Abstract: There are limited options for treatment of the common disease, equine asthma. The aim of this study was to estimate the feasibility and potential efficacy of using nebulized lidocaine for treating equine asthma, while at the same time treating a separate cohort of asthmatic horses with inhaled budesonide. Nineteen horses with a history consistent with equine asthma were recruited from our referral population for a double-blind, randomized, controlled pilot clinical trial using Consolidated Standards of Reporting Trials (CONSORT) guidelines. After screening, 16 horses met the inclusion criteria for equine asthma and 13 horses actually completed the study. Horses were treated by their owners at home for 14 d before returning to our hospital for follow-up assessment. Interventions consisted of nebulization q12h for 14 d with 1.0 mg/kg body weight (BW) of lidocaine or corticosteroid treatment (nebulized budesonide 1 μg/kg, q12h). Clinical and tracheal mucus score, pulmonary function testing, and respiratory secretion cytology were assessed after 2 weeks of treatment to determine the outcome. Both lidocaine and budesonide cohorts had significant decreases ( < 0.05) in clinical score; the lidocaine cohort showed a significant decrease in bronchoalveolar lavage (BAL) neutrophil percentage and tracheal mucus score. Neither treatment resulted in significant changes in lung function parameters. No adverse events occurred. Lidocaine may be an effective and safe treatment for equine asthma in horses that cannot tolerate treatment with corticosteroids. Il existe des options limitées pour le traitement de la maladie répandue, l’asthme équin. Le but de cette étude était d’estimer la faisabilité et l’efficacité potentielle de l’utilisation de la lidocaïne nébulisée pour traiter l’asthme équin, tout en traitant en même temps une cohorte distincte de chevaux asthmatiques avec du budésonide inhalé. Dix-neuf chevaux ayant des antécédents compatibles avec l’asthme équin ont été recrutés dans notre population de référence pour un essai clinique pilote contrôlé, randomisé, en double aveugle, conformément aux directives CONSORT (). Après dépistage, 16 chevaux répondaient aux critères d’inclusion de l’asthme équin et 13 chevaux ont terminé l’étude. Les chevaux ont été traités par leurs propriétaires à domicile pendant 14 jours avant de retourner à notre hôpital pour une évaluation de suivi. Les interventions consistaient en une nébulisation deux fois par jour pendant 14 jours avec 1,0 mg/kg de poids corporel (PC) de lidocaïne ou un traitement aux corticostéroïdes (budésonide nébulisé 1 μg/kg, q12h). Le score clinique et de mucus trachéal, les tests de la fonction pulmonaire et la cytologie des sécrétions respiratoires ont été évalués après 2 semaines de traitement pour déterminer le résultat. Les cohortes de lidocaïne et de budésonide présentaient des diminutions significatives ( < 0,05) du score clinique; la cohorte de lidocaïne a montré une diminution significative du pourcentage de neutrophiles du lavage bronchoalvéolaire (BAL) et du score de mucus trachéal. Aucun des deux traitements n’a entraîné de changements significatifs dans les paramètres de la fonction pulmonaire. Aucun événement indésirable n’est survenu. La lidocaïne peut être un traitement efficace et sûr de l’asthme équin chez les chevaux qui ne tolèrent pas le traitement aux corticostéroïdes.(Traduit par Docteur Serge Messier).
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The research aims to examine the potential effectiveness and feasibility of using nebulized lidocaine as a treatment for equine asthma, in comparison to inhaled budesonide. The study finds that both lidocaine and budesonide demonstrate notable improvements in clinical scores, with lidocaine showing a significant reduction in bronchoalveolar lavage (BAL) neutrophil percentage and tracheal mucus score.
Objective and Methodology
This study is designed as a consortium-guided, double-blind, randomized pilot clinical trial to explore new treatment methods for equine asthma, which currently has limited therapeutic options.
During the trial, 19 horses with equine asthma were randomly selected and segregated into two groups. One cohort was treated with nebulized lidocaine and the other with nebulized budesonide for a period of 14 days.
All treatments were conducted by their owners at their home, and the horses were brought back to the hospital for a post-treatment assessment after two weeks.
Outcome and Findings
At the end of the trial, it was observed that both cohorts of horses, treated with either lidocaine or budesonide, had significant decreases in their clinical scores.
More specifically, horses treated with lidocaine showcased a remarkable decrease in bronchoalveolar lavage (BAL) neutrophil percentage and tracheal mucus score.
However, there were no significant changes noticed in the lung function parameters of the horses after undergoing either treatment.
No adverse events were reported during the course of the study, suggesting that both lidocaine and budesonide were not associated with any safety risks.
Conclusion
The research concludes that lidocaine has the potential to be an effective and safe treatment for equine asthma, particularly for horses that are intolerant to corticosteroid treatment.
Despite the study not noting any significant changes in lung function parameters, the marked improvements in clinical scores and tracheal mucus score for the lidocaine cohort indicate a promising avenue for future exploration and more comprehensive studies.
Cite This Article
APA
Mahalingam-Dhingra A, Mazan MR, Bedenice D, Ceresia M, Minuto J, Deveney EF.
(2022).
A CONSORT-guided, randomized, double-blind, controlled pilot clinical trial of inhaled lidocaine for the treatment of equine asthma.
Can J Vet Res, 86(2), 116-124.
Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA (Mahalingam-Dhingra, Mazan, Bedenice, Minuto); Pharmacology, Massachusetts College of Pharmacy and Health Sciences, Boston, Massachusetts, USA (Ceresia); Physics, Bridgewater State University, Bartlett College of Science and Mathematics, Bridgewater, Massachusetts, USA (Deveney).
Mazan, Melissa R
Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA (Mahalingam-Dhingra, Mazan, Bedenice, Minuto); Pharmacology, Massachusetts College of Pharmacy and Health Sciences, Boston, Massachusetts, USA (Ceresia); Physics, Bridgewater State University, Bartlett College of Science and Mathematics, Bridgewater, Massachusetts, USA (Deveney).
Bedenice, Daniela
Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA (Mahalingam-Dhingra, Mazan, Bedenice, Minuto); Pharmacology, Massachusetts College of Pharmacy and Health Sciences, Boston, Massachusetts, USA (Ceresia); Physics, Bridgewater State University, Bartlett College of Science and Mathematics, Bridgewater, Massachusetts, USA (Deveney).
Ceresia, Michelle
Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA (Mahalingam-Dhingra, Mazan, Bedenice, Minuto); Pharmacology, Massachusetts College of Pharmacy and Health Sciences, Boston, Massachusetts, USA (Ceresia); Physics, Bridgewater State University, Bartlett College of Science and Mathematics, Bridgewater, Massachusetts, USA (Deveney).
Minuto, Jill
Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA (Mahalingam-Dhingra, Mazan, Bedenice, Minuto); Pharmacology, Massachusetts College of Pharmacy and Health Sciences, Boston, Massachusetts, USA (Ceresia); Physics, Bridgewater State University, Bartlett College of Science and Mathematics, Bridgewater, Massachusetts, USA (Deveney).
Deveney, Edward F
Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA (Mahalingam-Dhingra, Mazan, Bedenice, Minuto); Pharmacology, Massachusetts College of Pharmacy and Health Sciences, Boston, Massachusetts, USA (Ceresia); Physics, Bridgewater State University, Bartlett College of Science and Mathematics, Bridgewater, Massachusetts, USA (Deveney).
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