Clinical efficacy of inhaled corticosteroids in equine asthma: A meta-analysis and number needed to treat.

The research article provides a meta-analysis of the effectiveness of inhaled corticosteroids in managing equine asthma, requiring approximately three horses to be treated for one to see a significant benefit.

Objective of Research

• The research was undertaken to evaluate the clinical efficacy of inhaled corticosteroids (ICS) in treating equine asthma, a popular inflammatory condition in horses, which significantly impacts their performance and quality of life.
• The study focuses on the number needed to treat (NNT) – how many horses need to be treated with ICS for one to achieve a marked clinical response, and the likelihood of achieving a clinical response.

Methodology of Research

• A comprehensive literature search was carried to identify studies comparing ICS with placebo controlled treatments. This yielded data from four clinical trials involving 252 asthmatic horses.
• The research also focused on synthesizing data from these studies and using meta-analysis, a statistical technique for combining the findings from separate but similar studies, to develop an overall conclusion.

Results of Research

• Meta-analysis revealed that there was an overall NNT of 3.2, implying approximately three horses must be treated with ICS for one to achieve a significant clinical improvement.
• Moreover, the relative risk of achieving clinical improvement with ICS versus placebo was 1.73, showing a significant increase in therapeutic effectiveness. This supports the use of ICS in managing equine asthma.
• The subgroup analysis showed an NNT of 3.0 for severe cases, emphasizing the efficacy of ICS across horses with different severity levels of asthma.
• The GRADE assessment rated the quality of the research evidence as high despite potential biases.

Conclusion and Future Directions

• The research concludes that these results demonstrate the therapeutic value of ICS in managing equine asthma and provides evidence-based recommendations for their clinical use.
• Future studies are recommended to investigate long-term outcomes of using ICS treatment and explore potential synergistic effects of combining ICS with other treatments to enhance clinical efficacy in managing equine asthma.