Epicutaneous immunotherapy as a new hope for canine atopic dermatitis: a
proof-of-concept study
Abstract
Background – Allergen immunotherapy is a well-established
treatment for canine atopic dermatitis (CAD), but non-invasive, safe,
effective, and easy-to-use home-administration routes that promote
owner’s compliance are needed. Epicutaneous immunotherapy (EPIT) has
been suggested as a promising alternative treatment for human allergies.
This study primarily evaluated EPIT’s feasibility, effectiveness, and
safety for CAD. Methods – Sixteen client-owned dogs with
spontaneous, nonseasonal, mite-sensitive CAD were enrolled for a
6-month, once-weekly, 12-hour EPIT. A costume-made 3D-printed device was
designed to deliver the allergen-based formulation. Primary efficacy
outcomes included the owner’s assessed pruritus (PVAS10) and treatment
efficacy (OGATE), and veterinarian-assessed skin lesions (2D-IGA).
Secondary efficacy outcomes were the quality-of-life (QoL) and
serological allergen-specific IgE’s concentrations. Effectiveness was
defined by the success of the primary efficacy outcomes, according to
the ICADA’s COSCAD’18 recommendations. EPIT was deemed safe in the
absence of severe side-effects. Results – EPIT effectively
improved clinical condition, with a success rate of 73.3% for pruritus,
66.7% for skin lesions, and 93.3% for QoL. A good-to-excellent
response to EPIT was rated by 93.3% of owners in OGATE. EPIT
significantly improved PVAS10 (p=0.000015), 2D-IGA (p=0.006) and QoL
(p=0.000014) scores over six months. A significant difference was
evident within one month for PVAS10 (p=0.003) and 2D-IGA (p=0.009)
scores. Seven dogs partially desensitised to at least one mite and two
fully desensitised to all mites after six months. Severe adverse events
were not recorded. Conclusions – This pioneer study emphasises
EPIT’s potential as a novel and promising, non-invasive, feasible,
effective, safe, and well-tolerated CAD treatment, supporting further
investigation.