Glucocorticoid treatment in horses with asthma: A narrative review.
Authors: Mainguy-Seers Sophie, Lavoie Jean-Pierre
Journal: Journal of veterinary internal medicine
Summary
# Glucocorticoid treatment in horses with asthma: A narrative review Glucocorticoids remain the most effective pharmacological treatment for equine asthma despite decades of clinical use, yet substantial uncertainty persists around optimal dosing strategies, comparative efficacy between different agents, and the mechanisms driving variable inflammatory responses in individual horses. This narrative review synthesised existing literature to evaluate how various glucocorticoid formulations affect lung function, airway inflammation, and bronchial remodelling in asthmatic horses, whilst cataloguing both therapeutic benefits and documented adverse effects specific to this population. Although glucocorticoids' potent ability to relieve airway obstruction justifies their widespread application, the authors identified critical evidence gaps regarding minimal effective doses and why inflammatory modulation differs between patients—information that would substantially refine clinical decision-making. For equine professionals managing asthma cases, this review underscores that current treatment protocols lack the evidence base for truly individualised therapy, meaning dosing remains somewhat empirical rather than based on pharmacokinetic or inflammatory biomarkers. Future research targeting dose-response relationships and patient stratification could move the field towards more targeted glucocorticoid use, potentially reducing cumulative systemic side-effects whilst maintaining respiratory control.
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Practical Takeaways
- •Glucocorticoids are essential for managing equine asthma, but clinicians need better guidance on drug selection and dosing optimization to maximize efficacy while minimizing adverse effects
- •Further research is needed to establish minimal effective doses and comparative effectiveness of different glucocorticoid preparations to improve individual treatment protocols
- •Monitor for glucocorticoid-specific adverse effects in asthmatic horses and consider long-term management strategies given the chronic nature of the disease
Key Findings
- •Glucocorticoids remain the cornerstone of pharmacological treatment for equine asthma despite potential adverse effects
- •Comparative efficacy of different glucocorticoid drugs in asthmatic horses remains incompletely characterized
- •Minimal effective doses and mechanisms of variable airway inflammation modulation by glucocorticoids are not well established in equine medicine
- •Literature gaps exist regarding long-term effects of glucocorticoids on lung function and bronchial remodeling in asthmatic horses