A Survey of Clinical Usage of Non-steroidal Intra-Articular Therapeutics by Equine Practitioners.
Authors: Velloso Alvarez Ana, Boone Lindsey H, Braim Amy Poulin, Taintor Jenifer S, Caldwell Fred, Wright James C, Wooldridge Anne A
Journal: Frontiers in veterinary science
Summary
# Editorial Summary: Non-steroidal Intra-articular Therapeutics in Equine Practice Despite growing interest in regenerative joint therapies, corticosteroids and hyaluronic acid remain the dominant intra-articular treatments amongst equine practitioners, yet a significant knowledge gap existed regarding how NSIATs are actually being used in clinical settings. A cross-sectional survey of 353 equine practitioners internationally examined prescribing patterns for non-steroidal intra-articular therapeutics including platelet-rich plasma, autologous conditioned serum (ACS), autologous protein solution, cellular therapies, and polyacrylamide hydrogel, alongside traditional corticosteroid use. The findings revealed that 87.5% of respondents incorporated NSIATs into practice, with blood-derived products (particularly ACS and PRP) substantially outpacing synthetic and cellular options; practitioners treating high volumes of equine cases (>10 intra-articular injections monthly) and those with predominantly equine caseloads (>50%) were significantly more likely to employ these therapies, whilst polyacrylamide hydrogel saw minimal uptake. Notably, practitioners more frequently chose NSIATs for acute articular pathologies than historical literature suggests, diverging from the traditional narrative that these products are reserved primarily for chronic degenerative conditions. The reliance on subjective clinical assessment rather than recorded outcome data highlights an important limitation, yet the results underscore a practice shift worth investigating further—establishing robust outcome tracking and evidence-based protocols for acute joint injuries could substantially improve therapeutic decision-making across the profession.
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Practical Takeaways
- •NSIATs are widely adopted in equine practice for joint disease, but corticosteroids with hyaluronic acid remain the gold standard—switching to alternatives should be based on specific clinical scenarios, not routine practice.
- •Blood-based products (PRP, ACS) are the most popular NSIАТ alternatives, but survey data reflect clinician perception rather than rigorous outcome data; demand evidence-based protocols from suppliers when considering these treatments.
- •High-volume joint injection practitioners treating sport horses report more NSIАТ use; if you inject multiple horses monthly, you may benefit from developing standardized protocols for acute versus chronic pathology to optimize outcomes.
Key Findings
- •87.5% of equine practitioners surveyed use non-steroidal intra-articular therapeutics (NSIATs), with corticosteroids and hyaluronic acid remaining the most commonly used agents.
- •Among NSIATs, blood-based products (autologous conditioned serum, platelet-rich plasma) are preferred over cellular therapies and synthetic products like polyacrylamide hydrogel.
- •Practitioners with >50% equine caseload and those treating >10 horses intra-articularly per month were significantly more likely to use NSIATs (P<0.001).
- •Treatment of acute articular pathology was one of the most common reasons for NSIАТ selection, though complication and efficacy data were based on subjective recall rather than clinical records.