Equine pituitary pars intermedia dysfunction: Identifying research priorities for diagnosis, treatment and prognosis through a priority setting partnership.
Authors: Tatum Rebecca C, McGowan Cathy M, Dean Rachel S, Ireland Joanne L
Journal: PloS one
Summary
# Editorial Summary: PPID Research Priorities Pituitary pars intermedia dysfunction represents the most common endocrine disorder in older horses, yet significant evidence gaps persist regarding its diagnosis, treatment and long-term management. Researchers adapted the James Lind Alliance Priority Setting Partnership framework to systematically identify these knowledge gaps: 524 respondents (predominantly horse owners) submitted over 1,200 individual questions that were thematically analysed into 47 core evidence uncertainties, then ranked through two-stage voting to establish priorities. The top 10 consensus research questions centred on long-term prognosis, diagnostic accuracy, pergolide efficacy, alternative management strategies and treatment options for pergolide non-responders—areas where clinicians and horse owners currently lack robust evidence to guide decision-making. These priorities highlight urgent needs for prospective prognostic studies, diagnostic validation work and comparative treatment trials; addressing them should substantially improve clinical confidence when managing PPID cases and managing client expectations around disease trajectory. The breadth of identified uncertainties (47 distinct evidence gaps) underscores how much remains unknown about this prevalent condition, providing a clear research roadmap for the equine veterinary and allied professions community.
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Practical Takeaways
- •Veterinarians and horse owners agree that better diagnostic tools and long-term outcome data for PPID are urgently needed to improve clinical management
- •Current pergolide-based treatment has significant limitations; research into alternative or adjunctive therapies for non-responders should be prioritized
- •This priority-setting framework highlights the gap between clinical practice needs and current evidence—expect more research funding directed toward PPID management in coming years
Key Findings
- •524 respondents (92.6% horse owners, 7.4% veterinarians) generated 1,260 individual questions about PPID that were thematically analyzed into 47 evidence uncertainties
- •Top 10 research priorities focus on long-term prognosis, diagnostic accuracy, pergolide treatment efficacy, and alternative management strategies for PPID
- •Extensive evidence gaps exist regarding diagnosis, treatment, and prognosis of PPID, the most prevalent endocrine disorder in older horses
- •Research priorities identified through stakeholder engagement prioritize pergolide non-responder treatment options and alternative therapeutic approaches