Arofylline

AbstractThe efficacy of pharmacological interventions used to treat canine atopic dermatitis, excluding fatty acid supplementation and allergen‐specific immunotherapy, was evaluated based on the systematic review of prospective clinical trials published between 1980 and 2002. Studies were compared with regard to design characteristics (randomization generation and concealment, masking, intention‐to‐treat analyses and quality of enrolment of study subjects), benefit (improvement in skin lesions or pruritus scores) and harm (type, severity and frequency of adverse drug events) of the various interventions. Meta‐analysis of pooled results was not possible because of heterogeneity of the drugs evaluated. Forty trials enrolling 1607 dogs were identified. There is good evidence for recommending the use of oral glucocorticoids and cyclosporin for the treatment of canine atopic dermatitis, and fair evidence for using topical triamcinolone spray, topical tacrolimus lotion, oral pentoxifylline or oral misoprostol. Insufficient evidence is available for or against recommending the prescription of oral first‐ and second‐generation type‐1 histamine receptor antagonists, tricyclic antidepressants, cyproheptadine, aspirin, Chinese herbal therapy, an homeopathic complex remedy, ascorbic acid, AHR‐13268, papaverine, immune‐modulating antibiotics or tranilast and topical pramoxine or capsaicin. Finally, there is fair evidence against recommending the use of oral arofylline, leukotriene synthesis inhibitors and cysteinyl leukotriene receptor antagonists.

Forty atopic dogs were studied for 28 days after the oral administration of four randomised treatments: (A) arofylline (1 mg/kg) twice daily for four weeks; (B) prednisone (0.5 mg/kg) twice daily for the first week, once a day during the second week and every 48 hours for the remaining two weeks; (C) prednisone following the same protocol but at a dose of 0‐25 mg/kg; or (D) arofylline (1 mg/kg) twice daily for four weeks plus prednisone (0.25 mg/kg) following the same protocol as in (B) and (C). The degree of pruritus and skin lesions and the side effects were evaluated and graded from 0 to 3 before and weekly during the treatments. In all cases there was a progressive clinical improvement in the clinical signs, with no statistical differences among the four treatments. However, many of the dogs treated with arofylline vomited and had adverse gastrointestinal signs.