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Equine veterinary journal2019; 51(6); 779-786; doi: 10.1111/evj.13093

Effect of different doses of inhaled ciclesonide on lung function, clinical signs related to airflow limitation and serum cortisol levels in horses with experimentally induced mild to severe airway obstruction.

Abstract: Inhaled corticosteroids are effective for the treatment of equine asthma but they induce cortisol suppression with potential side effects. Objective: To study the efficacy of ciclesonide, an inhaled corticosteroid with an improved safety profile, on lung function, clinical signs related to airway obstruction, and serum cortisol levels in asthmatic horses exposed to a mouldy hay challenge. Methods: Cross-over placebo controlled, blinded, randomised experiment. Methods: Sixteen horses were enrolled in three subsequent dose-titration studies (8 horses/study) to investigate the effects of inhaled ciclesonide administered for 2 weeks at doses ranging from 450 to 2700 μg twice daily or 3712.5 μg once daily. Systemic dexamethasone (0.066 mg/kg per os) was our positive control. A placebo group was also studied. Lung function and clinical scores were blindly performed before and after 7 and 14 days of treatment. Serum cortisol was measured before and after 3, 5, 7, 10, 14 days of treatment as well as 3 and 7 days post treatment. Results: After 7 days, dexamethasone induced a significant reduction in pulmonary resistance (from 2.5 ± 0.6 at day 0 to 1.1 ± 0.7 cm H O/L/s), pulmonary elastance (5.0 ± 2.6 to 1.2 ± 1.0 cm H O/L), and of the weighted clinical score (14.8 ± 4.7 to 8.0 ± 4.4). Similarly, ciclesonide 1687.5 μg twice daily significantly improved pulmonary resistance (2.7 ± 1.1 to 1.6 ± 0.8 cm H O/L/s), pulmonary elastance (5.2 ± 3.1 to 2.2 ± 1.3 cm H O/L), and weighted clinical score (13 ± 2.9 to 10.8 ± 4.2). Serum cortisol suppression (<50 nmol/L) systematically occurred with dexamethasone from day 3 of treatment up to day 3 post treatment, but not with ciclesonide at any tested doses. Placebo did not exert any significant beneficial effect. Conclusions: Experimentally induced asthma exacerbations in horses might respond differently to treatment than naturally occurring exacerbations. Conclusions: Inhaled ciclesonide is an effective treatment for horses with equine asthma. Serum cortisol was unaffected by treatment.
© 2019 Université de Montréal. Equine Veterinary Journal published John Wiley & Sons Ltd on behalf of EVJ Ltd.
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Publication Date: 2019-04-05 PubMed ID: 30854685PubMed Central: PMC7379559DOI: 10.1111/evj.13093Google Scholar: Lookup
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  • Clinical Trial
  • Veterinary
  • Journal Article

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 article investigates how different doses of an inhaled corticosteroid called ciclesonide affects lung function, clinical signs associated with blocked airways, and serum cortisol levels in horses with artificially induced airway obstruction, showing it is an effective treatment for horse asthma without disturbing serum cortisol levels.

Research Methodology

  • The research was carried out in a controlled and randomised cross-over placebo experiment. This type of experiment ensures that all horses had the opportunity to receive the placebo and all doses of the treatment (ciclesonide), which helps minimise any potential bias.
  • Sixteen horses were subjected to three subsequent dose-titration studies with each study having eight horses. The administered doses of ciclesonide ranged from 450 to 2700 µg twice daily or 3712.5 µg once daily.
  • Systemic dexamethasone was used as a positive control and a placebo group was included, providing a baseline for comparison.
  • Lung functions and clinical scores were blindly conducted before and after 7 and 14 days of treatment.
  • Serum cortisol was also measured before and after 3, 5, 7, 10, 14 days of treatment as well as 3 and 7 days post treatment.

Research Results

  • After 7 days of treatment, the research showed systemic dexamethasone significantly reduced lung resistance, pulmonary elasticity, and overall clinical score. It was also observed that administration of ciclesonide at 1687.5 µg twice daily similarly improved the same clinical parameters.
  • The placebo group did not display any significant improvement, helping to reaffirm the effectiveness of the actual drugs.
  • Systemic dexamethasone resulted in suppression of serum cortisol levels from day 3 up to day 3 post-treatment. However, ciclesonide treatment did not result in any cortisol level alterations, a key result supporting ciclesonide as a safer alternative.

Research Conclusions

  • The conclusions drawn from this research indicate that asthmatic flare-ups induced in a lab environment for horses may respond differently to treatment compared to naturally occurring exacerbations.
  • Finally, it can be concluded that inhaled ciclesonide is an effective treatment for horses with equine asthma without altering serum cortisol levels. This suggests that ciclesonide can be used without worrying about the cortisol suppression-related side effects commonly associated with other corticosteroids.

Cite This Article

APA
Lavoie JP, Bullone M, Rodrigues N, Germim P, Albrecht B, von Salis-Soglio M. (2019). Effect of different doses of inhaled ciclesonide on lung function, clinical signs related to airflow limitation and serum cortisol levels in horses with experimentally induced mild to severe airway obstruction. Equine Vet J, 51(6), 779-786. https://doi.org/10.1111/evj.13093

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 51
Issue: 6
Pages: 779-786

Researcher Affiliations

Lavoie, J-P
  • Department of Clinical Sciences, Université de Montréal, St-Hyacinthe, Q, Canada.
Bullone, M
  • Department of Clinical Sciences, Université de Montréal, St-Hyacinthe, Q, Canada.
Rodrigues, N
  • Department of Clinical Sciences, Université de Montréal, St-Hyacinthe, Q, Canada.
Germim, P
  • Department of Clinical Sciences, Université de Montréal, St-Hyacinthe, Q, Canada.
Albrecht, B
  • Boehringer Ingelheim Vetmedica GmbH, Ingelheim am Rhein, Germany.
von Salis-Soglio, M
  • Boehringer Ingelheim Vetmedica GmbH, Ingelheim am Rhein, Germany.

MeSH Terms

  • Administration, Inhalation
  • Animals
  • Cross-Over Studies
  • Dose-Response Relationship, Drug
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / therapeutic use
  • Horse Diseases / drug therapy
  • Horses
  • Hydrocortisone / blood
  • Lung Diseases, Obstructive / chemically induced
  • Lung Diseases, Obstructive / drug therapy
  • Lung Diseases, Obstructive / veterinary
  • Pregnenediones / administration & dosage
  • Pregnenediones / therapeutic use

Grant Funding

  • Boehringer Ingelheim Vetmedica GmbH

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Citations

This article has been cited 21 times.
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