RAO horse

In an Adult Horse With Severe Asthma (Previously Recurrent Airway Obstruction) Does Using Inhaled Corticosteroids Result in an Equal Improvement in Clinical Signs When Compared to Systemic Corticosteroids?

Natasha A Jocelyn

Published:  10/04/2018    in:  Knowledge Summaries

RAO horse
PICO question

In an adult horse with severe asthma (previously recurrent airway obstruction (RAO)) does using inhaled corticosteroids result in an equal improvement in clinical signs when compared to systemic corticosteroids?

Clinical bottom line

The level of confidence in the outcomes from the body of evidence in the 4 papers identified is high. This suggests inhaled corticosteroids (fluticasone and beclomethasone) when used at an appropriate dose can have equivalent effects on severe equine asthma as systemic intravenous dexamethasone. Inhaled corticosteroids can take longer to have the desired effects. 

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  1. Couëtil, L.L. et al., 2006. Effect of beclomethasone dipropionate and dexamethasone isonicotinate on lung function, bronchoalveolar lavage fluid cytology, and transcription factor expression in airways of horses with recurrent airway obstruction. Journal of veterinary internal medicine / American College of Veterinary Internal Medicine, 20(2), pp.399–406. doi: http://dx.doi.org/10.1111/j.1939-1676.2006.tb02875.x
  2. Couëtil, L.L. et al., 2005. Randomized, controlled study of inhaled fluticasone propionate, oral administration of prednisone, and environmental management of horses with recurrent airway obstruction. American journal of veterinary research, 66(10), pp.1665–1674. doi: http://dx.doi.org/10.2460/ajvr.2005.66.1665
  3. Robinson, N.E. et al., 2009. Fluticasone Propionate Aerosol is More Effective for Prevention than Treatment of Recurrent Airway Obstruction. Journal of Veterinary Internal Medicine, 23(6), pp.1247–1253. doi: http://dx.doi.org/10.1111/j.1939-1676.2009.0382.x
  4. Rush, B.R. et al., 1998. Pulmonary function in horses with recurrent airway obstruction after aerosol and parenteral administration of beclomethasone dipropionate and dexamethasone, respectively. American journal of veterinary research, 59(8), pp.1039–1043.

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