0.3% Tacrolimus Ointment - A success Story
by Karen Lindberg

Summer 2003, NEWS

Everyone has experienced allergies in one form or another. The itchy skin, brown footed, foot licking Westie appears prone to a variety including food, contact, inhalant, and atopic dermatitis. A survey conducted by the West Highland White Terrier Club of America in 1999 listed "Allergy" as the #1 health concern. The Westie Foundation set out to change these statistics and funded numerous research grants. Researchers studied a slightly different part of the whole picture for each project.

The exciting news is that under the direction of the Morris Animal Foundation, University of Florida researcher, Rosanna Marsella, DVM has successfully completed a two year study. Her team began with the hypothesis that a topical ointment could be a useful tool in the treatment of Atopic Dermatitis. The team selected 0.3% Tacrolimus ointment. While observing its effectiveness, they also conducted independent studies to determine the drug's safety.

Atopic Dermatitis (AD) is frequently found in Westies, and is the second most common allergy in dogs. It probably causes the greatest frustration to owners because it may be seasonal or year round; caused by grass, weeds, trees, house dust etc., and exhibits varied symptoms. The disease is not well understood, difficult to diagnosis, and limited treatments are available. It has been defined as the inherited ability of the body to form antibodies against environmental allergens. An allergen may be any substance that causes the body to react and it may be eaten, inhaled, or contacted. The substance first causes a problem within the dog's system and when the body responds, physical signs are observed as scratching, licking, and skin changes.

Canine disease seems to parallel eczema, a very well known human condition. As with eczema, the exact cause is unknown.

Tacrolimus ointment (TAC) is a relatively recent addition to the treatment of eczema in humans but has never been used for dogs. It is classed as an immunomodulator, meaning a topical immunosuppresent.

Our Westies can be very grateful to the donors who made this grant available, and to Dr. Marsella and her team who did this outstanding piece of work. She has offered yet another tool to the allergy puzzle. The team carefully selected dogs with confirmed AD and applied the skin ointment. Blood samples for chemistry and hematology tests were drawn at regular intervals with no significant changes noted in Blood Chemistry Profile (BCP) or Complete Blood Cell Count (CBC) results.

While not a cure, nonsteroidal TAC ointment works relatively fast to bring the condition under control and maintain healthy skin and coat, without toxic side affects. Gradually as we demystify allergic conditions, it becomes even more important to recognize the allergic dog and to identify its type. AD is difficult to diagnose because dogs present with varied symptoms. Skin/blood tests must be performed to exclude other problems, including secondary skin infections, food and flea bite allergy, etc. Owners should be advised to contact a veterinary dermatologist so specific treatment can be applied as soon as possible.

0.3% Tacrolimus Ointment Update
Winter 2004

by Karen Lindberg

Previously reported investigative work, performed by Dr. Rosanna Marsella, was very successful. TAC lotion is a topical immunosuppressent that appears to control atopic dermatitis rapidly and safely. The topical ointment works on the immune system and reduces the activity level of skin cells involved in inflammation. It also works on blood vessels in inflamed areas and helps abnormal cells to regrow normally.

Her study concluded that twice daily application of 0.3% TAC cream significantly reduced AD symptoms within 4 weeks. AD remains a chronic disease and repeat application of the cream is required if symptoms reappear. Correct diagnosis of AD is very important to differentiate from bacterial and parasitic diseases of the skin.

The ointment works on both the immune system and cells in the skin. It reduces the activity level of cells that are involved in inflamed areas. It also works on blood vessels in already inflamed cells and helps abnormal cells grow again normally.

Human studies have been reported using 0.03 %, 0.1% and 0.3% concentrations. Unfortunately the 0.3% reported in Dr. Marsella's study may be difficult to obtain. Its use in human medicine as a topical lotion for eczema is also relatively new and dermatologists are probably the best informed about its availability. It may be necessary to contact a pharmacist directly to have the correct ointment prepared.

See also: Topical Lotion for Canine Atopy