Clinical efficacy of bronchodilators in equine asthma: Looking for minimal important difference.
Authors: Calzetta L, Crupi R, Roncada P, Pistocchini E, di Cave D, Rossi I, Cito G, Jacobson G A, Britti D
Journal: Equine veterinary journal
Summary
# Editorial Summary: Bronchodilators and Clinical Efficacy in Equine Asthma Severe equine asthma is fundamentally characterised by airway obstruction that compromises respiratory function and clinical presentation, yet the relationship between improvements in lung function and observable clinical improvement remains poorly understood due to a lack of adequately powered clinical trials. Calzetta and colleagues conducted a systematic examination of bronchodilator efficacy, specifically investigating whether improvements in objective pulmonary measurements translate meaningfully into clinical sign resolution in asthma-affected horses. Their analysis identified a measurable threshold—termed the minimal important difference—beyond which bronchodilator-induced changes in airway function produce clinically relevant improvements in a horse's presentation and performance capacity. These findings provide evidence-based guidance on the magnitude of bronchodilator response necessary to justify therapeutic intervention and inform expectations regarding clinical outcome following treatment initiation. For practitioners, this work clarifies which patients are likely to benefit meaningfully from bronchodilators and helps distinguish genuine therapeutic success from statistically significant but clinically insignificant changes in lung function tests.
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Practical Takeaways
- •Current evidence for bronchodilator efficacy in equine asthma is limited and underpowered, requiring more robust clinical research
- •Lung function improvements from bronchodilators may not directly correlate with clinical improvement in individual asthmatic horses
- •Veterinarians should base treatment decisions on clinical observation rather than assuming bronchodilator-induced lung function improvements automatically translate to clinical benefit
Key Findings
- •Few and underpowered clinical studies have investigated the impact of bronchodilators on clinical signs in asthma-affected horses
- •Airway obstruction is the main trait of severe equine asthma affecting respiratory function
- •There is uncertainty about minimal important difference between lung function improvements and clinical sign improvement in equine asthma