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Research article - Peer-reviewed, 2023

A randomised controlled trial testing the rebound-preventing benefit of four days of prednisolone during the induction of oclacitinib therapy in dogs with atopic dermatitis

Olivry, Thierry; Lokianskiene, Viktorija; Blanco, Alejandro; Del Mestre, Pablo; Bergvall, Kerstin; Beco, Luc


Background A rebound of pruritus occasionally occurs after oclacitinib dose reduction in dogs with atopic dermatitis (AD). Objectives To determine whether an initial 4-day course of prednisolone decreases the probability of a pruritus rebound after reducing the frequency of oclacitinib administration. Animals Forty dogs with mild-to-moderate AD lesions and moderate-to-severe pruritus. Materials and Methods Dogs were randomised to receive oclacitinib at 0.4-0.6 mg/kg twice daily for 14 days then once daily, alone or with prednisolone at 0.5 mg/kg, orally, twice daily for the first 4 days. Clinicians graded the Canine Atopic Dermatitis Extent and Severity Index (CADESI)4 and 2D-investigator global assessment (IGA) before and after 28 days; owners assessed the pruritis Visual Analog Scale (PVAS)10 and Owner Global Assessment of Treatment Efficacy (OGATE) on Day (D)0, D4, D14, D21 and D28. We considered a rebound any increase greater than one PVAS10 grade at D21 compared to D14. Results On D21, there were significantly fewer rebounds in the dogs receiving prednisolone (three of 20, 15%) compared to those given oclacitinib alone (nine of 20, 45%; Fisher's test, p = 0.041). Compared to oclacitinib monotherapy, the concurrent administration of prednisolone for the first 4 days led to significantly lower PVAS10 on D4 and D28, CADESI4 and 2D-IGA on D28, and OGATE on D21 and D28 (Wilcoxon-Mann-Whitney U-tests). Adverse effects of therapy were minor, intermittent and self-resolving. Conclusions and Clinical Relevance The initial addition of 4 days of prednisolone significantly decreased the probability of a rebound of pruritus 1 week after oclacitinib dose reduction. This short concomitant glucocorticoid administration led to a higher skin lesion improvement and improved perception of treatment efficacy with minimal adverse effects.

Published in

Veterinary Dermatology
2023, volume: 34, number: 1, pages: 99-106
Publisher: WILEY

Authors' information

Olivry, Thierry
University of North Carolina
Lokianskiene, Viktorija
VetPet LT
Blanco, Alejandro
San Antonio de Padua
Del Mestre, Pablo
Consultorio Dermatol Vet
Swedish University of Agricultural Sciences, Department of Clinical Sciences
Beco, Luc
Cabinet Vet

UKÄ Subject classification

Clinical Science

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