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Animal Skin and Allergy Clinic Blog

Battle of the Dermatology Titans: Differences Between Atopica, Apoquel, and Cytopoint

A white and brown dog scratchingAllergies are never fun for anyone. When it comes to animals with allergies, there is no magic solution that works for every pet. Oftentimes, managing allergy problems can require a bit of trial and error to find out what works, and there are a variety of medications and products we may recommend.

Sometimes systemic medications are the foundation of successful management of itchiness, one of the most common allergy symptoms. Three of the more frequently used medications that we reach for at the Animal Skin and Allergy Clinic may give the same end result, but the differences between Atopica, Apoquel, and Cytopoint are quite dramatic.

Getting Rid of the Itch

Itchiness, or pruritus, in pets is a common and aggravating problem. An itchy pet is an uncomfortable pet, and this behavior can be disruptive and lead to secondary issues.

When the cause of the pruritus is something like fleas or a food allergy, the solution is relatively simple. Many pets, however, suffer from a condition known as atopy. Atopic animals have a defect in their skin’s barrier, leaving them vulnerable to all sorts of environmental allergens and infections. We can get rid of fleas or stop feeding your pet chicken, but we cannot get rid of all of the infectious agents or environmental irritants that may affect them.

Treating atopy requires a multi-modal approach to deal with the defective skin barrier, the immune system hypersensitivity, and the itchy symptoms from the immune reaction. Addressing the skin barrier requires using topical protectants: shampoos, cream rinses, and replacement barrier lipids. Next we focus on the immune hypersensitivity by developing an immunotherapy program of allergy shots or allergy oral drops to desensitize their system to the allergens that cause them to react. Then, this is where anti-pruritic treatments come in.

Steroids have historically been the most commonly prescribed medications to help calm a pet’s immune reaction. We now know that steroids have many unwanted side effects and can cause trouble when used long term.

Atopica is a veterinary formulation of micro-emulsified cyclosporine, a drug known to affect the immune system. It has been around for over 15 years and works by suppressing the T cells in the body.

Apoquel (oclacitinib) is a much newer drug that works at a different level to control pruritus. This medication interferes in the pathway that controls itchiness.

Cytopoint is the newest anti-pruritic treatment option. It is an antibody that blocks the signal coming from the immune cells in the skin that signals itch in the skin nerves.

The Big Differences Between Atopica, Apoquel, and Cytopoint

While each of these medications can be very effective for itchy pets, there are some big differences between Atopica, Apoquel, and Cytopoint:

  • Atopica can take 5 to 7 days to be effective; Apoquel and Cytopoint begin working within the same day
  • Atopica is considered an immunomodulatory drug; Apoquel is a drug that inhibits the nerve response of itch to immune stimulation; Cytopoint is a dog anti-body, so is not actually considered a drug, that blocks the itch signal in the nerves
  • Apoquel and Cytopoint decrease itch, while Atopica inhibits the immune reaction to allergen stimulants
  • Atopica and Apoquel require giving your pet a pill every day; Cytopoint is an injection that usually lasts 4-5 weeks
  • Apoquel is designed for acute flares of itchiness, whereas Atopica is targeted at the cause of the immune response; Cytopoint provides relief to chronic itchiness for an extended period
  • Atopica treats the immune system cause of the itch, so is more effective at preventing skin infections, ear infections, and itch; Apoquel and Cytopoint only suppress the itch and do not address the underlying cause.

Even with these anti-pruritic options we still need to work on preventing irritant entrance through the skin by frequent skin barrier restoration with shampoos and cream rinses. Making the immune system more tolerant and less reactive with allergen specific immunotherapy (allergy shots or oral drops) can greatly decrease itchiness and, in many dogs, Atopica is better because it blocks the skin immune cells from reaction to these stimulant allergens. Unfortunately, Atopica is not an option for some pets, so it’s good we have Apoquel and Cytopoint available to round out an atopy treatment plan for these pets.

Itchy pets everywhere can rejoice, since now that we have many options when it comes to managing their discomfort. Pet allergies can be complicated. While not everything works for every pet, with a variety of medications to choose from, we can usually find something that will help.