In dogs with atopic skin disease, is lokivetmab more effective than oclacitinib in reducing the Canine Atopic Dermatitis Lesion Index score (or some other recognised scoring system)?
Clinical bottom line
Category of research question
The number and type of study designs reviewed
One randomised controlled trial and one before and after study were critically appraised
Strength of evidence
One randomised controlled trial studied the effects of lokivetmab and oclacitinib and found that both drugs were similar in reducing the Canine Atopic Dermatitis Lesion Index (CADESI-03) score.
An additional study was evaluated but had non-standardised data as it was a before-and-after study on use of lokivetmab. The paper noted that dogs’ response to oclacitinib can be used to predict how well these dogs respond to lokivetmab. This study also reported a reduction in Pruritus Visual Analog Scale (PVAS) score between before and after lokivetmab administration
In view of the strength of evidence and outcomes from the studies, there is insufficient quality of evidence to answer the PICO question and so further comparative study is required
The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
Bensignor, E. & Videmont, E. (2021). Weekly topical therapy based on plant extracts combined with lokivetmab in canine atopic dermatitis. Veterinary Dermatology. 33(1), 1–6. DOI: https://doi.org/10.1111/vde.13004
Van Brussel, L., Moyaert, H., Escalada, M., Mahabir, S.P. & Stegemann, M.R. (2021). A masked, randomised clinical trial evaluating the efficacy and safety of lokivetmab compared to saline control in client‐owned dogs with allergic dermatitis. Veterinary Dermatology. 32(5), 477–e131. DOI: https://doi.org/10.1111/vde.12984
Cosgrove, S.B., Wren, J.A., Cleaver, D.M., Walsh, K.F., Follis, S.I., King, V.I., Tena, J.K.S. & Stegemann, M.R. (2013). A blinded, randomized, placebo-controlled trial of the efficacy and safety of the Janus kinase inhibitor oclacitinib (Apoquel®) in client-owned dogs with atopic dermatitis. Veterinary Dermatology. 24(6), 587–597. DOI: https://doi.org/10.1111/vde.12088
Fleck, T.J., Bammert, G., Shelly, J., Fici, G., Walters, R.R., Mahabir, S., Michels, G.M., Rugg, J.J., Martinon, O. & Dunham, S. (2015). Identification and characterization of ZTS-00103289, a monoclonal antibody neutralizing interleukin-31-mediated pruritus, in beagle dogs (abstract). Veterinary Dermatology., 26(3), 133–159.
Gortel, K. (2018). An embarrassment of riches: An update on the symptomatic treatment of canine atopic dermatitis. Canadian Veterinary Journal. 59(9): 1013–1016.
Halliwell, R. (2006). Revised nomenclature for veterinary allergy. Veterinary Immunology and Immunopathology. 114(3–4), 207–208. DOI: https://doi.org/10.1016/j.vetimm.2006.08.013
Hill, P.B., Lau, P. & Rybnicek, J. (2007). Development of an owner-assessed scale to measure the severity of pruritus in dogs. Veterinary Dermatology. 18(5), 301–308. DOI: https://doi.org/10.1111/j.1365-3164.2007.00616.x
Marsella, R. & Ahrens, K. (2018). A pilot study on the effect of oclacitinib on epicutaneous sensitization and transepidermal water loss in a colony of atopic beagle dogs. Veterinary Dermatology. 29(5), 439–e146. DOI: https://doi.org/10.1111/vde.12660
Marsella, R., Ahrens, K., Wilkes, R., Trujillo, A. & Dorr, M. (2020). Comparison of various treatment options for canine atopic dermatitis: a blinded, randomized, controlled study in a colony of research atopic beagle dogs. Veterinary Dermatology. 31(4), 284–e69. DOI: https://doi.org/10.1111/vde.12849
Michels, G.M., Ramsey, D.S., Walsh, K.F., Martinon, O.M., Mahabir, S.P., Hoevers, J.D., Walters, R.R. & Dunham, S.A. (2016a). A blinded, randomized, placebo-controlled, dose determination trial of lokivetmab (ZTS-00103289), a caninized, anti-canine IL-31 monoclonal antibody in client owned dogs with atopic dermatitis. Veterinary Dermatology. 27(6), 478–e129. DOI: https://doi.org/10.1111/vde.12376
Michels, G.M., Walsh, K.F., Kryda, K.A., Mahabir, S.P., Walters, R.R., Hoevers, J.D. & Martinon, O.M. (2016b). A blinded, randomized, placebo-controlled trial of the safety of lokivetmab (ZTS-00103289), a caninized anti-canine IL-31 monoclonal antibody in client-owned dogs with atopic dermatitis. Veterinary Dermatology.27(6), 505–e136. DOI: https://doi.org/10.1111/vde.12364
Moyaert, H., Van Brussel, L., Borowski, S., Escalada, M., Mahabir, S.P., Walters, R.R. & Stegemann, M.R. (2017). A blinded, randomized clinical trial evaluating the efficacy and safety of lokivetmab compared to ciclosporin in client-owned dogs with atopic dermatitis. Veterinary Dermatology. 28(6), 593–e145. DOI: https://doi.org/10.1111/vde.12478
Olivry, T., Rivierre, C., Jackson, H.A., Murphy, K.M., Davidson, G. & Sousa, C.A. (2002). Cyclosporine decreases skin lesions and pruritus in dogs with atopic dermatitis: A blinded randomized prednisolone-controlled trial. Veterinary Dermatology. 13(2), 77–87. DOI: https://doi.org/10.1046/j.1365-3164.2002.00283.x
Olivry, T., Marsella, R., Iwasaki, T., Mueller, R., Bensignor, E., Carlotti, D., DeBoer, D.J., Griffin, C., Halliwell, R., Hammerberg, B., Hill, P., Jackson, H., Maeda, S., Masuda, K., Nuttall, T., Prélaud, P., Sousa, C. & Willemse, T. (2007). Validation of CADESI-03, a severity scale for clinical trials enrolling dogs with atopic dermatitis. Veterinary Dermatology. 18(2), 78–86. DOI: https://doi.org/10.1111/j.1365-3164.2007.00569.x
Olivry, T., Saridomichelakis, M., Nuttall, T., Bensignor, E., Griffin, C.E. & Hill, P.B. (2014). Validation of the Canine Atopic Dermatitis Extent and Severity Index (CADESI)-4, a simplified severity scale for assessing skin lesions of atopic dermatitis in dogs. Veterinary Dermatology. 25(2), 77–86. DOI: https://doi.org/10.1111/vde.12107
Olivry, T., DeBoer, D.J., Favrot, C., Jackson, H.A., Mueller, R.S., Nuttall, T. & Prélaud, P. (2015). Treatment of canine atopic dermatitis: 2015 updated guidelines from the International Committee on Allergic Diseases of Animals (ICADA). BMC Veterinary Research. 11(1), 1–15. DOI: https://doi.org/10.1186/s12917-015-0514-6
Souza, C.P., Rosychuk, R.A.W., Contreras, E.T., Schissler, J.R. & Simpson, A.C. (2018). A retrospective analysis of the use of lokivetmab in the management of allergic pruritus in a referral population of 135 dogs in the western USA. Veterinary Dermatology. 29(6), 489–e164. DOI: https://doi.org/10.1111/vde.12682
Steffan, J., Alexander, D., Brovedani, F. & Fisch, R.D. (2003). Comparison of cyclosporine A with methylprednisolone for treatment of canine atopic dermatitis: A parallel, blinded, randomized controlled trial. Veterinary Dermatology. 14(1), 11–22. DOI: https://doi.org/10.1046/j.1365-3164.2003.00318.x
Szczepanik, M., Wilkołek, P., Gołyński, M., Sitkowski, W., Taszkun, I. & Toczek, W. (2019). The influence of treatment with lokivetmab on transepidermal water loss (TEWL) in dogs with spontaneously occurring atopic dermatitis. Veterinary Dermatology. 30(4), 330–e93. DOI: https://doi.org/10.1111/vde.12758
Szczepanik, M.P., Popiel, J., Cekiera, A., Pomorska-Handwerker, D., Karaś-Tęcza, J., Ściskalska, M., Oczkowska, K., Taube, M., Olender, V. & Parys, P. (2020). Evaluation of the clinical efficiency of lokivetmab in client privately owned atopic dogs – multicenter study. Polish Journal of Veterinary Sciences. 23(2), 191–195. DOI: https://doi.org/10.24425/pjvs.2020.132765
Zoetis. (2017). 'CYTOPOINT® SOLUTION FOR INJECTION FOR DOGS'. AH430/17 datasheet, June 2017. [online] Available from: https://www.zoetis.co.uk/products/dogs/cytopoint/img/cytopoint_dosing_chart.pdf [Accessed 5 Jan 2022].
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