Evidence-Based Veterinary Dermatology: A Systematic Review

Medical guidelines should insists on proof that time-honored medical practices and procedures that cost money and may harm or kill patients are actually effective. This Forum is about how to force organized veterinary medicine to issue Evidence Based Guidelines.

Evidence-Based Veterinary Dermatology: A Systematic Review

Postby malernee » Tue Mar 16, 2004 10:55 pm

Evidence-Based Veterinary Dermatology: A Systematic Review of the Pharmacotherapy of Canine Atopic Dermatitis
Vet Dermatol 14[3]:121-146 Jun'03 Clinical Trial 66 Refs

* T. Olivry; R.S. Mueller and The International Task Force on Canine Atopic Dermatitis
* Department of Clinical Sciences, North Carolina State University, College of Veterinary Medicine, 4700 Hillsborough Street, Raleigh, NC 27606, USA
The 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. [Abstract]
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Postby cornelgingarasu » Sun Nov 21, 2004 4:09 am

This is an interesting review of medicines and combination of medicines that are classical in canine atopic dermatitis or intense pruritus.
I would have appreciated a presentation of medicines and therapies that have been tried in chronic skin diseases which are less known, such as :immunoregenerative and immunomodulatory therapies, spider venom extracts,the use of herbs, tissue therapy, foetal blood injections.
These may offer a new perspective and hope for the dermatological pharmacology
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