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Equine veterinary journal2022; 55(5); 905-915; doi: 10.1111/evj.13899

Residual effects of intra-articular betamethasone and triamcinolone acetonide in an equine acute synovitis model.

Abstract: Intra-articular (IA) corticosteroids are regularly used in equine athletes for the control of joint inflammation. Objective: The goal of this study was to use an acute synovitis inflammation model to determine the residual effects of IA betamethasone and triamcinolone acetonide on various inflammatory parameters and lameness. Methods: Crossover randomised trial. Methods: Five mixed-breed, 2-year-old horses were randomly allocated to an IA treatment of the radiocarpal joint with 9 mg of either betamethasone or triamcinolone acetonide. Two weeks following treatment, horses were injected with 1 μg of lipopolysaccharide (LPS) diluted in 1 ml of saline. Following LPS injection, horses were crossed-over and both sets of injections were repeated after a washout period. Blood samples were collected at multiple time points for mRNA analysis, as well as serum amyloid A (SAA) and cortisol determination. At each time point, lameness was also subjectively scored. Additional injections with saline-only or LPS-only (twice) were conducted as negative and positive controls, respectively. Two-way repeated measures analysis of variance was used to analyse all data. Results: Corticosteroid-only treatments result in significant mRNA expression differences, as well as significant and prolonged cortisol suppression. Following LPS injection, there was a residual treatment effect with triamcinolone evidenced by a significant treatment effect on IL-6 and PTGS1 (cyclooxygenase-1), lameness, SAA and cortisol concentrations, while only IL-6 expression was affected by betamethasone. Conclusions: The acute synovitis model used here results in significant inflammation and is not representative of the low-grade inflammation seen with typical joint disease and residual anti-inflammatory effects may be more profound in naturally occurring joint disease. Conclusions: Current regulatory guidelines may be insufficient if the concern is residual anti-inflammatory effects. Additionally, intra-articular corticosteroid administration is not without risk, as evidenced by a significant suppression of serum cortisol concentration and, as such, the benefits of their administration should be weighed against those risks.
© 2022 EVJ Ltd.
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Publication Date: 2022-12-01 PubMed ID: 36397207DOI: 10.1111/evj.13899Google Scholar: Lookup
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  • Randomized Controlled 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 paper details a study on the residual effects of intra-articular betamethasone and triamcinolone acetonide, two types of corticosteroids, in a model of equine acute synovitis, which is a condition characterized by joint inflammation. The primary focus was to see how these drugs impacted different factors relating to inflammation and lameness.

Methodology

  • The study was conducted as a crossover randomised trial with five mixed-breed, 2-year-old horses being the subjects.
  • Each horse was randomly allocated to treatment with either 9mg of betamethasone or triamcinolone acetonide in the radiocarpal joint, a joint in the forelimb of the horse.
  • After two weeks, the horses were injected with lipopolysaccharide (LPS) – a molecule that induces inflammation – which was diluted in 1ml of saline.
  • Following this, they were switched (crossed-over) to the other drug and the same procedure was followed.
  • Blood samples were collected at different intervals to monitor mRNA expressions, and levels of serum amyloid A (SAA), and cortisol.
  • Lameness in the horses was also subjectively scored at each interval.
  • Additional injections of just saline or LPS were given, acting as negative and positive controls, respectively. The researchers used two-way repeated measures analysis of variance to analyze the data.

Results

  • The corticosteroid injections resulted in significant differences in mRNA expression and sustained suppression of cortisol.
  • Following LPS injection, there was a noticeable residual treatment effect from triamcinolone, evidenced by a significant treatment effect on IL-6 and PTGS1 (two explanatory genes of inflammation), lameness, SAA, and cortisol levels.
  • However, only IL-6 expression was impacted by betamethasone treatment.

Conclusions

  • The researchers concluded that the model of acute synovitis used in this research leads to significant inflammation and doesn’t represent the mild inflammation typically seen with joint disease.
  • They also suggested that current regulations may not be adequate if the residual anti-inflammatory effects of these drugs are a concern.
  • Furthermore, intra-articular corticosteroid administration poses a risk, as shown by the significant suppression of serum cortisol concentration, so one must carefully consider the benefits and risks before such administration.

Cite This Article

APA
Partridge E, Adam E, Wood C, Parker J, Johnson M, Horohov D, Page A. (2022). Residual effects of intra-articular betamethasone and triamcinolone acetonide in an equine acute synovitis model. Equine Vet J, 55(5), 905-915. https://doi.org/10.1111/evj.13899

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 55
Issue: 5
Pages: 905-915

Researcher Affiliations

Partridge, Emma
  • Department of Veterinary Science, University of Kentucky, Maxwell H. Gluck Equine Research Center, Lexington, Kentucky, USA.
Adam, Emma
  • Department of Veterinary Science, University of Kentucky, Maxwell H. Gluck Equine Research Center, Lexington, Kentucky, USA.
Wood, Courtney
  • Lincoln Memorial University, Harrogate, Tennessee, USA.
Parker, Jordan
  • Department of Veterinary Science, University of Kentucky, Maxwell H. Gluck Equine Research Center, Lexington, Kentucky, USA.
Johnson, Mackenzie
  • Department of Veterinary Science, University of Kentucky, Maxwell H. Gluck Equine Research Center, Lexington, Kentucky, USA.
Horohov, David
  • Department of Veterinary Science, University of Kentucky, Maxwell H. Gluck Equine Research Center, Lexington, Kentucky, USA.
Page, Allen
  • Department of Veterinary Science, University of Kentucky, Maxwell H. Gluck Equine Research Center, Lexington, Kentucky, USA.

MeSH Terms

  • Horses
  • Animals
  • Triamcinolone Acetonide / therapeutic use
  • Betamethasone / therapeutic use
  • Hydrocortisone
  • Lipopolysaccharides
  • Lameness, Animal / drug therapy
  • Interleukin-6
  • Synovitis / chemically induced
  • Synovitis / drug therapy
  • Synovitis / veterinary
  • Inflammation / chemically induced
  • Inflammation / drug therapy
  • Inflammation / veterinary
  • Joint Diseases / veterinary
  • Anti-Inflammatory Agents
  • Injections, Intra-Articular / veterinary
  • Horse Diseases / drug therapy
  • Horse Diseases / metabolism

Grant Funding

  • Jes E. and Clementine M. Schlaikjer Endowment at the University of Kentucky
  • Lincoln Memorial University
  • Zoetis

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Citations

This article has been cited 3 times.
  1. Duggan MJS, Kearney C, Baltrimaite M, Labberté MC, Gibney R, Brama PAJ. Refinement of the Lipopolysaccharide-Induced Synovitis Model in Equine Middle Carpal Joints. Animals (Basel) 2025 Aug 22;15(17).
    doi: 10.3390/ani15172474pubmed: 40941269google scholar: lookup
  2. Page AE, Johnson M, Parker JL, Jacob O, Poston R, Adams AA, Adam EN. The Effects of Intra-Articular Triamcinolone and Autologous Protein Solution on Metabolic Parameters in Horses. Animals (Basel) 2024 Aug 2;14(15).
    doi: 10.3390/ani14152250pubmed: 39123776google scholar: lookup
  3. Finding EJT, Faulkner A, Nash L, Wheeler-Jones CPD. Equine Endothelial Cells Show Pro-Angiogenic Behaviours in Response to Fibroblast Growth Factor 2 but Not Vascular Endothelial Growth Factor A. Int J Mol Sci 2024 May 30;25(11).
    doi: 10.3390/ijms25116017pubmed: 38892205google scholar: lookup
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