Equine Osteoarthritis: Recent Therapeutic Advances
Osteoarthritis (OA) is a multifactorial disease that is characterized by the progressive degradation of articular cartilage (the cartilage in joints). OA results from a number of complex biological and mechanical processes; however, generally the condition is a consequence of either abnormal forces on normal cartilage, or normal forces on damaged cartilage.
OA is a very common cause of lameness, and remains a hot topic in equine practice because of its far-reaching impact on horses, owners, and the entire equine industry. OA is a progressive disease that is incurable; however, a multimodal approach is often used to manage the condition and prolong the horses’ athletic function.
Conventional treatments include: pain management with non-steriodal anti-inflammatory drugs (NSAIDs, such as phenylbutazone or ‘Bute’), intra-articular medications (medication injected into a joint, such as hyaluronic acid and corticosteroids), intramuscular PSGAG’s (trade name Adequan), weight management and controlled exercise, and oral joint supplements. The aim of therapy is to slow the progressive loss of articular cartilage while managing pain and inflammation.
So what’s new in OA therapy? Recent advances include:
Autologous conditioned serum (ACS, trade name IRAP)- this system utilizes the horse’s own blood, which is incubated with specialized beads. The serum obtained is enriched with growth factors and anti-inflammatory mediators, and is injected into joints.
Gene therapy- current research is investigating the insertion of a gene into a viral vector, which produces an anti-inflammatory protein that can be delivered to joints with OA.
Platelet-rich plasma (PRP)- this therapy also utilizes a fraction of the horse’s own blood, which is conditioned to concentrate platelets. Platelets are a source of growth factors that facilitate healing. This therapy has been used to treat tendon and ligament injuries, and is currently being evaluated as an intra-articular therapy.
New NSAIDs- the systemic COX-2 inhibitor firocoxib (trade name Equioxx) and the topical diclofenac cream (trade name Surpass) are new anti-inflammatory drugs that provide pain relief with less adverse side effects than traditional NASIDs such as Bute.
Shockwave therapy- Recent research shows that shockwave therapy may benefit horses with OA by decreasing inflammation and improving lameness.
Advanced physical rehabilitation techniques- Current
research is evaluating physical therapy techniques such as
underwater treadmill exercises for their potential beneficial effect
on horses with OA.
