Acceptance of Oclacitinib Maleate (Apoquel®) Chewable Tablets In Client-Owned Dogs With Allergic And Atopic Dermatitis.

Background: The oral acceptance of oclacitinib maleate (Apoquel®) chewable tablets administered twice daily for 7 days at the labeled dose range of 0.4-0.6 mg/kg was evaluated in 121 dogs treated at ten general practice veterinary clinics in the United States. Results: Dogs that were enrolled in the study ranged were client-owned, from 1 to 14 years of age, weighed 3.7 to 60.7 kg, and required twice daily treatment with oclacitinib for allergic or atopic dermatitis. One hundred and twenty-one (121) dogs with 1,673 total dose administrations successfully completed the study and were included in the data summary. Out of a total number of 1673 administrations, 1533 (91.6%) were accepted voluntarily within 5 minutes, 134 (8%) were consumed with assistance (with food treats or by pilling) outside of the 5 minutes offering time and 6 (0.4%) doses were not consumed. The per dose percent acceptance rate for the 14 offered doses showed minimal variation ranging from 89.9% to 93.3%. Conclusions: Client-owned dogs from the general veterinary patient population that required treatment with oclacitinib found the Chewable tablets to be very palatable and no aversion occurred with repeated dosing. Oclacitinib chewable tablets were well tolerated and is a palatable alternative to the film-coated tablet.

892. Determination of the Unavailability of Alternative Antiretroviral Formulations

Background Many pediatric and some adult people living with HIV (PLWH) are unable to swallow tablets and require alternative antiretroviral formulations (ARVF) such as liquids, chewable tablets, or powders for suspension. A growing number of issues with the timely procurement of alternative ARVF have been reported; the full scope of this problem is unknown. Without access to appropriate treatment, PLWH are at increased risk of poor disease outcomes. This study’s objective was to determine the scope of availability issues of ARVF and its potential impact on patient care. Methods An online survey invitation was sent to members of AAHIVM and the ACCP HIV PRN. Data collection included provider demographics, number of issues related to ARVF availability, time spent procuring ARVFs, and identification of unavailable formulations. To determine potential impact on clinical care and cost of care the time required to resolve shortages was summarized. Results The analyzable sample was 154, a majority of whom were pharmacists or physicians (n=132, 85.7%; Figure 1), in a clinical role (n=134, 87.0%), and serve pregnant patients (n=121, 79.2%). 85 (55.2%) practice at sites that provide care to > 300 PLWH, 81 (52.6%) practice at sites that did not serve pediatric patients. 525 instances of gaps in care due to ARVF unavailability were reported. In 283 instances, a more complex regimen was prescribed due to first-choice ARVF unavailability. Providers also reported 186 situations in which a less optimal regimen was used and 140 cases of treatment delays. The average time spent to resolve such issues was 2.7 hrs (CI: 1.3 – 4.2). The longest time reported was 72 hrs; most providers spent 1 hr or less. The most common unavailable ARVF were branded ritonavir 80 mg/mL solution (n=12), zidovudine 50 mg/5 mL syrup (n=11), raltegravir 100 mg chewable tablets (n=11), and raltegravir 100 mg granules for suspension (n=10). Branded nevirapine 50 mg/5 mL suspension (n=7) and generic nevirapine 50mg/5ml powder for suspension (n=11) were also reported more frequently. Distribution of Respondents by Provider Type Conclusion Our report suggests the unavailability of alternative ARVF has the potential to significantly impact patient care. Further research is needed to identify the root causes of this problem to determine specific solutions. Disclosures Milena M. Murray, PharmD, MSc, BCIDP, AAHIVP, Merck (Speaker’s Bureau)Theratechnologies (Other Financial or Material Support, Medical Advisory Board) Eric Farmer, PharmD, BCPS, AAHIVP, TheraTechnologies, Inc (Other Financial or Material Support, Medical Advisory Board)

Fluralaner 5.46% (W/W) Flavored Chewable Tablet (Bravecto® 1-Month) Is Effective for Treatment of Canine Generalized Demodicosis

Background: Orally administered fluralaner (13.64% w/w) is effective for treating canine generalized demodicosis. A study was initiated to assess the efficacy of a novel 5.46% w/w fluralaner chewable tablet formulation for monthly administration in the treatment of this disease.Methods: Client-owned dogs diagnosed with generalized demodicosis were acclimatized to laboratory conditions and randomized to receive either orally administered fluralaner (Bravecto® 1-Month) (10.0 to 14.4 mg/kg body weight) (n = 8) or topical imidacloprid-moxidectin (Advocate® for dogs, Elanco) applied per label on Days 0, 28 and 56 (n = 8), or more frequently for ongoing severe demodicosis. On Days -2, 28, 56 and 84, deep skin scrapings were taken from 5 sites on each dog for mite identification and counting, and semi-quantitative clinical assessments of generalized demodicosis were recorded. Primary efficacy was based upon arithmetic mean mite count reductions relative to pre-treatment.Results: By Day 28, mean pre-treatment mite counts, >600 in both groups, were significantly reduced by 99.7% and 89.5% (both P < 0.001) in the fluralaner and imidacloprid-moxidectin groups, respectively. Parasitological cure (100% reduction in mite counts on Days 56 and 84) was achieved in all fluralaner-treated dogs (100%) and in 2 imidacloprid-moxidectin treated dogs (25%). In the imidacloprid-moxidectin group, the reduction in mean mite counts was 89.5% (Day 28), 94.4% (Day 56) and 97.5% (Day 84). All study dogs were free of crusts on Days 56 and 84. Scales resolved by Day 84 in all fluralaner-treated dogs and in 3 imidacloprid-moxidectin treated dogs. All fluralaner-treated dogs and 5 imidacloprid-moxidectin treated dogs had > 90% hair re-growth on Day 84.Conclusion Three consecutive monthly oral administrations of fluralaner (5.46% w/w) flavored chewable tablets (minimum dose rate 10 mg/kg body weight) eliminated Demodex canis mites from dogs diagnosed with generalized demodicosis.

Knowledge and consumption of probiotics and prebiotics in India: a narrative review

In this narrative review, we discuss existing literature on the knowledge, consumption, and factors influencing the consumption of probiotics and prebiotics in India. We also examined the current nature of the probiotics and prebiotics market in the country. There were only a handful of studies on the knowledge and consumption of probiotics and prebiotics among Indians, mainly conducted in urban areas and middle to high-income households. Limited research showed that the knowledge of probiotics had increased appreciably in the past decade, while there is still poor technical knowledge among Indians. Simultaneously, prebiotics is an unfamiliar concept to the general public. Younger individuals are more aware than their older counterparts. The probiotics market in India offers several milk-based beverages, yogurt, and curd, while few non-dairy beverages are available from overseas. The prebiotics market in India has several powder formulas and some chewable tablets. The consumption of probiotics and prebiotics is limited to popular foods like curd, probiotic drinks, buttermilk, and milk, wheat, onion, tomatoes respectively. The modern Indian diet lacks traditional probiotic and prebiotic sources despite their presence in several regional cuisines. Furthermore, awareness of these foods and the knowledge and belief in their health benefits are the most influential factors in their consumption. Contrarily, the perception of not requiring these foods for the maintenance of good health prevents their consumption. Improving awareness and knowledge while offering diverse gut-healthy foods in all strata of Indian society can increase the utilization of these foods and improve general health and prevent chronic diseases.

EVALUATION OF THE QUALITY OF DIFFERENT BRANDS OF ASCORBIC ACID IN FREETOWN, SIERRA LEONE

Objective: This study evaluates the registration status and the quality of nine brands of Vitamin C sold in Freetown, Sierra Leone, using official and non-official methods of analysis. Methods: The parameters taken into consideration during the study include non-official methods (friability and disintegration) and the official methods (identification test, uniformity of dosage unit, and assay by titrimetric and colorimetric tests). The different brands of vitamin C were selected and classified as registered and unregistered based on the data derived from the National Medicines Regulatory Authority. Results: One vitamin C product collected was unregistered at the National medicines regulatory authority (Pharmacy Board of Sierra Leone). All nine vitamin C products met the requirements for uniformity of dosage unit. The vitamin C products also conformed to the BP specification for friability and identification test (retention factor). The identification test showed that each brand contained vitamin C (ascorbic acid). The disintegration test was not applicable for chewable tablets. Three of the four non-chewable vitamin C products complied with the BP specification for disintegration, while one failed and did not meet the requirement. The assay results for ascorbic acid using titration and colourimetric method were comparable and appropriate for determining vitamin C. Out of a total of nine samples; seven met the requirement for BP specification (Passed) for assay. In contrast, one product did not meet the BP requirement (failed), and one sample had more vitamin C than the Pharmacopoeia limit. Conclusion: Periodic quality evaluation and routine checks for pharmaceutical products can ascertain the quality of products, their storage conditions and identify potential counterfeit medications.