Effect of Inhaled Ciclesonide on Clinical Signs, Lung Function

Introduction Corticosteroids are the most effective drugs for equine asthma, but their systemic and inhalant use is associated with potential side effects, as they induce cortisol suppression.1–3 Ciclesonide has a low oral bioavailability, and a low affinity for glucocorticoid receptors while in its inactive form, which increases 100 times after activation in the lungs.4 Due to this favorable profile, ciclesonide might be a valuable drug for the treatment of horses with asthma. 2. Materials and Methods Using a crossover placebo controlled, blinded, randomized design, 16 horses with severe equine asthma in exacerbation of the disease were enrolled in three dose-titration studies (8 horses/study). The effects of different doses of inhaled ciclesonide administered for a 2-week period on clinical scores, lung function, and serum cortisol were investigated. Systemic dexamethasone served as a positive control and placebo as a negative control. 3. Results Both ciclesonide and dexamethasone significantly improved clinical scores, pulmonary resistance, and pulmonary elastance after 7 days of treatment. Serum cortisol suppression occurred with dexamethasone from day 3 of treatment up to day 3 post-treatment, but not with ciclesonide at any tested doses. 4. Conclusions It can be concluded that inhaled ciclesonide was safe and effective for enrolled horses with severe.

 Jean-Pierre Lavoie, DMV; Mathilde Leclere, DMV, PhD*; Michela Bullone, DMV, PhD; Natalia Rodrigues, BMV, MSc; Pamela Germim, BMV, MSc; Balazs Albrecht, DVM, PhD; and Marcella von Salis-Soglio, DVM Inhaled ciclesonide was safe and effective for enrolled horses with severe asthma in a moldy hay challenge model. Authors’ addresses: Department of Clinical Sciences, Faculty of Veterinary Medicine, Universite´ de Montre´al, 3200 rue Sicotte, St-Hyacinthe, J2S 2M2, QC, Canada (Lavoie, Leclere, Bullone, Rodgrigues, Germim); Boehringer Ingelheim Vetmedica GmbH, Binger Strasse 173, 55216 Ingelheim am Rhein, Germany (Albrecht, von Salis-Soglio);