Current use of biologic therapies for musculoskeletal disease: A survey of board-certified equine specialists.
Abstract: To evaluate the use of mesenchymal stem cells (MSCs), autologous conditioned serum (ACS), platelet-rich plasma (PRP), and autologous protein solution (APS) for the treatment of equine musculoskeletal disease by diplomates of the American College of Veterinary Surgery (ACVS), and American College of Veterinary Sports Medicine and Rehabilitation (ACVSMR). Methods: Cross-sectional study. Methods: Diplomates (n = 423). Methods: An email link was sent to ACVS and ACVMR diplomates. A survey contained 59 questions regarding demographics, as well as indications, frequency, adverse effects, and limitations of use. Responses were analyzed using Fisher's exact test. Results: One hundred and fifty four surveys were analyzed. Years in practice and type of practice were not associated with biologic therapy use. PRP was the most used therapy (120/137; 87.5%). PRP and MSCs were most often administered intralesionally while ACS and APS were most often administered intra-articularly. ACS (50/104; 48.1%) treatment was repeated commonly within 2 weeks of initial injection. MSCs (39/90; 43.3%) and PRP (38/100; 38%) were commonly repeated 1-2 months after initial injection and APS was typically repeated >4 months after initial injection (21/53; 39.6%). Local inflammation and expense were the most common adverse effect and limitation of use. Conclusions: Diplomates most commonly utilized PRP and MSC intralesionally for soft-tissue injuries, and ACS and ACP intra-articularly for joint injury. Protocols for repeated administration varied widely. Local inflammation was a clinical concern with the use of biologics. Conclusions: Biologic therapies are used commonly by ACVS and ACVSMR diplomates for soft tissue and joint disease.
© 2022 The Authors. Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.
Publication Date: 2022-04-05 PubMed ID: 35383972PubMed Central: PMC9322007DOI: 10.1111/vsu.13805Google Scholar: Lookup
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Summary
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The research presents a survey conducted among the diplomates of the American College of Veterinary Surgery (ACVS) and American College of Veterinary Sports Medicine and Rehabilitation (ACVSMR), aimed at evaluating their use of biologic therapies like mesenchymal stem cells, autologous conditioned serum, platelet-rich plasma, and autologous protein solution in treating horse (equine) musculoskeletal disease.
Methodology
- The study utilizes a cross-sectional methodology, distributing a survey through an email link sent to ACVS and ACVMR diplomates.
- The survey contains 59 questions addressing demographics, indications, frequency of use, adverse effects, and limitations concerning the usage of biologic therapies.
- A total of 423 diplomates were involved in the study, out of which responses from 154 surveys were analyzed.
- Fisher’s exact test was used to analyze survey responses.
Findings
- The findings highlighted that the type and years of practice were not related to the use of biologic therapy.
- Platelet-rich plasma (PRP) was found to be the most frequently used therapy.
- PRP and mesenchymal stem cells (MSCs) were most often delivered intralesionally (injected directly into lesions), while autologous conditioned serum (ACS) and autologous protein solution (APS) were usually administered intra-articularly (injected into a joint).
- Regimens for repeated administration varied broadly. ACS treatment was often repeated within 2 weeks of the initial injection, while MSCs and PRP were usually repeated 1-2 months after the initial injection.
- APS was typically re-administered more than 4 months after the initial injection.
- The two most common adverse effect and limitation of the biologic therapies were local inflammation and cost.
Conclusion
- The analysis demonstrated that diplomates frequently used PRP and MSC for soft-tissue injuries and ACS and ACP for joint injury.
- Findings confirmed that biologic therapies were commonly used by ACVS and ACVSMR diplomates for soft tissue and joint disease in horses.
Cite This Article
APA
Knott LE, Fonseca-Martinez BA, O'Connor AM, Goodrich LR, McIlwraith CW, Colbath AC.
(2022).
Current use of biologic therapies for musculoskeletal disease: A survey of board-certified equine specialists.
Vet Surg, 51(4), 557-567.
https://doi.org/10.1111/vsu.13805 Publication
Researcher Affiliations
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA.
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA.
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA.
- Orthopaedic Research Center, C. Wayne McIlwraith Translational Medicine Institute, Colorado State University, Fort Collins, Colorado, USA.
- Orthopaedic Research Center, C. Wayne McIlwraith Translational Medicine Institute, Colorado State University, Fort Collins, Colorado, USA.
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA.
MeSH Terms
- Animals
- Biological Therapy / veterinary
- Cross-Sectional Studies
- Horse Diseases / therapy
- Horses
- Humans
- Inflammation / veterinary
- Musculoskeletal Diseases / therapy
- Musculoskeletal Diseases / veterinary
- Platelet-Rich Plasma
- Surveys and Questionnaires
Grant Funding
- T32 OD010437 / NIH HHS
Conflict of Interest Statement
Dr. Laurie Goodrich is a shareholder in Advanced Regenerative Therapies (Fort Collins, Colorado) and a member of the scientific advisory board for EQCell, Inc. (Guelph, Canada). Dr. Wayne McIlwraith is a shareholder in Advanced Regenerative Therapies (Fort Collins, Colorado), a member of the board of directors of EQCell Inc. (Guelph, Canada), and a consultant for Arthrex (Naples, Florida). The remaining authors declare no conflict of interest related to this report.
References
This article includes 28 references
- Colbath AC, Dow SW, Hopkins LS, Phillips JN, McIlwraith CW, Goodrich LR. Single and repeated intra‐articular injections in the tarsocrural joint with allogeneic and autologous equine bone marrow‐derived mesenchymal stem cells are safe, but did not reduce acute inflammation in an experimental interleukin‐1beta model of synovitis.. Equine Vet J 2020;52:601‐612.
- Broeckx S, Borena BM, Zimmerman M. Intravenous application of allogenic peripheral blood‐derived mesenchymal stem cells: a safety assessment in 291 equine recipients.. Curr Stem Cell Res Ther 2014;9:452‐457.
- Broeckx SY, Martens AM, Bertone AL. The use of equine chondrogenic‐induced mesenchymal stem cells as a treatment for osteoarthritis: a randomised, double‐blinded, placebo‐controlled proof‐of‐concept study.. Equine Vet J 2019;51:787‐794.
- Depuydt E, Broeckx SY, Van Hecke L. The evaluation of equine allogeneic Tenogenic primed Mesenchymal stem cells in a surgically induced superficial digital flexor tendon lesion model.. Front Vet Sci 2021;8:641441.
- Smith RK, Werling NJ, Dakin SG, Alam R, Goodship AE, Dudhia J. Beneficial effects of autologous bone marrow‐derived mesenchymal stem cells in naturally occurring tendinopathy.. PLoS One 2013;8:e75697.
- Moraes AP, Moreira JJ, Brossi PM. Short‐ and long‐term effects of platelet‐rich plasma upon healthy equine joints: clinical and laboratory aspects.. Can Vet J 2015;56:831‐838.
- Mirza MH, Bommala P, Richbourg HA, Rademacher N, Kearney MT, Lopez MJ. Gait changes vary among horses with naturally occurring osteoarthritis following intra‐articular administration of autologous platelet‐rich plasma.. Front Vet Sci 2016;3:29.
- Bosch G, van Schie HT, de Groot MW. Effects of platelet‐rich plasma on the quality of repair of mechanically induced core lesions in equine superficial digital flexor tendons: a placebo‐controlled experimental study.. J Orthop Res 2010;28:211‐217.
- Romero A, Barrachina L, Ranera B. Comparison of autologous bone marrow and adipose tissue derived mesenchymal stem cells, and platelet rich plasma, for treating surgically induced lesions of the equine superficial digital flexor tendon.. Vet J 2017;224:76‐84.
- Marques‐Smith P, Kallerud AS, Johansen GM. Is clinical effect of autologous conditioned serum in spontaneously occurring equine articular lameness related to ACS cytokine profile?. BMC Vet Res 2020;16:181.
- Frisbie DD, Kawcak CE, Werpy NM, Park RD, McIlwraith CW. Clinical, biochemical, and histologic effects of intra‐articular administration of autologous conditioned serum in horses with experimentally induced osteoarthritis.. Am J Vet Res 2007;68:290‐296.
- Geburek F, Lietzau M, Beineke A, Rohn K, Stadler PM. Effect of a single injection of autologous conditioned serum (ACS) on tendon healing in equine naturally occurring tendinopathies.. Stem Cell Res Ther 2015;6:126.
- Bertone AL, Ishihara A, Zekas LJ. Evaluation of a single intra‐articular injection of autologous protein solution for treatment of osteoarthritis in horses.. Am J Vet Res 2014;75:141‐151.
- Caron JP, Kaneene JB, Miller R. Results of a survey of equine practitioners on the use and perceived efficacy of polysulfated glycosaminoglycan.. J Am Vet Med Assoc 1996;209:1564‐1568.
- Ferris DJ, Frisbie DD, McIlwraith CW, Kawcak CE. Current joint therapy usage in equine practice: a survey of veterinarians 2009.. Equine Vet J 2011;43:530‐535.
- Velloso Alvarez A, Boone LH, Braim AP. A survey of clinical usage of non‐steroidal intra‐articular therapeutics by equine practitioners.. Front Vet Sci 2020;7:579967.
- Wilson JM, McKenzie E, Duesterdieck‐Zellmer K. International survey regarding the use of rehabilitation modalities in horses.. Front Vet Sci 2018;5:120.
- Eysenbach G. Improving the quality of web surveys: the checklist for reporting results of internet E‐surveys (CHERRIES).. J Med Internet Res 2004;6:e34.
- Sargeant JM, O'Connor AM, Dohoo IR. Methods and processes of developing the strengthening the reporting of observational studies in epidemiology ‐ veterinary (STROBE‐vet) statement.. J Vet Intern Med 2016;30:1887‐1895.
- Fortier LA, Goodrich LR, Ribitsch I. One health in regenerative medicine: report on the second Havemeyer symposium on regenerative medicine in horses.. Regen Med 2020;15:1775‐1787.
- Waselau M, Sutter WW, Genovese RL, Bertone AL. Intralesional injection of platelet‐rich plasma followed by controlled exercise for treatment of midbody suspensory ligament desmitis in Standardbred racehorses.. J Am Vet Med Assoc 2008;232:1515‐1520.
- Ortved KF. Regenerative medicine and rehabilitation for Tendinous and ligamentous injuries in sport horses.. Vet Clin North Am Equine Pract 2018;34:359‐373.
- Arguelles D, Carmona JU, Climent F, Muñoz E, Prades M. Autologous platelet concentrates as a treatment for musculoskeletal lesions in five horses.. Vet Rec 2008;162:208‐211.
- Koch TG, Berg LC, Betts DH. Current and future regenerative medicine ‐ principles, concepts, and therapeutic use of stem cell therapy and tissue engineering in equine medicine.. Can Vet J 2009;50:155‐165.
- Geburek F, Gaus M, van Schie HT, Rohn K, Stadler PM. Effect of intralesional platelet‐rich plasma (PRP) treatment on clinical and ultrasonographic parameters in equine naturally occurring superficial digital flexor tendinopathies ‐ a randomized prospective controlled clinical trial.. BMC Vet Res 2016;12:191.
- Ardanaz N, Vazquez FJ, Romero A. Inflammatory response to the administration of mesenchymal stem cells in an equine experimental model: effect of autologous, and single and repeat doses of pooled allogeneic cells in healthy joints.. BMC Vet Res 2016;12:65.
- Joswig AJ, Mitchell A, Cummings KJ. Repeated intra‐articular injection of allogeneic mesenchymal stem cells causes an adverse response compared to autologous cells in the equine model.. Stem Cell Res Ther 2017;8:42.
- Ursini TL, Amelse LL, Elkhenany HA, Odoi A, Carter‐Arnold JL, Adair HS. Retrospective analysis of local injection site adverse reactions associated with 230 allogenic administrations of bone marrow‐derived mesenchymal stem cells in 164 horses.. Equine Vet J 2019;51:198‐205.
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