Fluticasone propionate aerosol is more effective for prevention than treatment of recurrent airway obstruction.
Abstract: Efficacy of inhaled fluticasone propionate (FP) for management of recurrent airway obstruction (RAO) has only been evaluated after several weeks' treatment. Objective: To compare efficacy of (1) 3-day treatments with FP to dexamethasone (DEX) for management of RAO; and (2) FP and DEX to no treatment in prevention of acute RAO exacerbations. Methods: Nine RAO affected horses. Methods: Crossover studies in RAO-affected horses compared (a) 3-day treatment of RAO exacerbation with FP (3 and 6 mg q12h) and DEX (0.1 mg/kg q24h) and (b) FP (6 mg q12h) and DEX (0.1 mg/kg q24h) to no treatment for prevention of acute exacerbations of RAO. Treatment efficacy and unwanted effects were judged from maximal change in pleural pressure (DeltaPpl(max)), serum cortisol (COR), bronchoalveolar lavage (BAL) cytology, and subjective scores for respiratory distress and lameness. Results: In treatment trial, DEX and FP (6 mg) significantly decreased DeltaPpl(max) by 48 and 72 hours, respectively; FP (3 mg) had no significant effect. DEX decreased COR more than did FP. In prevention trial, both DEX and FP (6 mg) prevented the increase in DeltaPpl(max) that occurred in untreated horses. Both treatments decreased COR to the same degree. FP and DEX had no effects on bronchoalveolar lavage fluid (BALF) cytology and there was no evidence of laminitis. Conclusions: FP (6 mg q12h) is as effective as DEX for prevention of acute exacerbations of RAO and lower doses should be evaluated. High-dose FP is not as effective as DEX for treatment of RAO exacerbations.
Publication Date: 2009-09-11 PubMed ID: 19747193DOI: 10.1111/j.1939-1676.2009.0382.xGoogle Scholar: Lookup
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- Controlled Clinical Trial
- Journal Article
- Research Support
- Non-U.S. Gov't
- Bronchoalveolar Lavage
- Clinical Findings
- Clinical Pathology
- Clinical Study
- Comparative Study
- Cortisol
- Dexamethasone
- Disease Management
- Disease Treatment
- Equine Health
- Horses
- Inflammation
- Lameness
- Pharmacology
- Pleural Pressure
- Prevention
- Recurrent Airway Obstruction
- Respiratory Disease
- Respiratory Health
- Veterinary Medicine
Summary
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The research finds that an aerosol form of fluticasone propionate, when inhaled by horses with recurrent airway obstruction, is more effective when used as a preventive measure rather than as a treatment after an obstruction has occurred.
Objectives and Methodology
The researchers sought to compare the effectiveness of two drugs, fluticasone propionate (FP) and dexamethasone (DEX), in managing recurrent airway obstruction (RAO) in horses. In the experiment, nine horses with RAO were subjected to two trials with FP and DEX.
- In the first trial, the team aimed to assess the efficacy of 3-day treatment doses of FP and DEX when an RAO exacerbation has occurred. They utilized both a low-dose (3mg) and a high-dose (6mg) of FP for comparison.
- In the second trial, the team investigated the preventative efficacy of FP and DEX against acute exacerbations of RAO, comparing the effects of treatment to a control group that received no treatment.
The efficacy of the treatments was evaluated based on changes in pleural pressure, serum cortisol levels, bronchoalveolar lavage (BAL) cytology, and subjective scores for respiratory distress and lameness in the horses.
Key Findings
The findings showed that both DEX and the high-dose FP (6mg) significantly reduced pleural pressure within 48 and 72 hours respectively. However, the lower-dose FP (3mg) yielded no significant impact.
- DEX reduced the serum cortisol levels more than FP did.
- In the prevention trial, both DEX and the high-dose FP effectively prevented an increase in pleural pressure that was noticed in untreated horses.
- Either treatments did not affect the bronchoalveolar lavage fluid cytology, and there were no signs of laminitis—the inflammatory disease that causes lameness in horses.
Conclusions
The study concludes that inhaled fluticasone propionate (FP), specifically dosed at 6mg, is as effective as dexamethasone (DEX) in preventing acute exacerbations of recurrent airway obstructions, indicating that lower doses merit further evaluation. However, when used for treatment, the high-dose FP lacks the efficacy of DEX.
Cite This Article
APA
Robinson NE, Berney C, Behan A, Derksen FJ.
(2009).
Fluticasone propionate aerosol is more effective for prevention than treatment of recurrent airway obstruction.
J Vet Intern Med, 23(6), 1247-1253.
https://doi.org/10.1111/j.1939-1676.2009.0382.x Publication
Researcher Affiliations
- Equine Pulmonary Laboratory, Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, MI 48824, USA. robinson@cvm.msu.edu
MeSH Terms
- Aerosols
- Androstadienes / administration & dosage
- Androstadienes / therapeutic use
- Animals
- Anti-Inflammatory Agents / administration & dosage
- Anti-Inflammatory Agents / therapeutic use
- Cross-Over Studies
- Dexamethasone / administration & dosage
- Dexamethasone / therapeutic use
- Dose-Response Relationship, Drug
- Fluticasone
- Horse Diseases / drug therapy
- Horses
- Lung Diseases, Obstructive / drug therapy
- Lung Diseases, Obstructive / veterinary
Citations
This article has been cited 7 times.- Klier J, Fuchs S, Winter G, Gehlen H. Inhalative Nanoparticulate CpG Immunotherapy in Severe Equine Asthma: An Innovative Therapeutic Concept and Potential Animal Model for Human Asthma Treatment.. Animals (Basel) 2022 Aug 16;12(16).
- Mainguy-Seers S, Lavoie JP. Glucocorticoid treatment in horses with asthma: A narrative review.. J Vet Intern Med 2021 Jul;35(4):2045-2057.
- Pirie RS, Mueller HW, Engel O, Albrecht B, von Salis-Soglio M. Inhaled ciclesonide is efficacious and well tolerated in the treatment of severe equine asthma in a large prospective European clinical trial.. Equine Vet J 2021 Nov;53(6):1094-1104.
- Verschoor-Kirss M, Rozanski EA, Sharp CR, Oura TJ, Egan A, Bain P, Knoll J. Treatment of naturally occurring asthma with inhaled fluticasone or oral prednisolone: A randomized pilot trial.. Can J Vet Res 2021 Jan;85(1):61-67.
- Lavoie JP, Bullone M, Rodrigues N, Germim P, Albrecht B, von Salis-Soglio M. 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 2019 Nov;51(6):779-786.
- Lavoie JP, Leclere M, Rodrigues N, Lemos KR, Bourzac C, Lefebvre-Lavoie J, Beauchamp G, Albrecht B. Efficacy of inhaled budesonide for the treatment of severe equine asthma.. Equine Vet J 2019 May;51(3):401-407.
- Bond SL, Timsit E, Workentine M, Alexander T, Léguillette R. Upper and lower respiratory tract microbiota in horses: bacterial communities associated with health and mild asthma (inflammatory airway disease) and effects of dexamethasone.. BMC Microbiol 2017 Aug 23;17(1):184.
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