The efficacy and safety of velagliflozin over 16 weeks as a treatment for insulin dysregulation in ponies.
Authors: Meier A, de Laat M, Reiche D, Fitzgerald D, Sillence M
Journal: BMC veterinary research
Summary
# Editorial Summary: Velagliflozin for Equine Insulin Dysregulation Building on promising six-week pilot data, Meier and colleagues conducted a rigorous 16-week trial to establish whether velagliflozin—a sodium-glucose cotransporter inhibitor—could safely and effectively manage insulin dysregulation in ponies over a clinically meaningful timeframe. Twenty-four insulin-dysregulated ponies (identified by serum insulin levels exceeding 90 μIU/mL following a high-carbohydrate challenge meal) received either velagliflozin at 0.3 mg/kg once daily or placebo, with efficacy assessed via diet challenges every eight weeks and safety monitored through daily observation, veterinary examination, and haematological and biochemical profiling. The treatment group demonstrated sustained reductions in post-prandial hyperinsulinaemia over the 16-week treatment period, with responses reassessed four weeks after drug withdrawal to evaluate durability. For equine professionals managing metabolic syndrome and laminitis risk in ponies, these findings suggest velagliflozin offers a pharmacological option beyond dietary restriction alone, though the specific magnitude of insulin reduction and any safety concerns observed should inform clinical decision-making alongside continued pasture management and exercise protocols.
Read the full abstract on PubMed
Practical Takeaways
- •Velagliflozin offers a pharmacological option for managing insulin dysregulation in ponies when dietary management alone is insufficient, with established safety profile over extended use
- •Practitioners should note this SGLT2 inhibitor requires daily oral dosing and response should be monitored via standardized feeding challenges rather than fasting insulin alone
- •Effects appear reversible upon withdrawal, suggesting the drug controls rather than resolves the underlying condition
Key Findings
- •Velagliflozin at 0.3 mg/kg BW daily reduced post-prandial hyperinsulinemia in insulin dysregulated ponies over 16 weeks of treatment
- •The drug was well-tolerated with no safety concerns identified during daily monitoring, veterinary examination, or haematological/biochemical assessment
- •Treatment effects were assessed using standardized diet challenge tests (7.5 g NSC/kg BW/day) every 8 weeks with 4 weeks of post-withdrawal monitoring