Why Prescribe RESPIT for atopic dermatitis?
By Jon Plant, DVM, DACVD


• Immunotherapy is the only treatment for atopic dermatitis that can change the course of the disease
• Standardized allergen immunotherapy is as effective as customized immunotherapy
• RESPIT avoids formulating immunotherapy based on tests with uncertain accuracy and reliability
• Available as Injectable and Oromucosal Spray formulations
• Your clients will value your honest appraisal of allergy testing and RESPIT’s practical approach to treatment

The goal of immunotherapy is to induce tolerance to environmental allergens, thereby reducing the clinical signs of atopic dermatitis. Traditionally, immunotherapy has been customized for each pet using allergy test results as a starting point. However, test results may be affected by seasonality, patient preparation, technique, subjective scoring, and the choice of laboratory (for serum testing) or dermatologist (for intradermal testing). False positive and false negative reactions occur with both testing methods. How much does this uncertainty in allergy testing influence the efficacy of immunotherapy? Neither testing technique has been proven superior,1 despite the poor agreement between them. Griffin and Hillier suggest that a favorable response to immunotherapy may be seen when a sufficient number of clinically relevant allergens are included.2 In humans, immunotherapy has been found to induce non-allergen-specific tolerance.3 RESPIT is based upon these lines of evidence and a study by Reid Garfield, DVM, DACVD.4

In this double-blinded study, Garfield found a 76% “good” to “excellent” response rate with a standardized mixture of 32 regional allergens for the treatment of canine atopic dermatitis, not significantly different from the response to customized immunotherapy based on intradermal test results (Figure 1). Skin test reactivity had changed in all 3 groups when retested, with the loss of some previously positive reactions and the addition of new reactions.

Conclusion: The study did not detect a significant difference between the response to customized immunotherapy (based on intradermal testing) and standardized allergy immunotherapy.

In a retrospective report on 103 dogs, RESPIT Injectable was found to be of similar efficacy as is often reported for allergen-specific immunotherapy based on allergy testing.5 The overall response to RESPIT was classified as excellent in 19%, good in 38%, fair in 25%,and poor in 18% of dogs.

1 Olivry T, et al. Treatment of canine atopic dermatitis: 2010 clinical practice guidelines from the International Task Force on Canine Atopic Dermatitis. Veterinary Dermatology, 2010, 21: 233-248.
2 Griffin CE, Hillier A. The ACVD task force on canine atopic dermatitis (XXIV): allergen-specific immunotherapy, Vet Immunol Immunopathol, 2001, 81: 363-383.
3 Marogna M, et al. Effects of sublingual immunotherapy for multiple or single allergens in polysensitized patients, Ann Allergy Asthma Immunol. 2007, 98: 274-80.
4 Garfield R. Injection immunotherapy in the treatment of canine atopic dermatitis: comparison of 3 hyposensitization protocols. 1992, 8th Proceedings Annual Members' Meeting AAVD & ACVD, 7-8.
5 Plant J, Neradilek, M. Effectiveness of regionally-specific immunotherapy for the management of canine atopic dermatitis. BMC Veterinary Research, 2017, 13:4.