Comparable efficacy of a topical 0.0584% hydrocortisone aceponate spray and oral ciclosporin in treating canine atopic dermatitis

This study compared the efficacy of a 0.0584% hydrocortisone aceponate (HCA) spray (Cortavance (R); Virbac SA) and ciclosporin (Atopica (R); Novartis Animal Health) in canine atopic dermatitis in a single-blind randomized controlled trial. Dogs received HCA (two sprays/100 cm2; n = 24) or ciclosporin (5 mg/kg; n = 21). Canine Atopic Dermatitis Extent and Severity Index (CADESI)-03, pruritus (visual analog scale with grade descriptors) and owner scores (5-point scales) were recorded every 28 days for 84 days. Intention-to-treat data were analysed. CADESI-03 and pruritus significantly decreased over time (P < 0.0001), but there was no difference between the treatment groups (P = 0.91 and P = 0.52, respectively). Similar proportions of HCA- and ciclosporin-treated dogs achieved =50% reductions in CADESI-03 and pruritus scores at 28 days (CADESI-03 58.3 and 57.1%, P = 0.76; pruritus 33.3 and 38.1%, P = 1.0), 56 days (CADESI-03 70.8 and 81.0%, P = 1.0; pruritus 62.5 and 57.1%, P = 1.0) and 84 days (CADESI-03 75 and 85.7%, P = 0.72; pruritus 65.2 and 57.1%, P = 0.76). The CADESI-03 and pruritus scores were close to equivalence (0.47 and 0.51, respectively). By 84 days, every-other-day or twice-weekly therapy was achieved in 13 of 24 HCA- and 12 of 21 ciclosporin-treated dogs (P = 0.85). There were no significant differences in scores for efficacy (P = 0.82), tolerance (P = 0.62) and ease of administration (P = 0.25). Scores for tolerance (0.49) and administration (0.46) were close to equivalence. The score for efficacy favoured HCA (0.68). Mild adverse events were noted in six of 21 ciclosporin and none of 24 HCA dogs (P = 0.008). Five HCA-treated dogs and three ciclosporin-treated dogs were prematurely withdrawn (P = 0.7). In conclusion, HCA and ciclosporin proved equally effective in treating canine atopic dermatitis for up to 84 days.