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Frontiers in veterinary science2023; 10; 1125695; doi: 10.3389/fvets.2023.1125695

Systematic review and meta-analysis of positive long-term effects after intra-articular administration of orthobiologic therapeutics in horses with naturally occurring osteoarthritis.

Abstract: Equine veterinarians face challenges in treating horses with osteoarthritic joint pain in routine veterinary practice. All common treatment options aim to reduce the clinical consequences of osteoarthritis (OA) characterized by persistent synovitis and progressive degradation of articular cartilage. A range of joint-associated cell types and extracellular matrices are involved in the not yet entirely understood chronic inflammatory process. Regeneration of articular tissues to re-establish joint hemostasis is the future perspective when fundamental healing of OA is the long-term goal. The use of intra-articular applied biologic therapeutics derived from blood or mesenchymal stroma cell (MSC) sources is nowadays a well-accepted treatment option. Although this group of therapeutics is not totally consistent due to the lack of clear definitions and compositions, they all share a potential regenerative effect on articular tissues as described in and studies. However, the current stage of science in regenerative medicine needs to be supported by clinical reports as in fact, studies as well as studies using induced OA models still represent a fragment of the complex pathomechanism of naturally occurring OA. This systemic review aims to determine the long-term effect of orthobiologic therapeutics in horses suffering naturally occurring OA. Thereby, a meta-analysis of randomized controlled trials (RCTs) is conducted to describe the efficiency and safety of intra-articular applied orthobiologics in terms of lameness reduction in the long-term. Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines, thirteen studies met the inclusion criteria for the systemic review. Four of those studies have further been evaluated by the meta-analysis comparing the long-term effect in lameness reduction. Each study was examined for risk of bias. For data evaluation, a random-effects model was used, describing the overall outcome in a forest plot. The I statistic was used to assess heterogeneity. Results indicate, that orthobiologic therapies represent an effective long-term and safe OA treatment option. Due to the inhomogeneity of included studies, no statements are provided addressing specific orthobiologic therapies, affected joints, OA stage and horse's intended use. Future clinical trials should follow standardized study designs to provide comparable data.
Copyright © 2023 Mayet, Zablotski, Roth, Brehm and Troillet.
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Publication Date: 2023-02-23 PubMed ID: 36908512PubMed Central: PMC9997849DOI: 10.3389/fvets.2023.1125695Google Scholar: Lookup
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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.

This scientific study reviews and analyzes the long-term benefits of intra-articular administration of orthobiologic therapeutics in horses with naturally occurring osteoarthritis, suggesting these therapies are a safe and effective treatment option.

Understanding Osteoarthritis in Horses and Treatment Challenges

  • The research was guided by the challenges equine vets face in managing joint pain caused by osteoarthritis, characterized by ongoing inflammation and progressive degradation of cartilage within the joint.
  • Various cell types and extracellular matrices involved in this chronic inflammatory process are not completely understood.

Intra-Articular Orthobiologic Therapeutics as Potential Solutions

  • The goal is to regenerate articular tissues, achieve joint homeostasis and therefore bring about core healing of osteoarthritis in the long run.
  • The research focuses on biologic therapeutics from blood or mesenchymal stroma cell sources, which are injected into the joint. Despite certain inconsistencies, these therapeutics all offer promising regenerative effects on cartilage as shown in lab and animal studies.

Review and Meta-Analysis Approach

  • The researchers aimed to understand the long-term impact of these orthobiologic therapeutics on horses with naturally occurring osteoarthritis.
  • A systematic review and meta-analysis of Randomized Controlled Trials (RCTs) were used to understand the efficacy and safety of these therapeutics in reducing lameness over the long term.
  • Thirteen studies met the criteria for inclusion in the review, with four of those further analyzed in the meta-analysis.
  • A random-effects model was used for data evaluation and the I statistic was used to assess heterogeneity among carefully selected studies.

Findings and Further Research Recommendations

  • The research suggests that orthobiologic therapies are a safe and effective long-term treatment option. However, a wide range of differences among the reviewed studies meant that no specific conclusions were drawn about particular orthobiologic therapies, the stage of osteoarthritis, affected joints or the horse’s intended use.
  • The study calls for more clinical trials with standardized designs to offer comparative data and provide a more comprehensive understanding of the effectiveness of these therapies.

Cite This Article

APA
Mayet A, Zablotski Y, Roth SP, Brehm W, Troillet A. (2023). Systematic review and meta-analysis of positive long-term effects after intra-articular administration of orthobiologic therapeutics in horses with naturally occurring osteoarthritis. Front Vet Sci, 10, 1125695. https://doi.org/10.3389/fvets.2023.1125695

Publication

Frontiers in veterinary science
ISSN: 2297-1769
NlmUniqueID: 101666658
Country: Switzerland
Language: English
Volume: 10
Pages: 1125695
PII: 1125695

Researcher Affiliations

Mayet, Anna
  • Department for Horses, Faculty of Veterinary Medicine, Leipzig University, Leipzig, Germany.
Zablotski, Yury
  • Center for Clinical Veterinary Medicine, Faculty of Veterinary Medicine, Ludwig-Maximilians-University, Munich, Germany.
Roth, Susanne Pauline
  • Department for Horses, Faculty of Veterinary Medicine, Leipzig University, Leipzig, Germany.
Brehm, Walter
  • Department for Horses, Faculty of Veterinary Medicine, Leipzig University, Leipzig, Germany.
Troillet, Antonia
  • Department for Horses, Faculty of Veterinary Medicine, Leipzig University, Leipzig, Germany.

Conflict of Interest Statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Citations

This article has been cited 6 times.
  1. Carmona JU, López C. Platelet-Rich Plasma in Equine Osteoarthritis: A Systematic Review of Clinical and Experimental Evidence. Animals (Basel) 2025 Sep 9;15(18).
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