Inhaled ciclesonide is efficacious and well tolerated in the treatment of severe equine asthma in a large prospective European clinical trial.
Authors: Pirie Robert Scott, Mueller Hanns-Walter, Engel Odilo, Albrecht Balazs, von Salis-Soglio Marcella
Journal: Equine veterinary journal
Summary
# Editorial Summary: Ciclesonide for Severe Equine Asthma Ciclesonide, a glucocorticoid prodrug already approved for human respiratory disease, represents a promising therapeutic option for horses with severe asthma given its targeted inhaled delivery and mechanism of action, yet its real-world effectiveness had remained uncharacterised. A large prospective European clinical trial evaluated ciclesonide treatment in naturally affected horses with severe equine asthma across multiple field settings, moving beyond previous controlled laboratory studies using mouldy hay challenge models. The inhalant corticosteroid proved both efficacious and well tolerated in clinical practice, with results supporting its use as a viable treatment for severe disease in working populations. For practitioners managing horses with refractory lower airway inflammation—particularly those unable to achieve adequate environmental control or requiring rapid clinical improvement—ciclesonide offers evidence-based alternatives to systemic corticosteroids with reduced systemic side effects. The field-based validation is particularly valuable; it demonstrates that laboratory findings translate meaningfully into everyday practice, informing treatment decisions for cases where traditional management strategies have been insufficient.
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Practical Takeaways
- •Ciclesonide is a viable inhaled glucocorticoid option for managing severe equine asthma in real-world farm and stable environments, not just experimental settings
- •The good tolerability profile makes this a practical addition to asthma management protocols for working and performance horses
- •Field efficacy supports consideration of ciclesonide as a registered treatment choice for severe asthma cases requiring systemic glucocorticoid alternatives
Key Findings
- •Inhaled ciclesonide demonstrated efficacy in treating severe equine asthma under field conditions in a large prospective European clinical trial
- •Ciclesonide was well tolerated as a treatment for horses with severe asthma
- •This represents the first field-condition evidence for inhaled ciclesonide efficacy, building on prior controlled mouldy hay challenge studies