Clinical effect of corticosteroids in asthma-affected horses: A quantitative synthesis.

The research article focuses on the comparative clinical impacts of inhaled and systemic corticosteroids on horses suffering from equine asthma, and explores a new scoring system called IDEASS for evaluating the disease’s severity.

Objective of the Study

• The study aims to evaluate and compare the effects of inhaled and systemic corticosteroids on equine asthma. It also seeks to establish a quantitative clinical score, known as the Minimal Important Difference (MID), also expressed as the Minimally Clinically Detectable Difference (MCDD). This involves the introduction and early assessment of a new scoring system known as the Improved clinically Detectable Equine Asthma Scoring System (IDEASS).

Methods

• A pair-wise and network meta-analysis was conducted by carrying out literature searches for studies exploring corticosteroid therapy in cases of equine asthma.
• To ensure the validity of the obtained studies, the risk of publication bias was evaluated using Funnel plots and Egger’s test.
• Furthermore, changes in clinical scores from treatment with corticosteroids versus controls were analysed using random-effects models and Bayesian networks.

Results

• The results indicated a significant improvement in the clinical condition of horses suffering from equine asthma after corticosteroid treatment (Both from inhaled and systemic corticosteroids).
• The IDEASS scoring system suggested a 30% improvement in the clinical condition of the asthma-affected horses compared to controls, after corticosteroid treatment.
• There was no substantial difference detected between the effects of inhaled and systemic corticosteroids on the changes observed in clinical scores.

Conclusion

• The study supports the use of inhaled corticosteroids as an effective solution for improving the clinical condition of horses with equine asthma and preventing exacerbations.
• Systemic corticosteroids should be reserved for selected cases only, especially those displaying symptomatic airway hyperresponsiveness during exacerbation.
• The IDEASS scoring system appears promising, but needs further validation. Once validated, it could be used to categorize the severity of equine asthma, and assess the clinical effectiveness of pharmaceutical treatments in horses suffering from the disease.