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Journal of veterinary internal medicine2024; doi: 10.1111/jvim.17052

A randomized placebo-controlled double-blinded study comparing oral and subcutaneous administration of mistletoe extract for the treatment of equine sarcoid disease.

Abstract: Equine sarcoids (ES) are the most common cutaneous tumors in equids. Systemic treatment options are sparse. Subcutaneous (SC) injections of Viscum album extract (VAE) demonstrate efficacy as a systemic treatment directed against ES. Objective: To critically assess the therapeutic efficacy of orally administered VAE. Methods: Forty-five ES-affected, privately owned, 3-12 year-old horses. Methods: A 3-armed randomized placebo-controlled, double-blinded study was conducted in a double-dummy design. Horses were subjected to oral administration and SC injections of either VAE or placebo (VAE oral/placebo SC, VAE SC/placebo oral, placebo oral/placebo SC) over a 7-month treatment period. Primary endpoint was the change of baseline of a composite index of ES number and ES area after 14 months. Second endpoint was the clinical response. Results: No statistically significant difference in the composite endpoint between the 3 study arms was found. The primary endpoint showed 4 (27%) horses in the VAE oral group with complete ES regression, 3 (21%) in the VAE SC injection group, and 2 (13%) in the placebo group. The clinical response revealed complete or partial regression in 6 horses of the oral VAE group (40%), 4 of the SC injection group (29%), and 4 of the placebo group (25%). Direct comparison of oral VAE and placebo showed an odds ratio, stratified for prognosis of 2.16 (95%-CI: 0.45-10.42) and a P-value of 0.336. Conclusions: Oral administration of VAE is well tolerated. No statistically significant difference in the effectiveness of systemic VAE versus placebo against ES was found.
© 2024 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.
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Publication Date: 2024-03-26 PubMed ID: 38529853DOI: 10.1111/jvim.17052Google Scholar: Lookup
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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.

The research examined the effectiveness of orally administered Viscum album extract (VAE), a mistletoe extract, in treating equine sarcoids (ES), which are common skin tumours in horses. The study, which was a randomized, double-blinded, and placebo-controlled, did not find a statistically significant difference in the therapeutic efficacy of orally administered VAE compared to subcutaneous injections or a placebo.

Study Overview

  • This investigation is a randomized, placebo-controlled, double-blinded study with a double-dummy design.
  • The focus is on the treatment of Equine Sarcoids (ES), the most common skin tumors in horses.
  • The treated groups were given Viscum Album Extract (VAE), a mistletoe extract, either orally or in a subcutaneous (SC) injection. The control group received a placebo treatment, either taken orally or as an SC injection.

Methods

  • 45 horses aged between 3 and 12 who were privately owned and affected by ES took part in the study.
  • The horses were subjected to a 7-month treatment period where they received their assigned treatment type.
  • The primary endpoint was the change of baseline of a composite index of ES number and ES area after 14 months.
  • The secondary endpoint was the clinical response to the treatment.

Results

  • No statistically significant difference was found between the three groups.
  • Four horses (27%) in the VAE oral group, three (21%) in the VAE SC injection group, and two (13%) in the placebo group showed complete ES regression in the primary endpoint.
  • In terms of clinical response, complete or partial regression was observed in six horses from the oral VAE group (40%), four from the SC injection group (29%), and four from the placebo group (25%).

Conclusions

  • The oral administration of VAE was well tolerated by the horses.
  • However, the study’s results do not show a statistically significant difference in the effectiveness of systemic VAE against ES, compared to a placebo.

Cite This Article

APA
Beermann A, Clottu O, Reif M, Biegel U, Unger L, Koch C. (2024). A randomized placebo-controlled double-blinded study comparing oral and subcutaneous administration of mistletoe extract for the treatment of equine sarcoid disease. J Vet Intern Med. https://doi.org/10.1111/jvim.17052

Publication

Journal of veterinary internal medicine
ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English

Researcher Affiliations

Beermann, Anke
  • Research Institute of Organic Agriculture (FiBL), Department of Livestock Sciences, Frick, Switzerland.
Clottu, Ophélie
  • Research Institute of Organic Agriculture (FiBL), Department of Livestock Sciences, Frick, Switzerland.
Reif, Marcus
  • Society of Clinical Research e.V, Berlin, Germany.
Biegel, Ulrike
  • Research Institute of Organic Agriculture (FiBL), Department of Livestock Sciences, Frick, Switzerland.
Unger, Lucia
  • Department of Clinical Veterinary Medicine, Swiss Institute of Equine Medicine (ISME), University of Bern, Bern, Switzerland.
Koch, Christoph
  • Department of Clinical Veterinary Medicine, Swiss Institute of Equine Medicine (ISME), University of Bern, Bern, Switzerland.

Grant Funding

  • The Society of Cancer Research, Arlesheim, Switzerland
  • The Veterinary Association of the Canton of Neuchu00e2tel, Neuchu00e2tel, Switzerland
  • The Swiss Veterinary Association for Alternative and Complementary Medicine (camvet.ch), Bern, Switzerland
  • The Rudolf Steiner Fund for Scientific Research e.V., Nuremberg, Germany

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Citations

This article has been cited 3 times.
  1. Duncan LJ, Bryant S, Feder G, Gresham M, Gibson P, Sharp D, Braybrooke JP, Huntley AL. The Mistletoe and Breast Cancer (MAB) Study: A UK Mixed-Phase, Pilot, Placebo-Controlled, Double-Blind, Randomised Controlled Trial. Cancers (Basel) 2025 Sep 29;17(19).
    doi: 10.3390/cancers17193169pubmed: 41097697google scholar: lookup
  2. Beermann A, Hamza E, Reinhard S, Koch C, Oberhänsli T, Unger L. Selected microRNAs as biomarkers in sarcoid-affected horses under immunotherapy with a mistletoe extract. J Vet Diagn Invest 2026 Jan;38(1):33-40.
    doi: 10.1177/10406387251362820pubmed: 41039872google scholar: lookup
  3. Smith CH, Stewart HL, Stefanovski D, Levine DG. Outcomes following autologous tumor tissue implantation with or without concurrent antineoplastic therapies in the treatment of sarcoids in 50 equids. Front Vet Sci 2025;12:1559519.
    doi: 10.3389/fvets.2025.1559519pubmed: 40417356google scholar: lookup
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