Treatment with ertugliflozin mitigates the hyperinsulinemic response to intra-articular triamcinolone acetonide.
Authors: Page Allen E, McPeek Jenna L, McGreevy Ella, Carattini Sophia, Adam Emma N
Journal: Equine veterinary journal
Summary
# Editorial Summary Intra-articular corticosteroid injections are invaluable for managing equine joint disease, yet they carry a significant metabolic consequence: they trigger hyperinsulinaemia, which substantially elevates laminitis risk in horses already compromised by insulin dysregulation. Allen and colleagues investigated whether ertugliflozin, a sodium-glucose cotransporter 2 inhibitor (SGLT2i), could ameliorate this iatrogenic metabolic complication in a controlled trial examining insulin response following triamcinolone acetonide administration. The treatment group receiving ertugliflozin demonstrated a meaningfully attenuated hyperinsulinaemic response compared to controls, suggesting that SGLT2i therapy may provide protective metabolic cover during IA corticosteroid procedures. For practitioners treating horses with concurrent joint pathology and insulin dysregulation—an increasingly common clinical scenario—this work offers a pharmacological strategy to mitigate a significant laminitis risk factor without necessarily forgoing beneficial intra-articular intervention. Given the expanding use of SGLT2i agents in equine metabolic management, periarticular corticosteroid protocols could reasonably incorporate ertugliflozin or similar agents as a preventative measure in at-risk populations.
Read the full abstract on PubMed
Practical Takeaways
- •Consider SGLT2 inhibitor therapy (ertugliflozin) when administering intra-articular corticosteroids to horses with insulin dysregulation to reduce hyperinsulinemia and laminitis risk
- •Horses with existing ID warrant enhanced metabolic monitoring following IA corticosteroid injection
- •SGLT2i drugs offer a pharmacological strategy to mitigate an important side effect of a common therapeutic intervention
Key Findings
- •Intra-articular triamcinolone acetonide induces hyperinsulinemic response in horses
- •SGLT2 inhibitors may mitigate post-IA corticosteroid hyperinsulinemia
- •Ertugliflozin shows potential for managing insulin dysregulation complications from joint injections
- •IA corticosteroids increase laminitis risk particularly in horses with pre-existing insulin dysregulation