Behandlungsmöglichkeiten für kanine atopische Dermatitis

Zusammenfassung

In dieser Übersicht wird Evidenz für wirksame Behandlungen der kaninen atopischen Dermatitis auf der Basis randomisierter kontrollierter Studien zusammengefasst. Neben der Vermeidung von auslösenden Faktoren, der allergenspezifischen Immuntherapie, einer guten Flohkontrolle, diätetischen Maßnahmen, der Supplementierung von essen-ziellen Fettsäuren und Anwendung von Shampoos können bei schwereren Fällen lokal oder systemisch applizierte Glukokortikoide oder Calcineurinhemmer wie Zyklosporin oder Takrolimus als Therapeutika Anwendung finden. Zur Rezidivprophylaxe kann die langfristige Gabe der oben genannten Medikamente bzw eine intermittierende Behandlung mit topisch angewendeten oder niedrig dosierten systemisch applizierten Glukokortikoiden hilfreich sein. Durch Fettsäuren und Antihistaminika lässt sich die zur Kontrolle der Symptome benötigte Glukokortikoiddosis reduzieren.

Summary

In this review evidence for efficacious treatments of canine atopic dermatitis is summarized on the basis of randomised controlled studies. For severely affected cases topical or systemic glucocorticoids or calcineurin inhibitors such as cyclosporin or tacrolimus can be used in addition to avoidance of flare factors, allergen-specific immunotherapy, a good flea control, dietetic measures, essential fatty acids and shampoos. To prevent recurrences long-term use of especially allergen-specific immunotherapy, essential fatty acids and antihistamines can be helpful. In some cases intermittent therapy with topical or systemic glucocorticoids at low dose may also be useful. Essential fatty acids and antihistamines may reduce the needed glucocorticoid dose.

Schlüsselwörter

Hund - atopische Dermatitis - Therapie - evidenzbasiert

Key words

Dog - atopic dermatitis - therapy - evidence-based

• Literatur

• 1 Bensignor E, Olivry T. Treatment of localized lesions of canine atopic dermatitis with tacrolimus ointment: a blinded randomized controlled trial. Vet Dermatol 2005; 16: 52-60.
• 2 Bizikova P, Linder K, Paps JS. Effect of a novel topical diester glucocorticoid spray on immerdiate and late phase cutaneous allergic reactions in maltese-beagle atopic dogs: A placebo-controlled, cross-over study. Vet Dermatol 2010; 21: 71-80.
• 3 Bizikova P, Papich MG, Olivry T. Hydroxyzine and cetirizine pharmacokinetics and pharmacodynamics after oral and intravenous administration of hydroxyzine to healthy dogs. Vet Dermatol 2008; 19: 348-357.
• 4 Carlotti DN, Boulet M, Ducret J. et al. The use of recombinant omega inter-feron therapy in canine atopic dermatitis: A double-blind controlled study. Vet Dermatol 2009; 20: 405-411.
• 5 Carlotti DN, Madiot G, Ducret J. Use of recombinant canine interferon-gamma in canine atopic dermatitis (Abstract). Vet Dermatol 2004; 15: 32
• 6 Codner EC, Tinker MK. Reactivity to intradermal injections of extracts of house dust and housedust mite in healthy dogs and dogs suspected of being atopic. J Am Vet Med Assoc 1995; 206: 812-816.
• 7 De Vos C, Maleux MR, Baltes E, Gobert J. Inhibition of histamine and allergen skin wheal by cetirizine in four animal species. Ann Allergy 1987; 59: 278-282.
• 8 DeBoer DJ, Hillier A. The ACVD task force on canine atopic dermatitis (XVI): laboratory evaluation of dogs with atopic dermatitis with serum-based „allergy“ tests. Vet Immunol Immunopathol 2001; 81: 277-287.
• 9 DeBoer DJ, Hillier A. The ACVD taskforce on canine atopic dermatitis (XV): Fundamental concepts in clinical diagnosis. Vet Immunol Immunopathol 2001; 81: 271-276.
• 10 DeBoer DJ, Marsella R. The ACVD task force on canine atopic dermatitis (XII): the relationship of cutaneous infections to the pathogenesis and clinical course of canine atopic dermatitis. Vet Immunol Immunopathol 2001; 81: 239-249.
• 11 Ewert G, Daems T. Treatment of canine atopic dermatitis by a fatty acid co-polymer: comparative double blind study. Prat Med Chir Anim Comp 2001; 36: 401-408.
• 12 Favrot C, Steffan J, Seewald W. A prospective study on the clinical features of chronic atopic dermatitis and its diagnosis. Vet Dermatol 2010; 21: 23-31.
• 13 Glos K, Linek M, Loewenstein C, Mayer U, Mueller RS. The efficacy of commercially available veterinary diets recommended for dogs with atopic dermatitis. Vet Dermatol 2008; 19: 280-287.
• 14 Gotzsche PC, Johansen HK. House dust mite control measures for asthma: systematic review. Allergy 2008; 63: 646-659.
• 15 Griffin CE, DeBoer DJ. The ACVD Taskforce on canine atopic dermatitis (XIV): clinical manifestations of canine atopic dermatitis. Vet Immunol Immunopathol 2001; 81: 255-269.
• 16 Griffin CE, Hillier A. The ACVD task force on canine atopic dermatitis (XXIV): allergen-specific immunotherapy. Vet Immunol Immunopathol 2001; 81: 363-383.
• 17 Hanifin J, Gupta AK, Rajagopalan R. Intermittent dosing of fluticasone propionate cream for reducing the risk of relapse in atopic dermatitis patients. Br J Dermatol 2002; 147: 528-537.
• 18 Hansson H, Bergvall K, Bondesson U, Hedeland M, Torneke K. Clinical pharmacology of clemastine in healthy dogs. Vet Dermatol 2004; 15: 152-158.
• 19 Hillier A, DeBoer DJ. The ACVD task force on canine atopic dermatitis (XVII): intradermal testing. Vet Immunol Immunopathol 2001; 81: 289-304.
• 20 Loewenstein C, Mueller RS. A review of allergen-specific immunotherapy in human and veterinary medicine. Vet Dermatol 2009; 20: 84-98.
• 21 Marsella R, Girolomoni G. Canine models of atopic dermatitis: a useful tool with untapped potential. J Invest Dermatol 2009; 129: 2351-2357.
• 22 Marsella R, Nicklin CF. Investigation on the use of 0.3% tacrolimus lotion for canine atopic dermatitis: a pilot study. Vet Dermatol 2002; 13: 203-210.
• 23 Masuda K, Sakaguchi M, Fujiwara S. et al. Positive reactions to common allergens in 42 atopic dogs in Japan. Vet Immunol Immunopathol 2000; 73: 193-204.
• 24 Miller WHJ. et al. A clinical trial on the efficacy of clemastine in the management of allergic pruritus in dogs. Can Vet J 1993; 34: 25
• 25 Morales CA, Schultz KT, DeBoer DJ. Antistaphylococcal antibodies in dogs with recurrent staphylococcal pyoderma. Vet Immunol Immunopathol 1994; 42: 137-147.
• 26 Morris DO, Olivier NB, Rosser EJ. Type-1 hypersensitivity reactions to Malassezia pachydermatis extracts in atopic dogs. Am J Vet Res 1998; 59: 836-841.
• 27 Mueller RS. Futterunverträglichkeit bei der Katze. Tierärztl Prax 2007; 35 (K) 441-446.
• 28 Mueller RS, Bettenay SV, Tideman L. Aero-allergens in canine atopic dermatitis in southeastern Australia based on 1000 intradermal skin tests. Aust Vet J 2000; 78: 392-399.
• 29 Mueller RS, Fieseler KV, Rosychuk RA, Greenwalt T. Intradermal testing with the storage mite Tyrophagus putrescentiae in normal dogs and dogs with atopic dermatitis in Colorado. Vet Dermatol 2005; 16: 27-31.
• 30 Nuttall T, Mueller R, Bensignor E. et al. Efficacy of a 0.0584% hydrocorti -sone aceponate spray in the management of canine atopic dermatitis: a rando mised, double blind, placebo-controlled trial. Vet Dermatol 2009; 20: 191-198.
• 31 Olivry T, Bizikova P. A systematic review of the evidence of reduced aller -genicity and clinical benefit of food hydrolysates in dogs with cutaneous adverse food reactions. Vet Dermatol 2010. in press
• 32 Olivry T, DeBoer DJ, Favrot C. et al. Treatment of Canine Atopic Dermatitis: 2010; Clinical Practice Guidelines from the International Task Force on Canine Atopic Dermatitis. Vet Dermatol 2010; 21: 233-248.
• 33 Olivry T, Deboer DJ, Prelaud P, Bensignor E. Food for thought: pondering the relationship between canine atopic dermatitis and cutaneous adverse food reactions. Vet Dermatol 2007; 18: 390-391.
• 34 Olivry T, Foster AP, Mueller RS, McEwan NA, Chesney C, Williams HC. Interventions for atopic dermatitis in dogs: A systematic review of randomized controlled trials. Vet Dermatol 2010; 21: 4-22.
• 35 Olivry T, Marsella R, Iwasaki T, Mueller R. Validation of CADESI-03, a severity scale for clinical trials enrolling dogs with atopic dermatitis. Vet Dermatol 2007; 18: 78-86.
• 36 Olivry T, Mueller R, Nuttall T, Favrot C, Prelaud P. Determination of CADESI-03 thresholds for increasing severity levels of canine atopic dermatitis. Vet Dermatol 2008; 19: 115-119.
• 37 Paradis M. et al. The efficacy of clemastine (Tavist), a fatty acid-containing product (DVM Derm Caps), and the combination of both products in the management of canine pruritus. Vet Dermatol 1991; 2: 17
• 38 Paradis M, Scott DW, Giroux D. Further investigations on the use of nonsteroidal and steroidal anti-inflammatory agents in the management of canine pruritus. J Am Anim Hosp Assoc 1991; 27: 44
• 39 Piekutowska A, Pin D, Reme CA, Gatto H, Haftek M. Effects of a topically ap-plied preparation of epidermal lipids on the stratum corneum barrier of atopic dogs. J Comp Pathol 2008; 138: 197-203.
• 40 Raffan E, Lawrence H, Henderson T. et al. Prevalence of the group 1 Dermatophagoides allergens Der p 1 and Der f 1 in homes with no dogs, healthy dogs and Dermatophagoides-sensitized atopic dogs in Liverpool. Vet Dermatol 2005; 16: 253-260.
• 41 Reme CA, Dufour P. Repeated daily application of 0.0584% hydrocortisone aceponate spray for 8 consecutive weeks in dogs: Impact on skin thickness (Abstract). Vet Dermatol 2008; 19: 47
• 42 Saevik BK, Bergvall K, Holm BR. et al. A randomized, controlled study to evaluate the steroid sparing effect of essential fatty acid supplementation in the treatment of canine atopic dermatitis. Vet Dermatol 2004; 15: 137-145.
• 43 Schmidt V, McEwan NA, Volk A. The glucocorticoid-sparing efficacy of phytopica in the management of canine atopic dermatitis: A randomised, double blind, placebo-controlled trial. Vet Dermatol 2010; 21: 97-105.
• 44 Schnabl B, Bettenay SV, Dow K, Mueller RS. Results of allergen-specific immunotherapy in 117 dogs with atopic dermatitis. Vet Rec 2006; 158: 81-85.
• 45 Sousa CA, Halliwell RE. The ACVD task force on canine atopic dermatitis (XI): the relationship between arthropod hypersensitivity and atopic dermatitis in the dog. Vet Immunol Immunopathol 2001; 81: 233-237.
• 46 Steffan J, Favrot C, Mueller RS. A systematic review and meta-analysis of the eficacy of cyclosporine for the treatment of canine atopic dermatitis. Vet Dermatol 2006; 17: 3-16.
• 47 Swinnen C, Vroom M. The clinical effect of environmental control of house dust mites in 60 house dust mite-sensitive dogs. Vet Dermatol 2004; 15: 31-36.
• 48 Thelen A, Mueller RS, Linek M, Peters S, Stechmann K, Steffan J. Influence of food intake on the clinical response to cyclosporin A in canine atopic dermatitis. Vet Rec 2006; 159: 854-856.
• 49 Thom N, Neiger R, Linek M. Diagnostic specificity of the Fcε-receptor based allergy screening test. Tierärztl Prax 2009; 37 (K) 239-243.
• 50 Yasukawa K, Saito S, Kubo T. Low-dose recombinant canine interferon-gamma for treatment of canine atopic dermatitis: An open randomized comparative trial of two doses. Vet Dermatol 2010; 21: 42-49.
• 51 Zimmer A, Mueller RS. Futterunverträglichkeit beim Hund. Kleintierprax 2007; 11: 692-701.