Ciclosporin for feline allergic skin disease — PROBABLE

PROBABLE: Ciclosporin at 7.0 mg/kg once daily controls feline hypersensitivity dermatitis — on one decisive randomised, double-blind, placebo-controlled trial, stated on its face as this shelf's basis. In King 2012 (100 client-owned cats, 6 weeks), mean Total Lesion Scores on 7.0 mg/kg ciclosporin were significantly lower than on 2.5 mg/kg ciclosporin (P = 0.0047) or placebo (P = 0.0003); Total Lesion Scores improved by more than 50% in 70% of the 7.0 mg/kg group vs 47% on 2.5 mg/kg and 23% on placebo (P = 0.0006), and Investigator Pruritus Scores improved significantly more on 7.0 mg/kg (54%) than on 2.5 mg/kg (32%; P = 0.0232) or placebo (21%; P = 0.0063). The 2.5 mg/kg dose is not the effective dose on this record. A second, smaller double blind, randomised trial (Wisselink 2009, 29 cats with presumed atopic dermatitis) found ciclosporin 5 mg/kg/day statistically indistinguishable from prednisolone 1 mg/kg/day over 4 weeks on lesion remission (P = 0.0562) and owner-assessed pruritus (P = 0.41) — supportive of ciclosporin as a steroid alternative, but a no-significant-difference result in 29 cats, not proof of equivalence. Correction to the build brief, recorded here: no ciclosporin vs methylprednisolone trial in cats was found at the gate — the assigned anchor (King 2012) is placebo-controlled, and the steroid head-to-head in the literature is against prednisolone (Wisselink 2009), which is the comparison carded. Limits: the placebo-controlled evidence is 6 weeks at one effective dose; mild gastrointestinal disorders were the most common adverse events in King 2012 and did not require cessation of therapy. Drafted Nov 10, 2026 (VetMed build, topic #275); all figures from abstracts fetched and verified at drafting.