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- Author or Editor: Jean Steffan x
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Abstract
Objective—To determine efficacy and safety of cyclosporine in the treatment of atopic dermatitis among dogs in North America.
Design—Randomized controlled (phase 1) and openlabel (phase 2) trials.
Animals—268 dogs with atopic dermatitis.
Procedure—In phase 1, dogs were randomly assigned to be treated with cyclosporine (5 mg/kg [2.3 mg/lb], PO, q 24 h) or a placebo. In phase 2, all dogs were treated with cyclosporine for 16 weeks. Frequency of cyclosporine administration was decreased if dogs improved clinically.
Results—At the end of phase 1, canine atopic dermatitis extent and severity index (CADESI) scores for dogs treated with cyclosporine were significantly lower than scores for control dogs. Percentage of dogs with severe pruritus decreased from 67% to 16% for the cyclosporine group but from 66% to only 61% for the control group. During phase 2, cyclosporine dosage was decreased to every-otherday administration in 39% of the dogs after 4 weeks. After 12 weeks, 22% of the dogs were treated twice weekly and 36% were treated every other day. After 16 weeks, CADESI score had decreased > 50% in 68% of the dogs and 47% of dogs had no or mild pruritus. The most frequent adverse reactions were gastrointestinal tract signs.
Conclusions and Clinical Relevance—Results suggest that cyclosporine is efficacious for the treatment of atopic dermatitis in dogs and that frequency of cyclosporine administration can be reduced following an initial induction period. The drug was well tolerated. (J Am Vet Med Assoc 2005:226:1855–1863)
Abstract
Objective—To evaluate efficacy of cyclosporine A, administered at either of 2 dosages, in dogs with atopic dermatitis (AD).
Design—Multicenter randomized controlled trial.
Animals—91 dogs with AD.
Procedure—Dogs were assigned to receive placebo (30 dogs), cyclosporine at a low dosage (2.5 mg/kg [1.1 mg/lb], PO, q 24 h for 6 weeks; 30 dogs), or cyclosporine at a high dosage (5.0 mg/kg [2.3 mg/lb], PO, q 24 h for 6 weeks; 31 dogs).
Results—After 6 weeks, mean percentage reductions, compared with baseline scores, in scores of lesion severity were 34, 41, and 67% for dogs treated with the placebo, cyclosporine at the low dosage, and cyclosporine at the high dosage, respectively. Similarly, mean percentage reductions in pruritus scores were 15, 31, and 45%, respectively. Percentage reductions in skin lesion and pruritus scores were significantly higher for dogs given cyclosporine at the high dosage than for dogs given the placebo. Treatment efficacy was significantly associated with whether dogs had a history of seasonal AD. Percentage reductions in skin lesion and pruritus scores were high for dogs treated with cyclosporine at the highest dosage that had a history of nonseasonal AD. Dogs in all groups with seasonal AD improved during the study period.
Conclusions and Clinical Relevance—Results suggest that oral administration of cyclosporine at a dosage of 5.0 mg/kg once daily is effective in reducing severity of pruritus and skin lesions in dogs with AD, especially those with nonseasonal disease. (J Am Vet Med Assoc 2002;221:370–377)
Abstract
Objective—To determine the optimal dosage of clomipramine for the treatment of urine spraying in cats.
Design—Randomized controlled multicenter clinical trial.
Animals—67 neutered cats.
Procedure—Cats with a minimum 1-month history of spraying urine against vertical surfaces at least twice per week were randomly assigned to be treated with a placebo or with clomipramine at a dosage of 0.125 to 0.25 mg/kg (0.057 to 0.11 mg/lb), 0.25 to 0.5 mg/kg (0.11 to 0.23 mg/lb), or 0.5 to 1 mg/kg (0.23 to 0.45 mg/lb), PO, every 24 hours for up to 12 weeks. Owners of all cats were given information on behavioral treatment and environmental modification.
Results—Prior to treatment, mean number of urine spraying events ranged from 0.9 to 1.3 urine spraying events/d for the 4 groups, and mean percentage of days with urine spraying events ranged from 62% to 69%. All 3 dosages of clomipramine were associated with significant reductions in frequency of urine spraying. Sedation was the most common adverse effect and was identified in 27 of the 50 cats treated with clomipramine; however, treatment was not discontinued in any cat because of sedation.
Conclusions and Clinical Relevance—Results of the present study suggest that compared with a placebo, clomipramine significantly reduces the frequency of urine spraying in cats in terms of the number of urine spraying events per day and the number of days with urine spraying events. For cats with urine spraying, the recommended initial dosage of clomipramine is 0.25 to 0.5 mg/kg, PO, every 24 hours. (J Am Vet Med Assoc 2004;225:881–887)
