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Veterinary medicine and science2022; 8(2); 561-567; doi: 10.1002/vms3.728

Evaluation of the treatment of equine glandular gastric disease with either long-acting-injectable or oral omeprazole.

Abstract: Equine glandular gastric disease (EGGD) is common in domesticated horses and can be challenging to treat. Oral omeprazole (ORLO) is used widely but the clinical response is frequently poor. Objective: To compare rates of EGGD healing and improvement between ORLO and a long-acting injectable omeprazole preparation (LAIO). Methods: Retrospective clinical study. Methods: The case records and gastroscopy images of horses presenting to masked for peer review over a 12-month period were reviewed, with images blindly assessed by one of the authors. Treatment responses to 4 mg/kg LAIO administered every 7 days for 2 and 4 weeks were compared with ORLO 4 mg/kg PO q24hrs for 4 weeks. Data were compared using a Mann-Whitney U test with post-hoc Dunn's test, Chi-squared test and a Fisher's exact test. Results: Thirty-three horses that received LAIO and 12 that received ORLO were identified. Nine horses in the LAIO had received other treatments previously. The groups were comparable in signalment and EGGD lesion severity. Long-acting injectable omeprazole was found to be non-inferior to ORLO. LAIO was associated with better healing rates than ORLO at 4 weeks (LAIO-80%; ORLO-42%; p = 0.02), and reduction in lesion severity at 2 and 4 weeks in the LAIO group but not in the ORLO group at 4 weeks. Eighteen percent of horses in the LAIO group and 50% in the ORLO group did not heal at 4 weeks. There was no association between rate of healing or improvement and resolution or improvement of clinical signs. Six localised and self-limiting injection site reactions were identified in 4 horses treated with LAIO (6.7%). Conclusions: Retrospective design, small numbers and the use of other treatments prior to use of LAIO. Conclusions: LAIO was found to be non-inferior to oral omeprazole for EGGD. Larger blinded randomised clinical trials are justified.
Publication Date: 2022-02-15 PubMed ID: 35167731PubMed Central: PMC8959258DOI: 10.1002/vms3.728Google Scholar: Lookup
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  • Clinical Study
  • Journal Article

Summary

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This research article investigates the effectiveness of long-acting injectable omeprazole (LAIO) as compared to oral omeprazole (ORLO) in treating equine glandular gastric disease (EGGD), a common ailment in domesticated horses. The results suggest that LAIO has higher healing rates and reduces lesion severity more effectively than ORLO.

Research Background

  • The research is motivated by the high prevalence of EGGD in domestic horses and the challenges associated with its treatment. The standard treatment, ORLO, often results in poor clinical responses.

Research Objective and Methodology

  • The objective of the study is to compare the efficacy of LAIO and ORLO in healing EGGD and improving the condition of the affected horses. It aims to establish if LAIO is non-inferior or even superior to ORLO.
  • The researchers conducted a retrospective clinical study where they reviewed the case records and gastroscopy images of horses treated with either LAIO or ORLO over a 12-month period.
  • The therapies involved administering 4 mg/kg of LAIO every 7 days for a duration of 2 to 4 weeks, or treating with 4mg/kg of ORLO every 24 hours for 4 weeks. The treatments given to both groups were statistically analysed to assess and compare their effectiveness.

Results

  • The study included 33 horses treated with LAIO and 12 horses treated with ORLO. Nine of the horses in the LAIO group had undergone other treatments before.
  • The two treatment groups were found to be comparable in terms of signalment and EGGD lesion severity.
  • LAIO was found to be non-inferior to ORLO, with higher healing rates (LAIO: 80%; ORLO: 42%) and reductions in lesion severity over the course of treatment.
  • The study also found that 18% of horses in the LAIO group and 50% in the ORLO group did not heal completely after 4 weeks of treatment.
  • No association was found between the rate of healing or improvement and the resolution or amelioration of clinical signs.
  • Six localised and self-limiting injection site reactions were identified in 4 horses treated with LAIO, representing a 6.7% occurrence rate.

Conclusion

  • While acknowledging the limitations of the study, such as its retrospective design and small sample size, the researchers concluded that LAIO is non-inferior to ORLO in treating EGGD.
  • Due to the promising results, they recommend conducting larger, blinded and randomised clinical trials to further validate the results of this preliminary study.

Cite This Article

APA
Gough S, Hallowell G, Rendle D. (2022). Evaluation of the treatment of equine glandular gastric disease with either long-acting-injectable or oral omeprazole. Vet Med Sci, 8(2), 561-567. https://doi.org/10.1002/vms3.728

Publication

ISSN: 2053-1095
NlmUniqueID: 101678837
Country: England
Language: English
Volume: 8
Issue: 2
Pages: 561-567

Researcher Affiliations

Gough, Sarah
  • Rainbow Equine Hospital, Malton, North Yorkshire, YO17 6SG.
Hallowell, Gayle
  • School of Veterinary Medicine and Science, University of Nottingham, Nottingham, United Kingdom.
Rendle, David
  • Rainbow Equine Hospital, Malton, North Yorkshire, YO17 6SG.

MeSH Terms

  • Animals
  • Gastroscopy / veterinary
  • Horse Diseases / drug therapy
  • Horses
  • Omeprazole / therapeutic use
  • Retrospective Studies
  • Stomach Diseases / veterinary

References

This article includes 26 references
  1. Allen EI, Seaman CA. Superiority, equivalence and non‐inferiority. Quality Progress .
  2. Andrews FM, Sifferman RL, Bernard W, Hughes FE, Holste JE, Daurio CP, Alva R, Cox JL. Efficacy of omeprazole paste in the treatment and prevention of gastric ulcers in horses.. Equine Vet J Suppl 1999 Apr;(29):81-6.
  3. Bell NJ, Burget D, Howden CW, Wilkinson J, Hunt RH. Appropriate acid suppression for the management of gastro-oesophageal reflux disease.. Digestion 1992;51 Suppl 1:59-67.
    pubmed: 1397746doi: 10.1159/000200917google scholar: lookup
  4. Carroll CL, Huntington PJ. Body condition scoring and weight estimation of horses.. Equine Vet J 1988 Jan;20(1):41-5.
  5. Crumpton SM, Baiker K, Hallowell GD, Habershon-Butcher JL, Bowen IM. Clinical Research Abstracts of the British Equine Veterinary Association Congress 2015.. Equine Vet J 2015 Sep;47 Suppl 48:9.
    pubmed: 26374956doi: 10.1111/evj.12486_18google scholar: lookup
  6. Daurio CP, Holste JE, Andrews FM, Merritt AM, Blackford JT, Dolz F, Thompson DR. Effect of omeprazole paste on gastric acid secretion in horses.. Equine Vet J Suppl 1999 Apr;(29):59-62.
  7. Hepburn R. Endoscopic examination of the squamous and glandular gastric mucosa in sport and leisure horses: 684 horses. Proceedings of the Equine Colic Symposium, Dublin .
  8. Hepburn R, Proudman C. Treatment of ulceration of the gastric glandular mucosa: Retrospective evaluation of omeprazole and sucralfate combination therapy in 204 sport and leisure horses. Proc 11th International Equine Colic Research Symposium .
  9. Jenkins CC, Frazier DL, Blackford JT, Andrews FM, Mattsson H, Olovsson SG, McCleod M. Pharmacokinetics and antisecretory effects of intravenous omeprazole in horses. Equine Veterinary Journal 24, 84–88.
    pubmed: 0
  10. Lee KN, Lee OY, Choi MG, Choi SR, Lee DH, Lee YC, Kim TN, Choi SC, Rew JS, Seol SY. Prevention of NSAID-associated gastroduodenal injury in healthy volunteers-a randomized, double-blind, multicenter study comparing DA-9601 with misoprostol.. J Korean Med Sci 2011 Aug;26(8):1074-80.
    pmc: PMC3154344pubmed: 21860559doi: 10.3346/jkms.2011.26.8.1074google scholar: lookup
  11. MacAllister CG, Sifferman RL, McClure SR, White GW, Vatistas NJ, Holste JE, Ericcson GF, Cox JL. Effects of omeprazole paste on healing of spontaneous gastric ulcers in horses and foals: a field trial.. Equine Vet J Suppl 1999 Apr;(29):77-80.
  12. Merritt AM, Sanchez LC, Burrow JA, Church M, Ludzia S. Effect of GastroGard and three compounded oral omeprazole preparations on 24 h intragastric pH in gastrically cannulated mature horses.. Equine Vet J 2003 Nov;35(7):691-5.
    pubmed: 14649361doi: 10.2746/042516403775696339google scholar: lookup
  13. Morrissey NK, Bellenger CR, Baird AW. Bradykinin stimulates prostaglandin E2 production and cyclooxygenase activity in equine nonglandular and glandular gastric mucosa in vitro.. Equine Vet J 2008 Jun;40(4):332-6.
    pubmed: 18331972doi: 10.2746/042516408x293556google scholar: lookup
  14. Murray MJ, Nout YS, Ward DL. Endoscopic findings of the gastric antrum and pylorus in horses: 162 cases (1996-2000).. J Vet Intern Med 2001 Jul-Aug;15(4):401-6.
    pubmed: 11467600
  15. Murray M. Aetiopathogenesis and treatment of peptic ulcer in the horse: a comparative review. Equine Veterinary Journal 24(S13), 63–74.
    pubmed: 0
  16. Rendle D, Bowen M, Brazil T, Conwell R, Hallowell G, Hepburn R, Hewetson M, Sykes B. Recommendations for the management of equine glandular gastric disease. UK Vet: Equine 2, 2–11.
  17. Rendle D, Bowen M, Brazil T, Conwell R, Hallowell G, Hepburn R, Hewetson M, Sykes B. Recommendations for the management of equine glandular gastric disease. UK‐Vet Equine 2(Sup1), 2–11.
  18. Scally B, Emberson JR, Spata E, Reith C, Davies K, Halls H, Holland L, Wilson K, Bhala N, Hawkey C, Hochberg M, Hunt R, Laine L, Lanas A, Patrono C, Baigent C. Effects of gastroprotectant drugs for the prevention and treatment of peptic ulcer disease and its complications: a meta-analysis of randomised trials.. Lancet Gastroenterol Hepatol 2018 Apr;3(4):231-241.
  19. Sykes BW. Factors affecting the pharmacokinetics and pharmacodynamics of omeprazole in the horse. PhD Thesis 1–170.
  20. Sykes BW, Hewetson M, Hepburn RJ, Luthersson N, Tamzali Y. European College of Equine Internal Medicine Consensus Statement--Equine Gastric Ulcer Syndrome in Adult Horses.. J Vet Intern Med 2015 Sep-Oct;29(5):1288-99.
    pmc: PMC4858038pubmed: 26340142doi: 10.1111/jvim.13578google scholar: lookup
  21. Sykes BW, Kathawala K, Song Y, Garg S, Page SW, Underwood C, Mills PC. Preliminary investigations into a novel, long-acting, injectable, intramuscular formulation of omeprazole in the horse.. Equine Vet J 2017 Nov;49(6):795-801.
    pubmed: 28397996doi: 10.1111/evj.12688google scholar: lookup
  22. Sykes BW, Sykes KM, Hallowell GD. A comparison of two doses of omeprazole in the treatment of equine gastric ulcer syndrome: a blinded, randomised, clinical trial.. Equine Vet J 2014 Jul;46(4):416-21.
    pubmed: 24102898doi: 10.1111/evj.12191google scholar: lookup
  23. Sykes BW, Sykes KM, Hallowell GD. A comparison of three doses of omeprazole in the treatment of equine gastric ulcer syndrome: A blinded, randomised, dose-response clinical trial.. Equine Vet J 2015 May;47(3):285-90.
    pubmed: 24761780doi: 10.1111/evj.12287google scholar: lookup
  24. Sykes BW, Underwood C, McGowan CM, Mills PC. The effect of feeding on the pharmacokinetic variables of two commercially available formulations of omeprazole.. J Vet Pharmacol Ther 2015 Oct;38(5):500-3.
    pubmed: 25676888doi: 10.1111/jvp.12210google scholar: lookup
  25. Varley G, Bowen IM, Habershon-Butcher JL, Nicholls V, Hallowell GD. Misoprostol is superior to combined omeprazole-sucralfate for the treatment of equine gastric glandular disease.. Equine Vet J 2019 Sep;51(5):575-580.
    doi: 10.1111/evj.13087pubmed: 30809869google scholar: lookup
  26. White NA, Moore JN, Mair TS. Equine acute abdomen. Teton New Media, Jackson .

Citations

This article has been cited 2 times.
  1. Vokes J, Lovett A, Sykes B. Equine Gastric Ulcer Syndrome: An Update on Current Knowledge.. Animals (Basel) 2023 Apr 5;13(7).
    doi: 10.3390/ani13071261pubmed: 37048517google scholar: lookup
  2. Pratt SL, Bowen M, Hallowell GH, Shipman E, Bailey J, Redpath A. Does lesion type or severity predict outcome of therapy for horses with equine glandular gastric disease? - A retrospective study.. Vet Med Sci 2023 Jan;9(1):150-157.
    doi: 10.1002/vms3.1034pubmed: 36495212google scholar: lookup