (2017). Utilização clínica de oclacitinib no maneio da dermatite atópica canina : avaliação da resposta ao tratamento na perspetiva dos tutores. Dissertação de mestrado. Universidade de Lisboa, Faculdade de Medicina Veterinária, Lisboa.
Publisher
Universidade de Lisboa, Faculdade de Medicina Veterinária