Just got back from the Derm Vet with Cinco, my itchy boy.

The FDA has recently approved a new drug to treat pruritus in dogs--Apoquel (oclacitinib) tablets. It is apparently being called the new "miracle drug" by Derm vets. It is not a steroid, antihistamine, or cyclosporin, but rather targets the itch receptors, with little to no impact on immune function. (I've done a lot of reading about this stuff in the last couple of days, and it really does look like a promising option--and a totally novel approach to treating itching.)

It hasn't officially come on the market yet--it's due for release in first quarter 2014. But my Derm vet had a small quantity of preview samples. Enough to start Cinco and continue until the med is widely available. He gets his first dose with dinner tonight. In clinical trials, most dogs showed symptom relief within hours of the first dose.

I'll keep you posted on how it goes. Fingers crossed.

My GP vet mentioned this to me a couple of weeks ago, too.

Here's one of the papers on it she pointed me to: http://www.ncbi.nlm.nih.gov/pubmed/23829933

It's the most exciting thing in dog-derm I have heard about in many years.

Yes, there are potential side effects (as with almost everything): http://news.zoetis.com/press-release/companion-animals/fda-approves-apoquel-oclacitinib-tablet-control-itch-and-inflammatio

But to finally have something like this seems almost like a miracle to me (and probably to anyone who has owned dogs with the misery and frustration of atopy).

Tracy, my fingers are crossed, too!

I have really good feelings about it, though.

At my Derm vet's practice, Cinco is the fifth dog that he has given some of these early-release pills to. Was told that the most common side effect is upset stomach, so give with food. But none of the other four dogs he prescribed had any issues.

They must have taken it down already, but the other day on the Zoetis web site were a whole bunch of videos from a Derm Vet conference where they were giving presentations on the trials of Apoquel. It was all pretty science-geeky stuff...but I sat through all of it, and was mighty impressed at the results they were seeing. Even at 5x label dosing, laboratory dogs' bloodwork remained within normal levels. The biggest issue with the drug is that it is only approved for dogs over 12 months of age. Among test dogs, an unacceptable percentage of younger dogs developed bacterial complications (probably due to immature immune systems.)

Is this supposed to be better than Atopica?

Many of the serious potential long-term side effects of Cyclosporine are avoided or significantly lessened .... a huge benefit even if it was less effective. But in tests, it is not less effective. (I'm not saying it doesn't have side effects .... see above .... just that they appear to be far less serious and/or less frequent.)

I completely get why Cyclosporine is used, and also why Pred is used .... atopy can leave a dog with terribly lowered quality of life, and some dogs just aren't helped enough by careful management, long-chain Omega 3s, frequent bathing, avoidance/removal of allergens, etc., to have acceptable life quality without an assist from the big guns of Pred or Cyclosporine.

But with both, it's a constant weighing of pros and cons.

To my mind, this is a big breakthrough.

All JMO!

Another key attribute of this new drug is that its effects are reversible. If the dog stops taking the medicine, any harm (or help) the drug was doing goes away. It doesn't accumulate in the body, or (as far as research knows on any new drug) doesn't negatively impact other body systems--like the liver/kidney damage that steroids and cyclosporin can sometimes cause.

I think all anyone can say about this new drug so far is this: in lab-tested dogs, and in blind clinical trials, the drug was highly effective in quickly reducing itching. At label dosing, there was negligible effects on hemoglobin and white blood cell levels...and at even 5x dosing (five times the recommended dosage which the FDA requires they give to laboratory test dogs) blood work remained within normal levels.

This new drug works differently than any other drug that has been available in the past. Prednisone/prednisolone and cyclosporin (Atopica) are powerful immune suppressants. They are basically suppressing the dog's entire immune response in order to tamp down the inflammation caused by the allergen. Antihistamines (dozens of them) all basically try to mediate the chemical response caused by histamine receptors in the dogs skin. They should work, but they don't work very reliably in most dogs.

Apoquel is a so-called JAK-1 inhibitor, which only targets the "itch receptors" without suppressing the dog's whole immune system.

My Derm vet is somebody that I think is very knowledgeable in this specialty--and he seems pretty excited to have a new option for patients.

I found all the video presentations. There's a lot to wade through here, but lots of info for those who want to know more about this new drug; how it works, clinical trial results, etc.

https://online.zoetis.com/US/EN/Products/Pages/Apoquel/index.aspx#sthash.UG5J1CGk.dpbs

Thanks. I am going to email this to a friend with a very itchy Lab.

 Quote: Tracy Collins

Just got back from the Derm Vet with Cinco, my itchy boy.

The FDA has recently approved a new drug to treat pruritus in dogs--Apoquel (oclacitinib) tablets. It is apparently being called the new "miracle drug" by Derm vets. It is not a steroid, antihistamine, or cyclosporin, but rather targets the itch receptors, with little to no impact on immune function. (I've done a lot of reading about this stuff in the last couple of days, and it really does look like a promising option--and a totally novel approach to treating itching.)

It hasn't officially come on the market yet--it's due for release in first quarter 2014. But my Derm vet had a small quantity of preview samples. Enough to start Cinco and continue until the med is widely available. He gets his first dose with dinner tonight. In clinical trials, most dogs showed symptom relief within hours of the first dose.

I'll keep you posted on how it goes. Fingers crossed.

Tracy, do you know what the cost of this drug is?? My derma vet was the clinic that did the clinical studies on it, and she told me about it 6 months ago. I'm on the list of people that will try the drug if I want to, but she's out on conference till next Tuesday, so I haven't heard from her yet. Last time we talked she said the drug company would only tell her that they would be cheaper than Atopica, but more than steroids - that's a big spread!! I'm thinking this could be rather costly for an 86lb dog! They also said that they keep the dogs on allergy shots while on this new drug - so that means paying for the allergy serum AND the new drug.

http://www.itchnot.com/images/Apoquel_PI.pdf

There's the dosing chart for Apoquel. I don't have the receipt from this morning's vet visit with me, but I remember being pleasantly surprised at getting out of there for under $100, including the office visit. (and we got several weeks worth of medicine.)

With your dog, looks like you'd be doing 1 of the 16 mg. tablets as your dose. With Cinco, he was on the borderline of the dosage weights, so the vet is having him do half of the 16 mg and half of of the 3.6 mg pills.

I discussed immunotherapy with the vet this morning as well. He's certainly open to it--and claims it's about 70% effective. But if the Apoquel works (knock on wood), then I'll consider the problem solved. If not, maybe we'll consider pursuing immunotherapy in the future. This vet uses an oral med for immunotherapy vs. injections.

eta: I'll check my receipt for the vet visit when I get home later and report back what I paid for the Apoquel.