New Allergy Blocker, Apoquel

A round table discussion regarding the new allergy blocker Apoquel was held at the North American Veterinary Dermatology Forum in Nashville, TN in April 2015. The round table was not open to all attendees but the results of the discussion were recently published. At ADRC we’ve had concerns about the implications of long term administration and wanted to share reported side effects from doctors attending the discussion:

  • Overall impression by participants was that the drug is well tolerated
  • Demodicosis: overgrowth of a mite typically considered to be a normal inhabitant of the skin
  • Viral papillomas (aka viral warts)
  • Weight gain: noted to be common, varying from minor to fairly severe. The cause of weight gain was unclear
  • Urinary tract infections. A residency project is underway to determine the incidence of UTIs
  • Loss of protein in the urine.
  • Low white blood cell counts making pets susceptible to infection.
  • Elevated liver values
  • Rectal bleeding: This was seen in 3 patients, but may not have been associated.
  • Tumors/Malignancy: None of participants felt that use of Apoquel had likely led to development of malignancy in patients, although many noted that they had seen malignancies develop during its use. Patient population must be considered as this is used as a rescue drug in older dogs
  • Collapse: This was also mentioned by two participants. In one case, a 5-year-old atopic Labrador, this condition was associated with myocardial infarction (heart attack) based on post mortem examination. This may or may not have been related to Apoquel use
  • Interdigital cysts: Apoquel may contribute to the development of this condition in patients without a history of this condition
  • Pneumonia: Two cases of pneumonia were reported
  • Blastomycosis (fungal infection): One case was reported, but from an area where this disease is fairly common

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