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Equine veterinary journal2014; 47(3); 285-290; doi: 10.1111/evj.12287

A comparison of three doses of omeprazole in the treatment of equine gastric ulcer syndrome: A blinded, randomised, dose-response clinical trial.

Abstract: A previous study demonstrated that a dose effect between 1.6 and 4.0 mg/kg bwt of omeprazole per os s.i.d. is present in the treatment of equine gastric ulceration. In the same study, healing of glandular ulceration appeared inferior to healing of squamous ulceration. However, several limitations were recognised in that study and further investigation is warranted. Objective: To further investigate the presence of a dose relationship in the treatment of gastric ulceration under conditions that may favour omeprazole efficacy such as administration prior to exercise and after a brief fast, and potential differences between the response of squamous and glandular ulceration to omeprazole therapy. Methods: A blinded, randomised, dose-response clinical trial. Methods: Sixty Thoroughbred racehorses with grade ≥2/4 squamous and/or glandular ulceration were identified by gastroscopy. Horses were randomly assigned to receive either 1.0, 2.0 or 4.0 mg/kg bwt of enteric coated omeprazole per os s.i.d. 1-4 h prior to exercise. Gastroscopy was repeated at approximately 28 days. Results: The lower doses studied (1.0 and 2.0 mg/kg bwt) were noninferior to the reference dose (4.0 mg/kg bwt) in the treatment of squamous ulceration. Healing was greater in squamous ulceration than glandular ulceration (86% vs. 14%; P<0.0001). Improvement in ulcer grade was more likely in squamous lesions than glandular lesions (96% vs. 34%; P<0.0001). Worsening of the glandular ulcer grade was observed in 36% of horses. Conclusions: The results of this study suggest that, under the conditions studied, where omeprazole is administered before exercise and following a brief fast, doses of omeprazole as low as 1 mg/kg bwt per os s.i.d. may be as effective as higher doses. The proportion of glandular ulceration that heals with 28 days of omeprazole therapy is less than that of squamous ulceration.
© 2014 EVJ Ltd.
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Publication Date: 2014-05-29 PubMed ID: 24761780DOI: 10.1111/evj.12287Google Scholar: Lookup
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  • Journal Article
  • Randomized Controlled Trial
  • Research Support
  • Non-U.S. Gov't

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This study investigates the effect of three different doses of omeprazole in treating equine gastric ulcers, concluding that lower doses of 1.0 and 2.0 mg/kg might be as effective as the higher 4.0 mg/kg dose, particularly when administered before exercise and after a short period of fasting. However, the treatment was found to be less effective on glandular ulcers compared to squamous ulcers.

Objective of the Study

  • The purpose of this research was to explore further the dose-response relationship of omeprazole in the treatment of gastric ulceration in horses under conditions that may enhance omeprazole efficacy like fasting and administration prior to exercise.
  • Another objective was also to evaluate any difference in how squamous and glandular ulcerations respond to omeprazole treatment.

Methods Used in the Study

  • The researchers conducted a blinded randomised dose-response clinical trial with sixty thoroughbred racehorses.
  • The horses, which had grade ≥2/4 squamous and/or glandular ulceration as identified by gastroscopy, were divided into groups to receive omeprazole doses of either 1.0, 2.0, or 4.0 mg/kg before exercise.
  • A follow-up gastroscopy was performed after approximately 28 days to assess the healing progress.

Key Findings of the Study

  • The study’s results indicated that lower doses of 1.0 and 2.0 mg/kg of omeprazole were not inferior to the reference dose (4.0 mg/kg), particularly in treating squamous ulceration.
  • However, the healing progress was remarkably slower in glandular ulceration than squamous ulceration (14% versus 86%).
  • Also, improvement in ulcer grade was more likely in squamous lesions than glandular lesions (96% vs. 34%). There was even worsening of the glandular ulcer grade observed in 36% of horses.

Conclusion From the Study

  • The researchers concluded that under the conditions examined in the study, lower doses of omeprazole (1 mg/kg), administered before exercise and after brief fasting, could be as effective as higher doses.
  • The research also highlighted that the proportion of glandular ulceration that healed with 28 days of omeprazole therapy is less than that of squamous ulceration. This suggest that different types of gastric ulcers might need varied therapeutic strategies.

Cite This Article

APA
Sykes BW, Sykes KM, Hallowell GD. (2014). A comparison of three doses of omeprazole in the treatment of equine gastric ulcer syndrome: A blinded, randomised, dose-response clinical trial. Equine Vet J, 47(3), 285-290. https://doi.org/10.1111/evj.12287

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 47
Issue: 3
Pages: 285-290

Researcher Affiliations

Sykes, B W
  • BW Sykes Consultancy, Upper Orara, New South Wales, Australia.
Sykes, K M
    Hallowell, G D

      MeSH Terms

      • Animals
      • Anti-Ulcer Agents / administration & dosage
      • Anti-Ulcer Agents / therapeutic use
      • Dose-Response Relationship, Drug
      • Female
      • Horse Diseases / drug therapy
      • Horses
      • Male
      • Omeprazole / administration & dosage
      • Omeprazole / therapeutic use
      • Stomach Ulcer / drug therapy
      • Stomach Ulcer / veterinary

      Citations

      This article has been cited 24 times.
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        doi: 10.3390/ani13111823pubmed: 37889700google scholar: lookup
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      7. Ferlini Agne G, May BE, Lovett A, Simon O, Steel C, Santos L, Guedes do Carmo L, Barbosa B, Werner LC, Daros RR, Somogyi AA, Sykes B, Franklin S. Horse Grimace Scale Does Not Detect Pain in Horses with Equine Gastric Ulcer Syndrome. Animals (Basel) 2023 May 12;13(10).
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      15. Sasaki N, Nishi Y, Fujiwara Y, Takeyama T, Kumagai H, Senarathna S, Ushiya S, Tokuyama T, Tokuyama T, Tokuyama T, Mii T, Ayaki S, Matsuno K, Nakagawa Y, Nishihara Y, Taura Y. Effect of a novel rice fermented extract on gastric ulcers in horses. J Equine Sci 2021 Jun;32(2):27-30.
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      17. Wise JC, Wilkes EJA, Raidal SL, Xie G, Crosby DE, Hale JN, Hughes KJ. Interobserver and intraobserver reliability for 2 grading systems for gastric ulcer syndrome in horses. J Vet Intern Med 2021 Jan;35(1):571-579.
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      18. Gough S, Hallowell G, Rendle D. A study investigating the treatment of equine squamous gastric disease with long-acting injectable or oral omeprazole. Vet Med Sci 2020 May;6(2):235-241.
        doi: 10.1002/vms3.220pubmed: 31945806google scholar: lookup
      19. Banse HE, Andrews FM. Equine glandular gastric disease: prevalence, impact and management strategies. Vet Med (Auckl) 2019;10:69-76.
        doi: 10.2147/VMRR.S174427pubmed: 31406687google scholar: lookup
      20. Liu W, Liu G, Liu J. Effects of astragaloside IV on the pharmacokinetics of omeprazole in rats. Pharm Biol 2019 Dec;57(1):449-452.
        doi: 10.1080/13880209.2019.1636828pubmed: 31290355google scholar: lookup
      21. Sykes BW, Bowen M, Habershon-Butcher JL, Green M, Hallowell GD. Management factors and clinical implications of glandular and squamous gastric disease in horses. J Vet Intern Med 2019 Jan;33(1):233-240.
        doi: 10.1111/jvim.15350pubmed: 30499188google scholar: lookup
      22. Hewetson M, Sykes BW, Hallowell GD, Tulamo RM. Diagnostic accuracy of blood sucrose as a screening test for equine gastric ulcer syndrome (EGUS) in adult horses. Acta Vet Scand 2017 Mar 11;59(1):15.
        doi: 10.1186/s13028-017-0284-1pubmed: 28284214google scholar: lookup
      23. Mönki J, Hewetson M, Virtala AM. Risk Factors for Equine Gastric Glandular Disease: A Case-Control Study in a Finnish Referral Hospital Population. J Vet Intern Med 2016 Jul;30(4):1270-5.
        doi: 10.1111/jvim.14370pubmed: 27461724google scholar: lookup
      24. Sykes BW, Hewetson M, Hepburn RJ, Luthersson N, Tamzali Y. European College of Equine Internal Medicine Consensus Statement--Equine Gastric Ulcer Syndrome in Adult Horses. J Vet Intern Med 2015 Sep-Oct;29(5):1288-99.
        doi: 10.1111/jvim.13578pubmed: 26340142google scholar: lookup
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