Clinical effect of corticosteroids in asthma-affected horses: A quantitative synthesis.
Authors: Calzetta L, Rogliani P, Page C, Roncada P, Pistocchini E, Soggiu A, Piras C, Urbani A, Matera M G
Journal: Equine veterinary journal
Summary
# Editorial Summary: Clinical Effect of Corticosteroids in Equine Asthma Individual studies on corticosteroid efficacy in equine asthma have typically involved small sample sizes and produced inconsistent results, creating uncertainty about the true clinical benefit of these commonly prescribed treatments. This meta-analysis synthesised data from multiple randomised controlled trials using Bayesian network modelling to quantify how effectively inhaled and systemic corticosteroids improve clinical outcomes, whilst establishing a meaningful threshold for detecting improvement in asthmatic horses. Corticosteroids produced a significant overall improvement in clinical condition compared with controls (standardised mean difference of −1.52), with both inhaled and systemic routes proving equally effective; importantly, a newly validated scoring system (IDEASS) demonstrated a 30% clinical improvement with corticosteroid treatment, and a single-point change in this scale represented the minimum clinically detectable difference. The evidence supports inhaled corticosteroids as the preferred option for managing equine asthma and preventing exacerbations, whilst systemic corticosteroids should be reserved for acute flare-ups with significant airway hyperresponsiveness. Practitioners can now use the IDEASS scoring system to objectively monitor treatment response and severity progression in individual horses, though further field validation is needed before widespread adoption in clinical practice.
Read the full abstract on PubMed
Practical Takeaways
- •Inhaled corticosteroids are effective for managing equine asthma and preventing exacerbations; consider as first-line therapy
- •Systemic corticosteroids should be reserved for selected cases with symptomatic airway hyperresponsiveness during acute exacerbations, not routine use
- •Use the IDEASS scoring system to quantify asthma severity and objectively monitor treatment response in affected horses
Key Findings
- •Corticosteroids significantly improved clinical condition in equine asthma with SMD of -1.52 compared to control (P<0.001)
- •No significant difference detected between inhaled and systemic corticosteroids in clinical score improvements (P=0.8)
- •IDEASS scoring system showed corticosteroids improved clinical condition by 30% compared to controls (P<0.001)
- •A one-point change in IDEASS represents the minimally clinically detectable difference in equine asthma