Breakthrough Clinical Results
Zomedica Corp. announced the launch of the Equine Asthma Clinical Registry, a program utilizing PulseVet® shock wave therapy as a non-invasive, drug-free treatment for equine asthma. The registry aims to gather real-world clinical evidence on the effectiveness of PulseVet in treating this common, often underdiagnosed condition affecting approximately 15% of horses over seven years old. Veterinary clinics can enroll up to 20 horses, contributing to research and receiving product credits. Early clinical studies have shown positive results with no reported adverse events. This initiative underscores Zomedica's commitment to evidence-based innovation and improving equine respiratory care.
Key Highlights
- Launch of the Equine Asthma Clinical Registry using PulseVet shock wave therapy.
- Non-invasive, drug-free treatment alternative for equine asthma.
- Registry aims to gather real-world clinical evidence on PulseVet's effectiveness.
- Veterinary clinics can participate and receive product credits.
Incidence and Prevalence
Equine asthma, also known as recurrent airway obstruction (RAO), is a common respiratory disease affecting horses worldwide. Unfortunately, precise global estimates of its incidence and prevalence are not readily available in the provided PubMed abstracts. The abstracts focus primarily on human diseases. However, some general information about equine asthma and the challenges in obtaining accurate epidemiological data can be gleaned from veterinary literature and extrapolated to the context of this question.
Challenges in Estimating Equine Asthma Incidence and Prevalence:
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Varied Terminology and Diagnostic Criteria: Similar to human asthma, equine asthma encompasses a spectrum of respiratory conditions, from mild, intermittent symptoms to severe, chronic obstruction. The terminology used to describe these conditions can vary (e.g., RAO, inflammatory airway disease [IAD], summer pasture-associated obstructive pulmonary disease). Furthermore, diagnostic criteria are not uniformly applied across different regions and studies, making comparisons difficult.
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Lack of Centralized Reporting: Unlike many human diseases, there isn't a global registry or surveillance system for equine asthma. Data collection often relies on individual veterinary practices, research studies, or regional surveys, which may not be representative of the entire horse population.
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Influence of Management Practices and Environmental Factors: The incidence and prevalence of equine asthma are heavily influenced by management practices (e.g., stabling, bedding, feeding) and environmental exposures (e.g., dust, mold, pollen). These factors can vary significantly between different regions and even individual farms, making it difficult to generalize findings.
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Subclinical Cases: Many horses with equine asthma may have subclinical disease, meaning they exhibit mild or no outward signs of respiratory distress but still have underlying airway inflammation. These cases are often missed in epidemiological studies, leading to underestimation of the true prevalence.
General Observations and Extrapolations:
While precise global figures are lacking, equine asthma is considered a significant health concern in horse populations worldwide. Prevalence estimates from regional studies vary widely, but it is generally accepted that a substantial proportion of adult horses, particularly those kept in stables, are affected by some form of equine asthma. Incidence rates are likely influenced by age, breed, and management practices, with older horses and certain breeds potentially at higher risk.
Future Directions:
To obtain more accurate global estimates of equine asthma incidence and prevalence, standardized diagnostic criteria and reporting methods are needed. International collaboration and the development of centralized data collection systems would be valuable steps in this direction. Further research is also needed to better understand the complex interplay of genetic, environmental, and management factors that contribute to the development of equine asthma in different horse populations.
It is important to note that this answer provides general information and extrapolations based on the available evidence. For more specific and detailed information on equine asthma epidemiology, consulting veterinary literature and experts in the field is recommended.
Mechanism of Action
Equine asthma, formerly known as recurrent airway obstruction (RAO) or heaves, is a chronic inflammatory airway disease in horses, similar to asthma in humans. While there aren't specific FDA-approved drugs exclusively for equine asthma, many human asthma medications are used off-label. The mechanisms of action of these drugs fall into several categories, with the most common being:
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Bronchodilators: These medications relax the smooth muscles surrounding the airways, allowing them to open up and improve airflow. There are two main types used in equine asthma:
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β2-adrenergic agonists: These drugs, such as albuterol (salbutamol) and clenbuterol, mimic the effects of adrenaline, stimulating β2 receptors on airway smooth muscle and causing relaxation. Albuterol is typically used for short-term relief of bronchospasm, while clenbuterol is often used for longer-term management.
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Anticholinergics: These medications, such as ipratropium and tiotropium, block the action of acetylcholine, a neurotransmitter that causes airway constriction. They are often used in combination with β2-agonists for enhanced bronchodilation.
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Corticosteroids: These are potent anti-inflammatory drugs that reduce airway inflammation and hyperreactivity. They are the cornerstone of long-term management of equine asthma. Examples include dexamethasone, prednisolone, and fluticasone. Inhaled corticosteroids, such as fluticasone, are preferred for long-term management as they deliver the drug directly to the lungs, minimizing systemic side effects. Systemic corticosteroids, such as dexamethasone and prednisolone, are generally reserved for severe cases or acute exacerbations.
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Other therapies: While not as commonly used as the first two categories, other therapies with different mechanisms of action are sometimes employed in equine asthma management:
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Mast cell stabilizers: These drugs, such as cromolyn sodium and nedocromil sodium, prevent the release of inflammatory mediators from mast cells, which play a role in allergic airway inflammation. They are more effective in preventing asthma attacks than in treating acute bronchospasm. Their use in equine asthma is less common than in human asthma.
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Leukotriene modifiers: These medications, such as montelukast and zafirlukast, block the action of leukotrienes, inflammatory molecules that contribute to bronchoconstriction and mucus production. Their use in equine asthma is less common and their efficacy is less well-established compared to other treatments.
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Methylxanthines: Theophylline, a methylxanthine, has bronchodilator and anti-inflammatory effects. It was historically used in equine asthma but has largely been replaced by other therapies due to its narrow therapeutic index and potential for side effects.
It is important to note that the specific drugs and treatment regimens used for equine asthma can vary depending on the severity of the disease, the individual horse's response to therapy, and the veterinarian's clinical judgment.
Drug used in other indications
PulseVet is a specific brand of electrohydraulic shock wave therapy (ESWT) system. While ESWT has shown promise in treating various equine orthopedic disorders, the provided text doesn't mention equine asthma as an indication, nor does it specifically discuss ongoing trials for PulseVet outside of general ESWT applications.
However, the provided paragraphs do mention several other conditions where ESWT, in general, is being investigated or used clinically in horses:
- Osteoarthritis: ESWT is being investigated for its use in treating osteoarthritis in horses, a common cause of lameness and pain. Clinical trials are exploring its efficacy in various joints.
- Thoracolumbar pain: ESWT is being used to treat back pain in horses, specifically in the thoracolumbar region.
- Navicular syndrome: This debilitating condition affecting the horse's foot is another area where ESWT is being investigated.
- Tendinopathy and proximal suspensory desmopathy: ESWT is being used to treat tendon and ligament injuries in horses, including conditions like tendinopathy and proximal suspensory desmopathy. Its concomitant use with biologics is an area of active research.
- Wound healing: ESWT has shown promise in promoting wound healing in horses, potentially through mechanisms like increased blood flow and growth factor stimulation.
The intervention models for these ESWT trials vary, but generally involve:
- Different ESWT technologies: While electrohydraulic systems are currently predominant, electromagnetic and piezoelectric systems are also used.
- Varying treatment protocols: Studies are exploring different combinations of energy levels, treatment depth, number of pulses, and frequency of sessions.
- Combination with other therapies: ESWT is sometimes used in conjunction with other treatments, such as biologics (e.g., platelet-rich plasma) or physical therapy, to enhance its effects.
It's important to note that direct comparisons of ESWT protocols and long-term efficacy studies are still lacking in many areas, and evidence-based recommendations are often anecdotal. Further research is needed to optimize ESWT protocols for different equine conditions and to establish clear guidelines for its use.