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短期联合局部免疫治疗和 Lokivetmab 治疗犬特应性皮炎的疗效:一项双盲、对照、随机研究。

Efficacy of short-term combination of intralymphatic allergen immunotherapy and lokivetmab treatment in canine atopic dermatitis: A double-blinded, controlled, randomised study.

机构信息

IVC Evidensia Netherlands, Evidensia Dierenziekenhuis Arnhem, Arnhem, the Netherlands.

University Utrecht, Utrecht, the Netherlands.

出版信息

Vet Dermatol. 2023 Oct;34(5):373-384. doi: 10.1111/vde.13165. Epub 2023 Apr 26.

Abstract

BACKGROUND

Allergen-specific immunotherapy (ASIT) is an effective therapy for canine atopic dermatitis (cAD). Intralymphatic immunotherapy (ILIT) is potentially beneficial in decreasing time to clinical effectiveness.

OBJECTIVE

To compare clinical efficacy of six monthly ILIT injections combined with three monthly injections of lokivetmab (LVM) with monthly LVM monotherapy at Day (D)168. To monitor dogs treated with ILIT for an additional six months of subcutaneous immunotherapy (SCIT).

ANIMALS

Thirty-six client-owned dogs with cAD.

MATERIALS AND METHODS

In this double-blinded, randomised study, dogs received either six monthly injections of ILIT combined with three monthly LVM injections (ILIT group) or six monthly LVM injections (LVM group). Monthly evaluations with pruritus Visual Analogue Scale (pVAS), Canine Atopic Dermatitis Extent and Severity Index, 4th iteration (CADESI-04) and medication scores (MS) were undertaken. Owners completed a Quality of Life (QoL) questionnaire. Treatment success was predefined as ≥50% reduction in pVAS and CADESI-04 score ≤ 10. After D168, the ILIT group continued with SCIT until subjective assessment at 12 months.

RESULTS

The treatment benchmark at D168 was achieved by 11.1% of the ILIT group and 11.8% of LVM group. A significant decrease in mean pVAS and CADESI scores was observed in both groups (p < 0.001). The ILIT group had a trend towards higher MS compared to LVM. QoL was better in LVM (p = 0.01). At 12 months subjective good-to-excellent response in 77.8% of dogs in the ILIT/SCIT group was seen.

CONCLUSION AND CLINICAL RELEVANCE

The efficacy of this ILIT protocol was comparable with LVM monotherapy at six months. When ILIT was continued with SCIT, a favourable response was seen.

摘要

背景

变应原特异性免疫疗法(ASIT)是治疗犬过敏性皮炎(cAD)的有效方法。淋巴内免疫疗法(ILIT)在缩短临床疗效时间方面可能具有优势。

目的

比较 168 天(D)时 6 个月 ILIT 注射联合 3 个月洛维莫司(LVM)注射与每月 LVM 单药治疗的临床疗效。监测接受 ILIT 治疗的犬接受额外 6 个月皮下免疫治疗(SCIT)的情况。

动物

36 只患有 cAD 的患犬。

材料和方法

在这项双盲、随机研究中,犬接受 6 个月 ILIT 注射联合 3 个月 LVM 注射(ILIT 组)或 6 个月 LVM 注射(LVM 组)。每月评估瘙痒视觉模拟量表(pVAS)、犬过敏性皮炎严重程度指数第 4 次迭代(CADESI-04)和药物评分(MS)。主人完成生活质量(QoL)问卷。治疗成功定义为 pVAS 和 CADESI-04 评分降低≥50%且≤10。D168 后,ILIT 组继续进行 SCIT,直到 12 个月时进行主观评估。

结果

ILIT 组和 LVM 组分别有 11.1%和 11.8%的犬在 D168 时达到治疗基准。两组的 pVAS 和 CADESI 评分均显著降低(p<0.001)。与 LVM 相比,ILIT 组的 MS 有升高趋势。LVM 的 QoL 更好(p=0.01)。在 12 个月时,ILIT/SCIT 组 77.8%的犬主观反应良好至极好。

结论和临床相关性

该 ILIT 方案的疗效在 6 个月时与 LVM 单药治疗相当。当 ILIT 继续进行 SCIT 时,可获得有利的反应。

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