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Cytopoint is a revolutionary new anti-itch therapy for symptomatic treatment of itch in dogs with allergies. This therapy provides an average of 4 weeks of itch relief and can be used in many dogs who cannot use other anti-itch treatments because of other medical conditions. Find out more about the benefits and drawbacks of this therapy.

Introduction

[00:01:05] Welcome everybody to today’s episode of Your Vet Wants You to Know. I’m very excited to continue our allergy therapy series by discussing the newest addition to our arsenal of symptomatic treatments for itch in dogs. On the episode for environmental allergies, I talked about the two main categories for treatment, one being symptomatic treatment to treat the itch with therapies like Apoquel, Cytopoint, steroids, and Atopica, and the other category being desensitization therapy to retrain the immune system so that we can minimize the amount of symptomatic treatment that we’re going to be using over the course of the animal’s life. I talked about Apoquel in the last episode and Cytopoint, the medication I’ll be discussing in today’s episode, also comes from Zoetis, who have continued to produce revolutionary scientific breakthroughs in the treatment of our pets. In the interest of full disclosure, Zoetis has previously provided me with an honorarium to present my research on Apoquel to a global expert panel of veterinary dermatologists, but all opinions in this podcast remain my own and are backed by peer reviewed, published research.

What is Cytopoint?

[00:02:14] Cytopoint is a revolutionary new anti-itch therapy for dogs. It’s also known as lokivetmab, or you may have heard it called CADI, short for canine atopic dermatitis immunotherapeutic. It uses a truly fascinating science of monoclonal antibodies to target one of the most powerful chemical messengers of itch, a cytokine called IL-31. Monoclonal antibodies are manmade proteins designed to mimic antibodies that are naturally produced by the immune system. Antibodies have a specific target and their goal is to neutralize or destroy that target. There are lots of different monoclonal antibodies being used in human medicine today, but Cytopoint was the first of its kind in veterinary medicine. These canine monoclonal antibodies bind to that itch message and neutralize the message from being sent, hitting the mute button on the itch signal.

What are the benefits of Cytopoint?

[00:03:14] There are lots of benefits to Cytopoint, including that it has a rapid and potent anti-itch effect for the majority of pets. Cytopoint provides an average of four weeks of itch relief. For some dogs with a really short environmental allergy season, that could mean one or two injections provides them with the relief that they need for the entire year. There are no contraindications for using this medication in patients with other diseases, things like cancer, infections, diabetes, or Cushing’s disease, where we may not be able to use other symptomatic treatments like steroids, Apoquel, or Atopica. And unless the pet has had an extremely rare reaction to this medication, there truly are no contraindications to using Cytopoint, which has been a game changer for those allergic pets who can’t have the other allergy medications that we have. It’s even okay for us to use this medication and growing puppies, which is great for some of those pets who have developed food allergies very early in life, like I discussed in episode two on food allergies. 

Is Cytopoint safe?

[00:04:17] Cytopoint is extremely safe compared to other symptomatic allergy medications. The first three studies looking at Cytopoint had zero adverse reactions in pets treated with this therapy. The fourth study published had less than 10% of over 100 dogs treated develop an adverse reaction with 73% of those reactions being lethargy, and I don’t know about you, but if I was uncontrollably itchy and I finally had a therapy that provided relief, I’d probably just want to enjoy being able to rest without chewing and scratching myself for once. If you’re using Cytopoint regularly for long-term symptomatic treatment of allergies, there’s no routine lab work that’s needed to monitor organ function.

Does Cytopoint help with ear infections?

[00:05:02] There are some drawbacks, however. Cytopoint does not have as strong of an anti-inflammatory effect. This medication might not be a great option for those allergic dogs whose paws are huge and whose ear canals are really swollen. Since it can be combined with other allergy treatments, if Atopica or steroids, which are really good at bringing down the swelling of the ears and the paws, are not enough to keep the itch under control, Cytopoint can be combined if the animal is still itchy.

Can Cytopoint be given to cats?

Cytopoint is not for use in cats. Unlike other allergy treatments, this is specifically designed to be compatible with the dog’s immune system. Giving this therapy to a cat could have potentially serious reactions. My husband asked me why there isn’t a Cytopoint for cats and I explained to him that unfortunately, researchers have been unable to identify a cytokine as strongly associated with itch in cats as IL-31 is for dogs. Now, what exactly does that mean? Well, it means cats are jerks and will do whatever they want.

What is the cost of Cytopoint?

[00:06:06] Cytopoint is priced based on the dose received and because of the groundbreaking science used to formulate this therapy, it can be expensive for large breed dogs. It may not work for every patient. Zoetis, the makers of Cytopoint, performed a study looking at how effective it was in decreasing itch associated with allergies. 110 dogs were given a dose of Cytopoint at the beginning of the study and about 65% of them had continued itch relief at day 30. Of the patients who did not have itch relief, a second monthly Cytopoint dose was administered, and by day 60, 85% of patients had seen a reduction in their itch. Of the patients who did not respond to the second injection, they repeated a third dose and by the end of three months, 93% of dogs had demonstrated a decrease in their itch score. So it may be that in that small population of dogs that doesn’t respond to the first or second injection that there’s so much IL-31, that itch signal, that’s being circulated in the beginning, that the first and sometimes even second dose doesn’t quite cut the itch. And in those cases, it may be worth trying again, especially if the dog has had some issue that would make the use of our other symptomatic therapies like Apoquel or steroids or Atopica, significantly riskier for that pet.

Does Cytopoint treat infections?

[00:07:23] It is important to keep in mind though that Cytopoint doesn’t treat infection. This may be more of a misconception than a drawback, but if there are bacteria or yeast that are contributing to the itch, these infections have to be addressed for Cytopoint to work effectively. This is particularly important for dogs who lick their paws constantly, even after a Cytopoint injection. As soon as I hear a dog is licking its paws at home, I’m going to pull out my toothpick to take a sample from the base of the claws by the cuticle and odds are, I might find some yeast or bacteria under the microscope that are making that dog lick, which typically responds better to treatment of infection rather than more anti-itch medication alone. As I’m recording this, my allergic dog, Russell Sprout, the Your Vet Wants You to Know mascot, is over in the corner demonstrating the paw licking behavior, reminding me that I have to put his medicated mousse on his paws. Thanks, Russell. My husband will be wandering through shortly mumbling something under his breath about the cobbler’s kids having no shoes. 

What should pet owners know about Cytopoint?

[00:08:26] Overall, Cytopoint is a revolutionary new allergy treatment for dogs. It provides a rapid relief of itch that lasts an average of four weeks and can be used on a short or long-term basis in dogs of any age with any other medical conditions, receiving any other medication, making it a safe therapy for some of the allergic dogs who can’t receive other allergy medications. As with any other symptomatic treatment, it’s important to understand that the underlying disease is still there. So one Cytopoint injection is not expected to cure the dog. Ongoing therapy and communication with your veterinarian is important for good long-term management of allergies and investigation of the underlying cause of the allergy will go a long way towards reducing the amount of symptomatic medication your pet receives throughout the course of its life.

[00:09:19] If your pet has received Cytopoint, I encourage you to visit the Your Vet Wants You to Know Facebook group to tell us about it and show us pictures of your allergic dogs. If you found value from today’s episode, please subscribe to the podcast so that you don’t miss upcoming episodes and leave us a review. 

[00:09:42] I’d like to close each episode with a segment called “Scratching the Itch.” The segment is designed to highlight something, either a human interest story, a product, or a website that provides relief, or just makes you feel good. Hence, “Scratching the Itch.” Please leave a comment in the Facebook group, or contact me through the website to let me know what you think about the “Scratching the Itch” segment and if you have any suggestions for something to feature in the future.

[00:10:12] Today’s “Scratching the Itch” is some recent legislation that was passed in the November 3rd, 2020 election. Voters in Denver repealed the city’s 30 year pit bull ban. Denver is another major metropolitan city that is joining a nationwide trend to repeal legislation banning pit bulls. Breed specific legislation does not have science to show that it decreases the incidence of bites and many critics of breed specific legislation say that it discriminates against communities of color.

[00:10:44] The American Veterinary Medical Association has been opposed to breed specific legislation discriminating against responsible pet owners and their dogs. Breed specific laws can be difficult to enforce, especially when a dog’s breed can’t be easily determined, or if it’s a mixed breed. Proponents of the measure to repeal the pit bull ban of Denver say that the breed-specific ban has cost the city of Denver more than $5.8 million. The American Veterinary Medical Association recommend strategies for dog bite prevention, including enforcement of generic and non-specific breed, dangerous dog laws, placing an emphasis on chronically irresponsible owners, prohibiting dog fighting and encouraging neutering for dogs that are not intended for breeding. Links for more information about breed specific legislation will be available on the episode post on our website for today’s episode. That’s all for today. I look forward to your next visit with Your Vet Wants You to Know.

References:

  1. American Veterinary Medical Association. Why Breed-specific Legislation Is not the Answer. Retrieved December 01, 2020, from https://www.avma.org/resources/pet-owners/why-breed-specific-legislation-not-answer
  2. AVSAB. “Position Statement on Breed Specific Legislation.” American Veterinary Society of Animal Behavior, Jan. 2019, avsab.org/wp-content/uploads/2019/01/Breed-Specific_Legislation_Position_Statement-FINAL.pdf. 
  3. Gortel, Kinga. “An embarrassment of riches: An update on the symptomatic treatment of canine atopic dermatitis.” The Canadian veterinary journal = La revue veterinaire canadienne vol. 59,9 (2018): 1013-1016.
  4. Michels GM, Ramsey DS, Walsh KF, et al. A blinded, randomized, placebo-controlled, dose determination trial of lokivetmab (ZTS-00103289), a caninized, anti-canine IL-31 monoclonal antibody in client owned dogs with atopic dermatitis. Vet Dermatol 2016;27:478-e129.
  5. Michels GM, Walsh KF, Kryda KA, et al. A blinded, randomized, placebo-controlled trial of the safety of lokivetmab (ZTS-00103289), a caninized anti-canine IL-31 monoclonal antibody in client-owned dogs with atopic dermatitis. Vet Dermatol 2016;27:505-e136.
  6. Moyaert, Hilde, et al. “A Blinded, Randomized Clinical Trial Evaluating the Efficacy and Safety of Lokivetmab Compared to Ciclosporin in Client-Owned Dogs with Atopic Dermatitis.” Vet Dermatol, vol. 28, no. 6, p. 593–+
  7. Souza CP, Rosychuck RA, Contreras ET, et al. A retrospective analysis of the use of lokivetmab in the management of allergic pruritus in a referral population of 135 dogs in the western USA. Vet Dermatol 2018;29:489-e164
  8. Tamamoto-Mochizuki, Chie, et al. “Proactive Maintenance Therapy of Canine Atopic Dermatitis with the Anti-IL-31 Lokivetmab. Can a Monoclonal Antibody Blocking a Single Cytokine Prevent Allergy Flares?” Vet Dermatol, vol. 30, no. 2, p. 98–+.

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