Nebulisation of dexamethasone sodium phosphate for the treatment of severe asthmatic horses.
Abstract: Inhaled corticosteroids are effective in the treatment of equine asthma. A recent study reported that nebulisation of injectable dexamethasone had low systemic bioavailability in healthy horses and could represent a cost-effective therapy for equine inflammatory lung diseases. Objective: To determine the effects of dexamethasone nebulisation on lung function in severe asthmatic horses. It was hypothesised that dexamethasone administered by nebulisation would be more effective than the same dose administered orally. Methods: Randomised blinded experimental study in severe asthmatic horses. Methods: Twelve severe asthmatic horses in clinical exacerbation were randomly assigned to treatment with 5 mg of dexamethasone sodium phosphate by nebulisation (n = 6) or by oral administration (n = 6), once daily for 7 days. Lung function was evaluated at baseline, after four treatment days (D4) and 24 h after the last dose (D8). The presence of residual bronchospasm was assessed on D8 with N-butylscopolammonium bromide administration (0.3 mg/kg i.v.). A respiratory clinical score was performed daily. Serum cortisol concentration was measured at baseline, D4 and D8. Results: The pulmonary elastance was unchanged in both groups while pulmonary resistance was significantly improved in the oral group on D8 (mean reduction in 1 cm H O/L/s [CI: 0.34-1.65, P = 0.003]). All horses had residual bronchospasm at the end of the study. There was a group difference in the respiratory clinical score as it was significantly reduced in the oral group, from D5 to D8. Serum cortisol concentration decreased in all subjects. Conclusions: Low number of horses and lack of placebo group. Conclusions: Considering the lack of improvement of lung function and the hypothalamic-pituitary-adrenal axis suppression, the results of this study do not support aerosolisation of an injectable form of dexamethasone for the treatment of severe equine asthma at the dose and with the nebuliser evaluated.
© 2019 EVJ Ltd.
Publication Date: 2019-03-28 PubMed ID: 30849189DOI: 10.1111/evj.13091Google Scholar: Lookup
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- Journal Article
- Randomized Controlled Trial
- Veterinary
Summary
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The research was focused on understanding the impact of dexamethasone administered via nebulisation versus orally in the treatment of severe asthma in horses. The results suggested that despite its popularity, dexamethasone nebulisation did not provide significant progress in enhancing lung function in the sample studied.
Objective and Hypothesis
- The key objective of this research was to ascertain the effects of dexamethasone nebulisation on lung function in severe asthmatic horses. The hypothesis stated that dexamethasone administered by nebulisation would be more effective than the same dose given orally.
Research Methodology
- A randomised blinded experimental study design was used.
- There were 12 severe asthmatic horses in clinical exacerbation which were randomly divided into two groups.
- One group was treated with 5 mg of dexamethasone sodium phosphate by nebulisation while the other was treated orally with the same dosage, for 7 days.
- Lung functions were evaluated at baseline, after four treatment days (D4), and 24 hours after the last dose (D8).
- The presence of residual bronchospasm was assessed on D8 with N-butylscopolammonium bromide administration.
- The horses underwent respiratory clinical scoring daily, and their serum cortisol concentration was measured at predetermined intervals.
Results of the Study
- The study revealed that while the pulmonary elastance was unchanged in both groups, pulmonary resistance showed significant improvement in the oral group on D8.
- All horses were found to have residual bronchospasm at the completion of the study.
- A significant reduction in respiratory clinical score was noticed in the oral group from D5 to D8.
- Interestingly, the serum cortisol concentration level decreased in all horses.
Conclusions
- The research concluded that depending on the lack of improvement in lung function and the suppression of the hypothalamic-pituitary-adrenal axis, aerosolisation of an injectable form of dexamethasone for the treatment of severe equine asthma at the investigated dose and with the evaluated nebuliser is not supported by this study.
- The study emphasised that the low number of horses used in the study and the absence of a placebo group were limitations that needed consideration.
Cite This Article
APA
Mainguy-Seers S, Bessonnat A, Picotte K, Lavoie JP.
(2019).
Nebulisation of dexamethasone sodium phosphate for the treatment of severe asthmatic horses.
Equine Vet J, 51(5), 641-645.
https://doi.org/10.1111/evj.13091 Publication
Researcher Affiliations
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, St-Hyacinthe, Q, Canada.
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, St-Hyacinthe, Q, Canada.
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, St-Hyacinthe, Q, Canada.
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, St-Hyacinthe, Q, Canada.
MeSH Terms
- Administration, Inhalation
- Adrenal Cortex Hormones / therapeutic use
- Aerosols
- Animals
- Asthma / veterinary
- Dexamethasone / administration & dosage
- Dexamethasone / analogs & derivatives
- Dexamethasone / therapeutic use
- Gene Expression Regulation, Enzymologic / drug effects
- Horse Diseases / drug therapy
- Horses
- Lung / enzymology
- Lung / metabolism
- Pancreatic Elastase / metabolism
Grant Funding
- 148807 / Canadian Institutes of Health Research
Citations
This article has been cited 2 times.- Mainguy-Seers S, Lavoie JP. Glucocorticoid treatment in horses with asthma: A narrative review.. J Vet Intern Med 2021 Jul;35(4):2045-2057.
- de Wasseige S, Picotte K, Lavoie JP. Nebulized dexamethasone sodium phosphate in the treatment of horses with severe asthma.. J Vet Intern Med 2021 May;35(3):1604-1611.
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