Tiludronate and clodronate do not affect bone structure or remodeling kinetics over a 60 day randomized trial.
Authors: Richbourg Heather A, Mitchell Colin F, Gillett Ashley N, McNulty Margaret A
Journal: BMC veterinary research
Summary
# Editorial Summary: Bisphosphonates and Equine Bone — What the Data Actually Show Bisphosphonates (tiludronate and clodronate) are licensed treatments for navicular disease, yet their effects on normal bone structure and remodelling remain poorly characterised, particularly in young horses where off-label use is increasingly common. This randomised controlled trial administered tiludronate or clodronate to clinically normal young horses over 60 days, measuring bone density, microarchitecture, and cellular remodelling markers through quantitative CT scanning and histological analysis; a separate cohort received clodronate following an induced bone defect to assess healing responses. Neither drug produced measurable changes in bone mineral density, trabecular architecture, or remodelling kinetics compared to control animals during the 60-day observation period, nor did clodronate appear to alter the trajectory of bone healing in defect sites. These findings suggest that short-term bisphosphonate use does not substantially alter bone structure in healthy young horses, though the clinical significance of this in diseased bone or over longer treatment intervals remains unanswered—practitioners should recognise this as reassurance regarding acute safety rather than licence to extend treatment protocols, and future work examining chronic dosing and naturally occurring pathological bone is warranted.
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Practical Takeaways
- •If using bisphosphonates off-label in young performance horses, current evidence suggests they do not adversely affect normal bone structure or remodeling over a 60-day period
- •Bisphosphonates do not appear to accelerate bone healing in acute bone injuries, so should not be relied upon as a primary fracture treatment strategy
- •The lack of structural changes with bisphosphonate use suggests their clinical benefit in navicular disease likely operates through pain modulation rather than bone remodeling
Key Findings
- •Tiludronate and clodronate did not significantly affect bone structure or remodeling kinetics over 60 days in clinically normal young horses
- •Clodronate did not demonstrate enhancement of bone healing in induced bone defects at 60 days post-injury
- •Bisphosphonate administration in young horses showed no detectable adverse effects on normal bone metabolism during the study period