Systematic review of the association between intrasynovial corticosteroid use and laminitis—What is the evidence?

Abstract

Intrasynovial corticosteroid therapy is commonly used in the treatment of joint disease in horses. Anecdotal evidence has linked its application with the development of laminitis in some cases (Rendle, 2019). This systematic review aims to gather and evaluate the level of published evidence regarding the incidence of laminitis following intrasynovial corticosteroids use. MATERIAL S AND ME THODSA systematic search on PubMed, CAB Direct (CAB) and Web of Science (WoS) databases was conducted in February 2022. Terms included in each search strategy are described in Table 1.Articles were selected if they had the full text available, were published in English and described the effects of intrasynovial use of corticosteroids and their relationship with the development of laminitis. Corticosteroids included were methylprednisolone acetate (MPA), betamethasone, triamcinolone acetonide (TA), dexamethasone (DEX) and isoflupredone. Articles including several different routes of administration for corticosteroids were selected if they specified the use of intrasynovial injections and provided the relevant information.Study designs included were in vivo experimental studies with horses, case series, retrospective or prospective observational (cohort) studies (with or without a control group) and randomised clinical trials. Other study designs not mentioned above were not included. Articles were excluded if they were not relevant to the question of this review; investigated only the systemic use of