Use of inhaled ciclesonide for treatment of moderate asthma in Thoroughbred racehorses.
Abstract: Mild-moderate asthma is common in horses. Inhaled ciclesonide has been approved only for treatment of severe asthma in horses. Objective: We hypothesized that a 10-day treatment course of inhaled ciclesonide (Aservo EquiHaler) would improve clinical signs, endoscopic tracheal mucus scores, and bronchoalveolar lavage fluid (BALF) cytology in racehorses with moderate asthma. Methods: Racehorses with moderate asthma housed at the Emerald Downs Racetrack in Auburn, WA. Methods: Prospective, randomized, double-blinded, placebo-controlled clinical study. Horses received inhaled ciclesonide (n = 12) or placebo (n = 9) for 10 days. Clinical signs were assessed at different times using the Tesarowski and HOARSI scores and cough during exercise. Endoscopy scoring, BALF cytology, and BALF cell selected gene expression (RT-qPCR) were assessed on Days 0 and 10. Linear and ordinal simple and mixed effects models were used to analyze the data using R statistical software. Significance was set at P < .05. Results: Only treated horses showed a decrease over time in HOARSI (P ≤ .001), cough (P = .001; -2.83 [-4.37, -1.29]), mast cell % (P = .03; -2.68 [-4.36, -1.0]) and relative expression of IL-6 (P = .002; 0.44 [0.04, -6.99]) and IL-13 (P = .03; 0.52 [0.04, -7.89]) in BAL cells. Treated horses had lower HOARSI (P = .002; -1 [1, 1]) and mast cell % (P = .02; -2.96 [-5.52, -0.39]) on Day 10. Conclusions: Treatment with inhaled ciclesonide improved clinical signs and decreased BALF mastocytic inflammation in racehorses with moderate asthma without change in the environment. Treatment effect on neutrophilic or eosinophilic asthma remains undetermined. The small number of horses was a study limitation.
© 2025 The Author(s). Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.
Publication Date: 2025-02-13 PubMed ID: 39945569PubMed Central: PMC11822996DOI: 10.1111/jvim.17267Google Scholar: Lookup
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- Journal Article
- Randomized Controlled Trial
- Veterinary
Summary
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The study investigates the effects of using inhaled ciclesonide, typically used for severe asthma, on moderate asthma in racehorses. It suggests that this treatment not only improves the clinical symptoms but also reduces inflammation in the respiratory system of these horses.
Research Aim and Hypothesis
- The research was guided by a hypothesis stating that the use of inhaled ciclesonide, delivered through an Aservo EquiHaler, over a course of 10 days could improve clinical signs, endoscopic tracheal mucus scores, and bronchoalveolar lavage fluid (BALF) cytology in Thoroughbred racehorses suffering from moderate asthma.
Research Methods
- The study was conducted using a prospective, randomized, double-blinded, and placebo-controlled clinical model.
- The participants of the study were Thoroughbred racehorses housed at the Emerald Downs Racetrack in Auburn, WA, diagnosed with moderate asthma.
- The horses were randomly assigned to either receive inhaled ciclesonide (12 horses) or a placebo (9 horses) for a period of 10 days.
- Assessments were made using the Tesarowski and HOARSI scores, and coughs during exercise were noted. Moreover, endoscopic scoring, BALF cytology, and BALF cell selected gene expression (RT-qPCR) were carried out on the first and tenth day of the treatment.
- The outcomes of the study were analyzed using linear and ordinal simple and mixed-effects models with the help of R statistical software.
Major Findings
- The results indicated that only the horses treated with inhaled ciclesonide showed significant improvements over time. This was reflected in decreased HOARSI scores, reduced coughing, and a reduction in mast cell percentages and relative expression of IL-6 and IL-13 in BAL cells.
- On the tenth day, the treated horses had lower HOARSI scores and mast cell percentages than their counterparts in the placebo group.
Conclusion and Limitations
- The study concluded that the use of inhaled ciclesonide improved the clinical symptoms and reduced mastocytic inflammation, typically observed in asthma, in the BAL fluid of raced horses suffering from moderate asthma. The improvements were observed without any change in the environment of the horses.
- The treatment’s impact on neutrophilic or eosinophilic asthma was not determined.
- One of the key limitations of this study was the small sample size of horses.
Cite This Article
APA
Sanz MG, Jellen G, Cody L, Bergsma J, Cha M, Kogan C, Kordas G, Bayly WM, Leguillette R.
(2025).
Use of inhaled ciclesonide for treatment of moderate asthma in Thoroughbred racehorses.
J Vet Intern Med, 39(2), e17267.
https://doi.org/10.1111/jvim.17267 Publication
Researcher Affiliations
- Washington State University, College of Veterinary Sciences, Pullman, Washington, USA.
- Washington State University, College of Veterinary Sciences, Pullman, Washington, USA.
- Faculty of Veterinary Sciences, University of Calgary, Calgary, Alberta, Canada.
- Cavalli Equine Veterinary Services, Auburn, Washington, USA.
- Simkins and Tingdale, Inc., Auburn, Washington, USA.
- StatsCraft LLC, Spokane, Washington 99203, USA.
- Statistical Consultant, Reno, Nevada, USA.
- Washington State University, College of Veterinary Sciences, Pullman, Washington, USA.
- Faculty of Veterinary Sciences, University of Calgary, Calgary, Alberta, Canada.
MeSH Terms
- Animals
- Horses
- Asthma / veterinary
- Asthma / drug therapy
- Horse Diseases / drug therapy
- Pregnenediones / administration & dosage
- Pregnenediones / therapeutic use
- Administration, Inhalation
- Male
- Female
- Bronchoalveolar Lavage Fluid / cytology
- Prospective Studies
- Double-Blind Method
- Anti-Inflammatory Agents / administration & dosage
- Anti-Inflammatory Agents / therapeutic use
Grant Funding
- Boehringer Ingelheim Animal Health
- University of Calgary
- Washington State University
Conflict of Interest Statement
Authors declare no conflict of interest.
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