An interview with ALLERCEPT® Product Manager Dr. Alana Lisano
We tend to think of atopic dermatitis as a quality-of-life issue. But for many patients, it can sadly become a matter of life and death.
“Atopic dermatitis can cause terrible damage to the human-animal bond, making both pets and their families so miserable that pet owners turn to euthanasia,” says Alana Lisano, DVM.
“I think that’s part of why I feel so passionate about immunotherapy. I want veterinary professionals and pet owners to know they have other options.”
As the Product Manager for ALLERCEPT®, Alana is perfectly positioned to speak to these “other options.” We recently talked with her about how ALLERCEPT works and what sets it apart from other options before digging into some of the data supporting immunotherapy as a first-choice treatment for atopic dermatitis.
ALLERCEPT Serum Allergy Testing
The first thing to understand about ALLERCEPT is that it’s both an assessment and a treatment – in that order. Designed for canine, feline, and equine patients who’ve already gone through the allergy workup and been diagnosed with atopic dermatitis, ALLERCEPT serum allergy assessment measures the level of IgE antibodies to individual allergens within the blood.
“IgE antibodies are the important antibodies when it comes to immunotherapy,” Alana explains. “Heska has a patented Fc epsilon receptor that’s highly specific for IgE. ALLERCEPT can detect as little as 10 picograms of allergen-specific IgE, making it the only immunotherapy program that has what many dermatologists consider to be the most accurate serum test on the market for allergy assessment.”
With a universal panel, every patient receives a comprehensive test that includes a broad range of allergens – 83 to be exact – as well as a food panel. The immunotherapy recommendations, however, are far more individualized.
ALLERCEPT Immunotherapy Treatments
Allergen-Specific Immunotherapy (ASIT) consists of small amounts of allergen extracts to which the patient is sensitive (as determined by the serum allergy assessment) and is the only allergy treatment that addresses the source of the disease. The goal, Alana explains, is to help the pet’s immune system figure out how to better respond to allergens in their environment, thereby reducing the incidence of clinical signs.
ALLERCEPT’s recommendations are based on more than just the assessment results, however. Factors like patient history, the cross-reactivity of allergens, and geographic location (using zip code) are all taken into account when developing treatment recommendations. ALLERCEPT even takes pet owner preferences into consideration, as there are two immunotherapy administration options: shots and drops.
“Pet owners are critical to immunotherapy success,” Alana emphasizes. “Treatment is lifelong and requires excellent compliance, so the more we’re able to tailor the therapy to the needs of the pet owner, the better.”
Subcutaneous injections are the more traditional immunotherapy route, and Alana explains that they’re typically given every two to four weeks. But families with needle-averse pets (or owners) can opt for sublingual therapy drops instead. These glycerin-based drops come in a special bottle that simplifies the dispensing process, which is good because pets using this form of therapy will need two drops twice a day for the rest of their life.
“That might sound daunting to a pet owner,” Alana admits, “but most dogs (and even some cats and horses) like the taste and will view it as a treat. Dispensing immunotherapy drops can become as routine and manageable for pet owners as feeding their pet twice a day. It can even become a twice-a-day bonding experience.”
It’s also worth noting here that because each method of immunotherapy administration approaches the immune system a little differently, a pet who isn’t successfully treated with one formula has a 50% chance of responding favorably to the other option.*
Immunotherapy Impact: What Does the Research Say?
As you well know from clinical experience (and likely frustration), atopic dermatitis is incredibly common. The disease is estimated to affect as many as 20% of cats, 30% of dogs, and 40% of horses. Considering both the high prevalence of atopic dermatitis and the extreme misery it can cause, Alana is adamant that just treating the clinical signs with medications and shampoos is a disservice to pets, pet owners, and veterinary professionals. “The disease will keep getting worse, because we’re only addressing what’s right in front of us,” she continues. “Immunotherapy targets the source of disease to offer lifelong relief.”
That sounds ideal, of course, but does it work? ASIT response rates range between 50 – 80%, and when patients do respond, the benefits are numerous. A recent retrospective study found that immunotherapy had the potential to improve the quality of life of not just the pet, but also the pet owner. According to survey responses, the owners of dogs treated with ASIT experienced less physical discomfort (due to unpleasant odor, the impression of a dirty apartment) and less influence on relationships with family and friends than the owners of dogs who did not receive immunotherapy. Owners of ASIT-treated dogs also noted feeling significantly less emotional distress; experienced significant improvements in their daily activities; and reported a significant reduction in their expenses (veterinary and treatment costs). In fact, a 2020 study found the need for concomitant medications was reduced by more than 87% in dogs treated with immunotherapy for at least 12 months.
Immunotherapy Impact: Jethro’s story
Sometimes, stories can speak louder than stats. Jethro is an atopic dermatitis patient whose years-long skin infection battles caused him to be surrendered to a veterinary practice for euthanasia. Fortunately, Veterinary Technician Lauren Hubbard adopted Jethro and gave him a literal second chance at life. After six months of treatment using ALLERCEPT sublingual immunotherapy drops, Lauren reports that Jethro is on the road to recovery. “His coat is growing back beautifully,” she explains. “He has not had a skin infection in months! He is a happy and healthy boy and a member of our family.”
But despite the potential life-saving benefits, Alana laments that less than 45% of practitioners recommend immunotherapy for canine patients. Even worse, the percentage sits at only 16% for feline patients.
“ALLERCEPT offers a fairly easy method to go about treating the source that doesn’t require a referral and isn’t linked to serious side effects,” Alana concludes. “By integrating advanced allergy testing into your routine diagnostic protocols, you can enhance your ability to alleviate suffering and improve your patients’ quality of life.”
