Efficacy of intravenous administration of hyaluronan, sodium chondroitin sulfate, and N-acetyl-d-glucosamine for prevention or treatment of osteoarthritis in horses

David D. Frisbie Gail Holmes Equine Orthopaedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523.

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C. Wayne McIlwraith Gail Holmes Equine Orthopaedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523.

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Christopher E. Kawcak Gail Holmes Equine Orthopaedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523.

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Natasha M. Werpy Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610.

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Abstract

OBJECTIVE To evaluate the efficacy of IV administration of a product containing hyaluronan, sodium chondroitin sulfate, and N-acetyl-d-glucosamine for prevention or treatment of osteoarthritis in horses.

ANIMALS 32 healthy 2- to 5-year-old horses.

PROCEDURES The study involved 2 portions. To evaluate prophylactic efficacy of the test product, horses received 5 mL of the product (n = 8) or saline (0.9% NaCl) solution (8; placebo) IV every fifth day, starting on day 0 (when osteoarthritis was induced in the middle carpal joint of 1 forelimb) and ending on day 70. To evaluate treatment efficacy, horses received either the product or placebo (n = 8/treatment) on days 16, 23, 30, 37, and 44 after osteoarthritis induction. Clinical, diagnostic imaging, synovial fluid, gross anatomic, and histologic evaluations and other tests were performed. Results of each study portion were compared between treatment groups.

RESULTS Limb flexion and radiographic findings were significantly worse for horses that received the test product in the prophylactic efficacy portion than for placebo-treated horses or product-treated horses in the treatment efficacy portion. In the prophylactic efficacy portion, significantly less articular cartilage erosion was identified in product-treated versus placebo-treated horses. In the treatment efficacy portion, joints of product-treated horses had a greater degree of bone edema identified via MRI than did joints of placebo-treated horses but fewer microscopic articular cartilage abnormalities.

CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that caution should be used when administering the evaluated product IV to horses, particularly when administering it prophylactically, as it may have no benefit or may even cause harm.

Abstract

OBJECTIVE To evaluate the efficacy of IV administration of a product containing hyaluronan, sodium chondroitin sulfate, and N-acetyl-d-glucosamine for prevention or treatment of osteoarthritis in horses.

ANIMALS 32 healthy 2- to 5-year-old horses.

PROCEDURES The study involved 2 portions. To evaluate prophylactic efficacy of the test product, horses received 5 mL of the product (n = 8) or saline (0.9% NaCl) solution (8; placebo) IV every fifth day, starting on day 0 (when osteoarthritis was induced in the middle carpal joint of 1 forelimb) and ending on day 70. To evaluate treatment efficacy, horses received either the product or placebo (n = 8/treatment) on days 16, 23, 30, 37, and 44 after osteoarthritis induction. Clinical, diagnostic imaging, synovial fluid, gross anatomic, and histologic evaluations and other tests were performed. Results of each study portion were compared between treatment groups.

RESULTS Limb flexion and radiographic findings were significantly worse for horses that received the test product in the prophylactic efficacy portion than for placebo-treated horses or product-treated horses in the treatment efficacy portion. In the prophylactic efficacy portion, significantly less articular cartilage erosion was identified in product-treated versus placebo-treated horses. In the treatment efficacy portion, joints of product-treated horses had a greater degree of bone edema identified via MRI than did joints of placebo-treated horses but fewer microscopic articular cartilage abnormalities.

CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that caution should be used when administering the evaluated product IV to horses, particularly when administering it prophylactically, as it may have no benefit or may even cause harm.

Contributor Notes

Address correspondence to Dr. Frisbie (david.frisbie@colostate.edu).
  • 1. Rossdale PD, Hopes R, Digby NJ, et al. Epidemiological study of wastage among racehorses 1982 and 1983. Vet Rec 1985;116: 66–69.

  • 2. NAHMS. Part 1: Baseline reference of 1998 equine health and management. National Animal Health Monitoring System. Fort Collins, Colo: USDA APHIS, Veterinary Services-Centers for Epidemiology and Animal Health, 1998. Available at: www.aphis.usda.gov/animal_health/nahms/equine/downloads/equine98/Equine98_dr_PartI.pdf. Accessed May 29, 2013.

    • Search Google Scholar
    • Export Citation
  • 3. NAHMS. Lameness and laminitis in US horses. National Animal Health Monitoring System. Fort Collins, Colo: USDA APHIS, Veterinary Services-Centers for Epidemiology and Animal Health, 2000. Available at: www.aphis.usda.gov/animal_health/nahms/equine/downloads/equine98/Equine98_dr_Lameness.pdf. Accessed May 29, 2013.

    • Search Google Scholar
    • Export Citation
  • 4. Todhunter R, Lust G. Pathophysiology of synovitis: clinical signs and examination in horses. Compend Contin Educ Pract Vet 1990;12: 980–992.

    • Search Google Scholar
    • Export Citation
  • 5. Frisbie DD, Kawcak CE, Werpy NM, et al. Evaluation of polysulfated glycosaminoglycan or sodium hyaluronan administered intra-articularly for treatment of horses with experimentally induced osteoarthritis. Am J Vet Res 2009; 70: 203–209.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6. Ferris DJ, Frisbie DD, McIlwraith CW, et al. Current joint therapy usage in equine practice: a survey of veterinarians 2009. Equine Vet J 2011;43: 530–535.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7. Frisbie DD, McIlwraith CW, Kawcak CE, et al. Evaluation of intra-articular hyaluronan, sodium chondroitin sulfate and N-acetyl-d-glucosamine combination versus saline (0.9% NaCl) for osteoarthritis using an equine model. Vet J 2013;197: 824–829.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8. Frisbie DD, Ghivizzani SC, Robbins PD, et al. Treatment of experimental equine osteoarthritis by in vivo delivery of the equine interleukin-1 receptor antagonist gene. Gene Ther 2002;9: 12–20.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9. Anonymous. Definition and classification of lameness. In: Guide for veterinary service and judging of equestrian events. Lexington, KY: American Association of Equine Practitioners, 1991;19.

    • Search Google Scholar
    • Export Citation
  • 10. Farndale RW, Buttle DJ, Barrett AJ. Improved quantitation and discrimination of sulphated glycosaminoglycans by use of dimethylmethylene blue. Biochem Biophys Acta 1986;883: 173–177.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11. McIlwraith CW, Frisbie DD, Kawcak CE, et al. The OARSI histopathology initiative—recommendation for histological assessments of osteoarthritis in the horse. Osteoarthritis Cartilage 2010;18(suppl 3): SS95–S105.

    • Search Google Scholar
    • Export Citation

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