Presenter – Anthony Chadwick BVSc Cert VD, MRCVS, dermatology referral consultant in the northwest and founder of ‘The Webinar Vet’
It was a few years ago when Anthony discussed the new and exciting drug, Oclacitinib, which was about to take the dermatology world by storm. This discussion took place at ‘The Webinar Vet’ with Anthony delivering highlights from the 2012 Vancouver World Dermatology Conference. Of course we all know the success story of oclacitinib (Apoquel) despite being a victim of its own success with demand far outweighing it’s supply (I’m glad to say this issue now appears to be resolved). There is now, however, another exciting addition to our drug armoury for the treatment of canine atopy, and Anthony told us all about this in a recent webinar discussing highlights from the 2016 World Dermatology Conference in Bordeaux.
The new drug is an antiIL31 monoclonal antibody called lokivetmab, which specifically inhibits the cytokine IL31, known to play a significant role in the pruritus caused by atopy. This drug is unlikely to be available within the UK for at least a year but when it does come to market it will be delivered in the form of an injection lasting for at least one month, and has been proven to significantly reduce the itch in dogs suffering from atopy.
Anthony then moved even further into the future by discussing the use of stem cell therapy for the treatment of dermatological conditions. Luis Ferrer from Tofts University delivered this lecture at the World Conference and explained that stem cells are very easy to grow and culture within a laboratory setting and are very useful for homing in on areas of damage and inflammation where they promote angiogenesis and tissue repair. Anthony cited an example of a dog whose anal fistulae healed within seven days of stem cell therapy.
Methicillin resistant staphylococcus was the final topic on Anthony’s agenda, having attended a panel discussion on the subject at the World Dermatology Conference. The good news is that compared to the US where over half the patients tested have MRS, only 5-10% test positive in the UK. However we should not rest on our laurels as we have to ensure MRS does not get a hold in the UK as it has in the US. A consensus statement was delivered by the panel outlining a plan on how to minimise the risk of MRS and included the use of topical therapy such as chlorhexidine as an alternative to systemic antibiotics.
The panel also advised against empirical drug use although Anthony advised that within the UK, empirical drug use is more acceptable due to the lower levels of MRS within the country, but only as long as we use antibiotics responsibly. Anthony explained that often our biggest mistake is to prescribe antibiotics for 10 days, then stop and re-prescribe a few weeks later when the problem recurs. This prescribing pattern is more likely to lead to the development of resistant bacteria. Instead Anthony advises always giving a 3-4 week course of antibiotics if systemic antibiotics are deemed necessary, and swabs for culture and sensitivity should always be performed in the presence of deep pyoderma.
Delivering a webinar on the highlights of the World Dermatology Conference (or of any veterinary conference for that matter) seems an excellent way of offering a snap shot on any topical issues and future developments within a particular discipline. I thoroughly enjoyed the webinar delivered in 2012 on the World Dermatology Conference and, without hesitation, I can also say the same for this year’s webinar. Long may they continue!
The Stethoscope (MRCVS)