This prospective, multi-center, placebo-controlled, randomized, double-blinded study was designed to assess the effectiveness and safety of inhaled ciclesonide for the treatment of severe equine asthma.
Ciclesonide is a glucocorticoid prodrug, already registered for human use. Due to its mode of action and inhaled route of administration, it was considered an appropriate treatment option for horses with severe equine asthma. Although the efficacy of inhaled ciclesonide has been demonstrated in horses with asthma exacerbations under controlled mouldy hay challenge conditions, it has not yet been reported under field conditions.
The research was titled, "Inhaled ciclesonide is efficacious and well tolerated in the treatment of severe equine asthma in a large prospective European clinical trial," and was authored by Robert Scott Pirie, Hanns‐Walter Mueller, Odilo Engel, Balazs Albrecht, Marcella von Salis‐Soglio.
In total, 220 horses with severe equine asthma were included in the study from 24 clinics in Germany, France and Switzerland. Horses were randomized to receive ciclesonide inhalation solution or placebo inhalation. No environmental modifications were implemented. Treatments were administered with the Aservo EquiHaler inhaler for horses at doses of eight actuations twice daily for 5 days and 12 actuations once daily for the following 5 days.
The ciclesonide group had a responder rate of 73% compared with 43% for the placebo group. The mean weighted clinical score reduction after 10 days of treatment was 7.2±4.8 in the ciclesonide-treated group, compared with 3.8±4.5 in the placebo group. Horses with more severe clinical signs showed a greater improvement compared to those with mild/moderate clinical signs.
Owners perceived an improved quality of life after 5 and 10 days of treatment in 60.2% and 69.3% of ciclesonide-treated horses, compared with 32.7% and 43.4% of placebo- treated horses.
Bottom line: Inhaled ciclesonide resulted in a clinical improvement and improved quality of life in horses with severe equine asthma after 10 days of treatment.
You can access this OPEN ACCESS article from BEVA's Equine Vet Journal on Wiley's online library here.