Artuvetrin® Therapy
Allergen specific immunotherapy
The underlying thought of treating an allergic dog by means of allergen-specific immuno-therapy (hypo-sensibilisation) is that the dog will gradually become less sensitive, or completely insensitive, to the allergens that cause the reaction. In order to achieve this, a therapy is compiled containing only the allergens that cause an allergic reaction in the dog.
Which dogs are eligible for Artuvetrin® Therapy?
In principle, dogs that have problems during at least three months of the year are eligible to undergo allergen-specific immunotherapy, such as Artuvetrin® Therapy. This treatment will help control the condition, and will significantly reduce the symptoms.
Advantages of immunotherapy from ArtuVet:
- effective3,5,6
- Safe4
- Licensed therapy*
- Delivery within 10 working days
- Causal treatment
- Identical allergens for allery tests and therapies
- 1 vial of Artuvetrin® provides treatment for 10 months
- 1 vial, 1 concentration, ready to use
3 Willemse. Tijdschr. Diergeneesk. Deel 129 (2004) 402-408
4 Griffin, et. al. Vet. Immunol. Path 81 (2001) 363-383
5 Tarpataki, et. al. Hun. Vet. J. 126 (2004) 545-552
6 International Task Force on Canine Atopic Dermatitis. 2010 clinical practice guidelines for the treatment of canine atopic dermatitis. Vet Derm. 21 (2010): 301-308
* geregistreerd in Nederland.
Composition and characteristics
Depending on the findings of the Artuvetrin® Serum Test or the Artuvetrin® Skin Test, the preparations may be composed of 1 to 8 allergens or allergen mixes per vial. In order to obtain good quality for immuno-therapy, a certain concentration of allergens is required. In order to achieve this concentration, a maximum of 8 allergens are mixed within each vial of Artuvetrin® Therapy. Each Artuvetrin® Therapy is a magistral preparation based on the veterinary’s prescription, tailored specifically for treating a single individual patient. Each vial contains 10 ml.
Side-effects
Allergen-specific immuno-therapy has virtually no side-effects and long-term use is, therefore, no problem1.
A slight worsening of pruritus can be noted after the allergen injection. In sporadic cases anaphylactic shock can occur after injections with allergens with symptoms like lethargy, oedema of the head, pruritus, dyspnea, vomiting, diarrhoea or fainting. In such cases intravenous treatment with 1 to 5 milliliter (until effective, inject slowly) of an adrenaline solution (1:1000) is indicated.
The impact of a treatment can be assessed based on improvement in the clinical symptoms. Generally, the clinical symptoms start improving within a few months of starting the treatment.
1 Griffin CE and Hillier A – The ACVD task force on canine atopic dermatitis: allergen-specific immunotherapy. Veterinary Immunology and Immunopathology 81 (2001) 363-383.
Licensed in Europe and product of choice
Artuvetrin® is the only licensed allergen specific immunotherapy in Europe*.
Therefore under the European veterinary medicines regulations (directives 2004/28/EC), Artuvetrin® is the product of choice.
*Licensed in the Netherlands.
Result of the treatment
The percentage of dogs responding favourably to treatment with Artuvetrin® Therapy amounts to approximately 75%1. It will take some time before the treatment results are shown. If no noticeable result has ensued eight to nine months after starting treatment, the advice is to stop treatment and re-examine the dog.
1 Willemse. Tijdschr. Diergeneesk. Deel 129 (2004) 402-408
%
Treatment result
Frequently Asked Questions
Upon the start of immunotherapy, it is necessary for the skin to be and remain calm. This often requires symptomatic medication. On average, the therapy will not show noticeable improvement until 5 or 6 months after starting the treatment. Our advice is to reduce the symptomatic medication as much as possible during the first months of immuno-therapy. Oral or local administering is preferred to parenteral administration.
In order to have the animal become habituated to the allergens, the initial dose is low with a gradual increase over time. The periods between injections will be increased in the course of the treatment, ranging from 2-week intervals between injections at the start of treatment to 4-week intervals at later stages of the treatment. The first injection contains 0.2 ml. After 2 weeks, 0.4 ml is injected. Another two weeks later, 0.6 ml is injected. Subsequently, a dose of 0.8 ml is injected once with 2-week intervals. After this injection, 1.0 ml is injected after three weeks. This injection is repeated after a 3-week interval. Subsequently, the maintenance therapy is started, consisting of monthly 1.0 ml injections.
| Recommended schedule | Dose |
|---|---|
| Week 1 | 0.2 ml |
| 2 weeks later (Week 3) | 0.4 ml |
| 2 weeks later (Week 5) | 0.6 ml |
| 2 weeks later (Week 7) | 0.8 ml |
| 3 weeks later (Week 10) | 1.0 ml |
| 3 weeks later (Week 13) | 1.0 ml |
| 4 weeks later (Week 17) | 1.0 ml |
| 4 weeks later (Week 21) | 1.0 ml |
| 4 weeks later (Week 25) | 1.0 ml |
Subsequently, continue the schedule with 1.0 ml once every 4 weeks.
The individual sensitivity of a dog may instigate a possible or necessary deviation from the standard dosing schedule. The dosing interval may be tailored to the individual patient. Some dogs respond better to two times 0.5 ml per month than one time 1.0 ml per month. We are happy to confer with you regarding the individual patient and its ideal treatment schedule.
Studies have proved that 75% of all dogs show improvement after hypo-sensibilisation treatment1. This improvement is defined as a clinical improvement by 50% or more. Improvement in the clinical symptoms without resolving 100% of the complaints is also a good result. With improvement based on the hypo-sensibilisation, this will lead to the reduction of long-term symptomatic medication and the risk of side-effects due to symptomatic medication.
1 Willemse. Tijdschr. Diergeneesk. Deel 129 (2004) 402-408
Just like the symptomatic medication, allergen-specific immuno-therapy (Artuvetrin® Therapy) is a life-long therapy. On average, the therapy will not show noticeable improvement until 5 or 6 months after starting the treatment. When no effect at all is visible within 8 or 9 months after starting the treatment, the chance that the patient could still improve is extremely small and discontinuing the therapy is then recommended. However, before stopping therapy, we recommend considering whether or not an alternative dosing schedule might improve the condition (see the question: Is it possible to deviate from the standard dosing schedule?). Additionally, it is recommended to consider if the causal allergens may have changed. Naturally, please always feel free to contact ALK in order to discuss any individual situation with us.
In the course of time, the strength of the allergens will slightly decrease. When starting with a new vial, the allergenicity of these allergens may be slightly stronger. Treating the stronger itch with symptomatic medication is not a problem.
The use of immuno-therapy in cats has not been researched extensively. During the ESVD/ECVD congress in Lisbon (2006), a lecture was given with the title “The Management of the Itchy Cat”, with Hillary Jackson claiming 60 to 70 per cent effectiveness of immuno-therapy in cats. Relating to the dosing schedule for cats, ALK is not able to provide any advice due to its registration status.