Evaluation of a nutraceutical for prevention of equine ulcer recurrence.
Authors: Hansen Sanni, Tecles Fernando, Cerón José Joaquín, From Cecilie, Carstensen Helena, Muñoz-Prieto Alberto
Journal: Equine veterinary journal
Summary
# Editorial Summary Equine gastric ulcer disease presents a significant clinical challenge, with high recurrence rates following omeprazole withdrawal, prompting investigation into adjunctive preventative strategies. This randomised, blinded, placebo-controlled trial enrolled 30 horses with concurrent squamous (ESGD) and glandular (EGGD) gastric disease, administering either a nutraceutical containing lecithin, pectin, and meadowsweet or placebo for 4–8 weeks post-treatment, with repeated gastroscopic evaluation and salivary biomarker analysis. Disappointingly, only five horses across both groups remained ulcer-free at trial conclusion, with no significant difference in gastroscopic scores between nutraceutical and placebo recipients; however, the treated group demonstrated lower salivary adenosine deaminase (ADA) and elevated bicarbonate concentrations at final assessment, suggesting potential modulation of gastric mucosal physiology. Whilst the nutraceutical failed to prevent ulcer recurrence at clinically meaningful levels, these biomarker changes warrant further investigation with larger cohorts and longer follow-up periods to establish whether such alterations correlate with delayed disease progression. Practitioners should remain cautious about relying solely on this formulation for ulcer prevention, particularly given the modest sample size and the stark reality that 83% of treated horses experienced recurrence regardless of intervention.
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Practical Takeaways
- •This nutraceutical should not be relied upon as a standalone preventative for gastric ulcer recurrence in horses after omeprazole treatment, as only 17% of treated horses remained ulcer-free
- •High recurrence rates (83%) in both groups highlight that alternative management strategies beyond pharmacological or nutraceutical treatment may be needed to prevent ESGD/EGGD recurrence
- •While salivary biomarker changes were detected with nutraceutical use, these did not translate to clinically meaningful improvements in gastroscopic findings, so their clinical relevance remains uncertain
Key Findings
- •Only 5 of 30 horses (17%) remained ulcer-free after the trial regardless of treatment group assignment
- •The nutraceutical containing lecithin, pectin, and meadowsweet was not superior to placebo for preventing gastric disease recurrence on gastroscopic evaluation
- •Nutraceutical group showed lower salivary ADA and higher bicarbonate concentrations compared to placebo group at final gastroscopy
- •Salivary biomarkers showed potential indicator changes despite lack of clinical efficacy on gastroscopic grading