RESPIRATORY
Nasal Spray Controls Severe Equine Asthma By Adam Marcus A novel form of the corticosteroid ciclesonide appears safe and effective for treating severe equine asthma, according to the results of a large, prospective trial in Europe. The nasal formulation led to a statistically significant reduction in asthma symptoms over the 10-day study, which included more than 220 animals with severe asthma related to their stable or pastures. A safety analysis found no adverse events attributable to the therapy, which is marketed in the United States as Aservo EquiHaler (Boehringer Ingelheim Animal Health). The new formulation is a pro-drug of ciclesonide
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Issue 12/2020 | ModernEquineVet.com
called des-ciclesonide. The medication is administered by a nasal applicator that sprays a low-velocity mist of tiny particles—nearly all of which are 5 µm in diameter or smaller—deep into the animals’ airways. There the particles bind to receptors in the airway epithelium with 12 times the affinity of dexamethasone and 100 times the affinity as conventional ciclesonide.
In the study, 95% of horses tolerated Aservo EquiHaler nasal spray, and 90% of owners complied with treatment. Animals in the study received 140 metered doses of the drug over a 10-day period. “We saw that the ciclesonide-treated group resulted in a 73.4% response rate and the placebo-treated group in a 43.2% response rate,” said R. Scott Pirie, BVM&S, PhD, the chair of equine clinical sciences at the University of Edinburgh, who presented the findings at the 2020 virtual convention of the American Association of Equine Pracitioners (presentation S1001). Moreover, horses that received the nasal spray experienced a much larger drop in a weighted clinical score of 9 asthma-related criteria, including nasal discharge, cough, and bronchial and tracheal noises, as assessed by their owners compared with animals in the placebo group, Pirie said—7.2 points 3. versus 3.8, respectively (P<0.0001). According to Pirie, 95% of the horses in the study tolerated the nasal spray, and more than 90% of owners complied with the treatment, he added. Pirie noted that the researchers could not rule out the possibility that some of the horses improved in the study because the allergen load in their environments lessened. However, he added, the owners were instructed not to take any special measures that might have such an effect, or to make the load worse. MeV The study was funded by Boehringer Ingelheim.
