apoquel

Re: apoquel

emma_j — Fri, 11 Apr 2014 14:15:28 GMT

Thanks Bob & Richard. I'm quite excited to see how this goes.

Re: apoquel

Bob Russell — Fri, 11 Apr 2014 12:48:15 GMT

Put them on Apoquel and reduce the steroids. Most on low dose, every other day should be ok to stop the preds pretty quickly!

Re: apoquel

Richard Carter — Fri, 11 Apr 2014 12:31:35 GMT

no - not related and apoquel not an anti-inflammatory (nsaid or steroid) so no interactions

Re: apoquel

emma_j — Fri, 11 Apr 2014 11:00:56 GMT

About to switch my first case!

Is there a set protocol for switching from pred to apoquel?

Re: apoquel

Bob Russell — Fri, 11 Apr 2014 09:47:33 GMT

I suspect it is cheaper to make a chart comparing things that happen (such as diarrhoea) in test animals and compare to placebo groups rather than spend time, effort and money checking whether that diarrhoea was related to drug administration.

I dread to think how many pages of side effects there would be if prednisolone required licencing today!

So far we have had no adverse reactions. I do admit to owners that it does seem a little too good to be true. Perhaps after five years on it dogs grow a second head. We will have to wait and see!

Re: apoquel

ChrisBVSc — Thu, 10 Apr 2014 20:54:09 GMT

Used it in 4 or 5 atopic dogs so far, no problems yet & excellent results (including one immunotherapy & ciclosporin non-responder with bad side effects on steroids, owner is very pleased!). My colleagues have had good success with it too, I think someone had a non-responder recently but overall it's getting the reputation of a bit of a wonder-drug here.

Re: apoquel

Stephen Courtney — Thu, 10 Apr 2014 20:25:20 GMT

side effects listed in the data sheet are remarkably similar both for placebo and for apoquel...

I've had one dog not respond, and from talking to some derm people at Congress, I g4et the impression that the number of poor responders is higher than zoetis will mention. but I.m still very very pleased with it.

Remember you also need to control other issues such as secondary pyoderma etc

Re: apoquel

Charlotte Marshall — Thu, 10 Apr 2014 15:04:07 GMT

Huh! So much for the guy on the stall at congress telling me the incidence of side effects was pretty much the same as the placebo group. Although to be fair he didn't say what these side effects were if seen :)

Re: apoquel

Bob Russell — Thu, 10 Apr 2014 10:10:59 GMT

A couple are not doing so well on the maintenance dose! One of these has a 2ary infection so is on antibiotics. Still pretty impressed!

Re: apoquel

Richard Carter — Thu, 10 Apr 2014 09:40:35 GMT

Had another 'failure' = atopic white boxer where the itch has stopped but the skin is still bright red, hair falling out and ears discharging - obviously need the anti-histamine effect as well

Re: apoquel

Anthony Todd — Thu, 20 Mar 2014 15:38:50 GMT

[quote user="Robin Grimmer"]Adverse reactions are not the same as side effects. Only a minority of dogs put on Apoquel will have an adverse reaction, but the drug company has to list them all.[/quote]

They are about the grimmest warnings I've ever read for a drug, let alone a comparatively new one, with obviously less anecdotal evidence.

Re: apoquel

Malcolm Ness — Thu, 20 Mar 2014 15:23:02 GMT

[quote user="Robin Grimmer"] Only a minority of dogs put on Apoquel will have an adverse reaction, but the drug company has to list them all.[/quote]

That is probably, and hopefully, true. However, if you go to the published data, you might be surprised how small is the clinical experience with this drug.

Re: apoquel

Anthony Todd — Wed, 19 Mar 2014 22:55:52 GMT

[quote user="Robin Grimmer"]However all dogs on preds will be pupd, polyphagic and long term will get iatrogenic Cushings if on high enough dose and possibly diabetes. [/quote]

Prejudice, like herpes, never dies.

Re: apoquel

Robin Grimmer — Wed, 19 Mar 2014 22:02:29 GMT

Adverse reactions are not the same as side effects. Only a minority of dogs put on Apoquel will have an adverse reaction, but the drug company has to list them all. However all dogs on preds will be pupd, polyphagic and long term will get iatrogenic Cushings if on high enough dose and possibly diabetes.

Re: apoquel

Anthony Todd — Wed, 19 Mar 2014 17:34:27 GMT

I knew I was right all the time.....

Pred's got it all the way, no side effects at all, comparatively.

Adverse reactions: Administration of single high doses are generally tolerated well, but medium to long term use may provoke reactions.

Corticosteroid therapy may lead to increased time in the healing of wounds and to a reduction in the ability of the body to resist infection. Appropriate anti-infective therapy may be required.

Use during pregnancy and lactation: Corticosteroids are not recommended for use in pregnant animals. Studies in laboratory animals have shown that administration during early pregnancy may cause foetal abnormalities. Administration during the later stages of pregnancy may cause abortion or early parturition.

Insignificant amounts of prednisolone are generally eliminated in the milk of lactating animals, and therefore such use is not contraindicated.

Interactions: There are no known interactions of significance in veterinary medicine.

Overdose: Signs of overdosage should be treated symptomatically.

Incompatibilities: There are no known incompatibilities.

Don't worry Mark, I'll stay retired, but just imagine if Apoquel had been going as long as steroids and "Pred" was introduced as the new wonder drug.

I'd love to hear and see the reactions to all the side effects of Apoquel which you are all supposed to warn clients about; they'll never let you use it!

Re: apoquel

Bob Russell — Wed, 19 Mar 2014 17:31:01 GMT

[quote user="Anthony Todd"]

Clinical observations that were considered likely to be related to oclacitinib treatment included: alopecia (local), papilloma, dermatitis, erythema, abrasions and scabbing/crusts, interdigital "cysts", and oedema of the paws. Dermatitis lesions were mostly secondary to the development of interdigital furunculosis on one or more paws during the study; the number and frequency of observations increased with increasing dose. Lymphadenopathy of peripheral nodes was noted in all groups and increased in frequency with increasing dose, and was frequently associated with interdigital furunculosis. Papilloma was considered treatment related, but not dose related.

[from NOAH]

Bloody 'ell, still, you can get them back on to pred

[/quote]

BUT most of these 'side effects' could be related to the underlying skin problem as well so may not be true side effects! Pretty mild in comparison to potential side effects of preds and cyclosporin!

Re: apoquel

Anthony Todd — Wed, 19 Mar 2014 14:50:54 GMT

[from NOAH]

Bloody 'ell, still, you can get them back on to pred

Re: apoquel

Anthony Todd — Wed, 19 Mar 2014 14:43:59 GMT

[quote user="robloxley"] "periodic monitoring with complete blood counts and serum biochemistry is recommended when dogs are on treatment long-term"[/quote]

Why?

Re: apoquel

Kirsten Simpson — Wed, 19 Mar 2014 14:33:14 GMT

Our local dermatology Referral sent out a wee newsletter and talked a lot about Apoquel. They advised bloods after a month, 3 months then every 6 months.

Re: apoquel

Richard Carter — Wed, 19 Mar 2014 14:02:31 GMT

[quote user="Anthony Dennison"]Would anyone consider using it off-licence in cats?[/quote] no - that is what ovarid is for

Re: apoquel

Anthony Dennison — Wed, 19 Mar 2014 13:42:56 GMT

Would anyone consider using it off-licence in cats? I understand that the reason it isn't licensed already is that cats lack the cytokine pathway that apoquel targets? (Well, I got told that by a derm person...). But hey, will only know if someone tries.

Re: apoquel

Rob Loxley — Wed, 19 Mar 2014 13:40:35 GMT

the SPC says "periodic monitoring with complete blood counts and serum biochemistry is recommended when dogs are on treatment long-term"

Anyone managed to get an answer out of Zoetis (or has a good suggestion) of how frequent 'periodic' should be, as I'm still waiting...

Re: apoquel

Richard Carter — Wed, 19 Mar 2014 10:20:45 GMT

So far have 3 x WHWT all very good response - as the blurb says will control 80 - 90 % so still needs to keep the coat clean/ skin uninfected.

1 x GSD with food allergic dermatitis - poor response

1 x hungarian visla with chronic ot.ext with confirmed house dust mite allergy - very good response.

1 x Airedale chronic atopy with pododermatitis was on Ucerax etc - moderate to good response - general itch level right down, still needs treatment for skin in feet.

Side effects - apart from every WHWT owner saying how improved their dogs are - none to date.

Costs - similar to rimadyl

Re: apoquel

Hannah Wynne Richards — Wed, 19 Mar 2014 09:21:59 GMT

Curiosity really. Why are you using them long-term in horses?

Wynne

Re: apoquel

Wren — Wed, 19 Mar 2014 08:57:26 GMT

[quote user="Stephen Courtney"]

i think preds are Waaay too cheap....

[/quote]

Try using them long term in horses.... We have to use the 5mg tablets too (at a rate of 100/day) as the 25mg tablets work out at about £20/day. A month's supply of those is about the same as my mortgage!