Clinical effect of corticosteroids in asthma‐affected horses: A quantitative synthesis

Abstract

Inhaled corticosteroids are effective in improving the clinical condition of horses with equine asthma and prevent exacerbations. Systemic corticosteroids should be used only in selected cases with symptomatic airway hyperresponsiveness during exacerbation. IDEASS requires further validation but may represent a suitable approach to rank the level of asthma severity and assess the clinical effect of pharmacotherapy in horses with equine asthma.

Clinical efficacy of bronchodilators in equine asthma: Looking for minimal important difference

“…were included. In brief, the clinical score consisted of ranking the degree of nasal flaring plus abdominal effort, each scored on a scale of 1–4 . Two veterinarians independently examined the studies, and any difference in opinion concerning the selection of the studies was resolved by consulting a third reviewer expert in meta‐analysis to reach a consensus.…”

“…Conversely, in horses affected by severe equine asthma, regular to frequent coughing, exercise intolerance, and increased respiratory effort at rest are the main reported clinical signs . Generally, airway inflammation is a common pathological trait of equine asthma that can be adequately treated by corticosteroid therapy . In more severe forms of asthma, lung inflammation is accompanied also by airway obstruction that affects respiratory function and also elicits detrimental effects on clinical presentation .…”

“…Robust evidence has recently demonstrated that anti‐inflammatory therapy improves the clinical condition of asthmatic horses , and that bronchodilator pharmacotherapy significantly improves the respiratory mechanics in horses with severe clinical disease . However, although airway obstruction represents a specific treatable trait in severe equine asthma, to date only few and underpowered clinical studies have investigated the impact of the improvement in lung function induced by bronchodilator agents on the clinical presentation of asthma‐affected horses .…”

“…We hypothesised that bronchodilator pharmacotherapy may be associated with an improvement in the clinical presentation of asthmatic horses via an appreciable reduction in breathing effort as assessed by a previously applied scoring system . Therefore, we performed a quantitative synthesis and meta‐regression analysis concerning the relationship between the changes in functional respiratory outcomes elicited by bronchodilators and the improvement in equine asthma clinical score, in order to identify the minimal important difference (MID) in lung function leading to a meaningful improvement in clinical signs.…”

Two-Dimensional Speckle Tracking for Quantitative Right Ventricular Wall Motion Analysis in Horses Affected by Equine Asthma

“…The diagnosis of equine asthma was based on clinical signs continued for at least 3 months including coughing, nasal discharge and dyspnoea at rest. The results of clinical scoring system included the clinical signs score, excessive mucous production and thickened tracheal bifurcation in the endoscopic examination, increased cellular density and neutrophils percentage in the cytological evaluation of the tracheal aspirates and an arterio-alveolar oxygen difference (AaDo2) >15 mmHg in arterial blood gas analysis were previously described (Barton et al, 2015;Calzetta et al, 2018;Couetil et al, 2016). The results of echocardiographic measurements in severely asthmatic horses were compared with those in control group of 6 healthy horses (Group 1).…”