Nebulized dexamethasone sodium phosphate in the treatment of horses with severe asthma

Abstract Background A study reported low systemic availability of injectable dexamethasone nebulized to healthy horses using the Flexineb mask. When used in horses with severe asthma and a different nebulizer, lack of efficacy and cortisol suppression were observed. Hypothesis Nebulized dexamethason...

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Autores principales:	Selena deWasseige, Khristine Picotte, Jean‐Pierre Lavoie
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	corticosteroids cortisol heaves hypothalamic‐pituitary‐adrenal axis suppression inhalation lung Veterinary medicine SF600-1100
Acceso en línea:	https://doaj.org/article/c9dcda3be03640c7bf30ef53e11d7340
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spelling	oai:doaj.org-article:c9dcda3be03640c7bf30ef53e11d73402021-11-30T17:01:05ZNebulized dexamethasone sodium phosphate in the treatment of horses with severe asthma1939-16760891-664010.1111/jvim.16113https://doaj.org/article/c9dcda3be03640c7bf30ef53e11d73402021-05-01T00:00:00Zhttps://doi.org/10.1111/jvim.16113https://doaj.org/toc/0891-6640https://doaj.org/toc/1939-1676Abstract Background A study reported low systemic availability of injectable dexamethasone nebulized to healthy horses using the Flexineb mask. When used in horses with severe asthma and a different nebulizer, lack of efficacy and cortisol suppression were observed. Hypothesis Nebulized dexamethasone is as effective as PO administration for the treatment of severe asthma in horses. Animals Twelve horses with severe asthma from a research herd. Methods Randomized clinical trial. Horses were divided into 2 groups and received 5 mg of dexamethasone sodium phosphate by nebulization using a Flexineb mask (NE, n = 6) or PO (OR, n = 6) q24h for 7 days. Lung function and serum cortisol concentrations were evaluated at baseline, after 4 days of treatment (D4) and 1 day after the last treatment (D8). Data were analyzed using linear mixed models with Benjamini‐Hochberg adjustments. Results Lung resistance significantly improved at D4 (mean decrease ± SD, −1.5 ± 0.45 cm H₂O/L/s; 95% confidence interval [CI], −2; −0.6) and D8 (−1.4 ± 0.45 cm H₂O/L/s; 95% CI, −2.4; −0.5) compared to baseline in the OR group only (P = .004 and .01, respectively). Serum cortisol concentration was significantly decreased at D4 and D8 for both groups (maximum decrease, −1.2 ± 0.3 μg/dL; 95% CI, −1.9; −0.6 at D4 for NE group and −2.2 ± 0.3 μg/dL; 95% CI, −2.8; −1.6 at D8 for OR group; P < .001). Conclusions and Clinical Importance Oral, but not nebulized dexamethasone is an effective therapy for horses with severe asthma and both treatment modalities inhibit the hypothalamic‐pituitary‐adrenal axis.Selena deWasseigeKhristine PicotteJean‐Pierre LavoieWileyarticlecorticosteroidscortisolheaveshypothalamic‐pituitary‐adrenal axis suppressioninhalationlungVeterinary medicineSF600-1100ENJournal of Veterinary Internal Medicine, Vol 35, Iss 3, Pp 1604-1611 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	corticosteroids cortisol heaves hypothalamic‐pituitary‐adrenal axis suppression inhalation lung Veterinary medicine SF600-1100
spellingShingle	corticosteroids cortisol heaves hypothalamic‐pituitary‐adrenal axis suppression inhalation lung Veterinary medicine SF600-1100 Selena deWasseige Khristine Picotte Jean‐Pierre Lavoie Nebulized dexamethasone sodium phosphate in the treatment of horses with severe asthma
description	Abstract Background A study reported low systemic availability of injectable dexamethasone nebulized to healthy horses using the Flexineb mask. When used in horses with severe asthma and a different nebulizer, lack of efficacy and cortisol suppression were observed. Hypothesis Nebulized dexamethasone is as effective as PO administration for the treatment of severe asthma in horses. Animals Twelve horses with severe asthma from a research herd. Methods Randomized clinical trial. Horses were divided into 2 groups and received 5 mg of dexamethasone sodium phosphate by nebulization using a Flexineb mask (NE, n = 6) or PO (OR, n = 6) q24h for 7 days. Lung function and serum cortisol concentrations were evaluated at baseline, after 4 days of treatment (D4) and 1 day after the last treatment (D8). Data were analyzed using linear mixed models with Benjamini‐Hochberg adjustments. Results Lung resistance significantly improved at D4 (mean decrease ± SD, −1.5 ± 0.45 cm H₂O/L/s; 95% confidence interval [CI], −2; −0.6) and D8 (−1.4 ± 0.45 cm H₂O/L/s; 95% CI, −2.4; −0.5) compared to baseline in the OR group only (P = .004 and .01, respectively). Serum cortisol concentration was significantly decreased at D4 and D8 for both groups (maximum decrease, −1.2 ± 0.3 μg/dL; 95% CI, −1.9; −0.6 at D4 for NE group and −2.2 ± 0.3 μg/dL; 95% CI, −2.8; −1.6 at D8 for OR group; P < .001). Conclusions and Clinical Importance Oral, but not nebulized dexamethasone is an effective therapy for horses with severe asthma and both treatment modalities inhibit the hypothalamic‐pituitary‐adrenal axis.
format	article
author	Selena deWasseige Khristine Picotte Jean‐Pierre Lavoie
author_facet	Selena deWasseige Khristine Picotte Jean‐Pierre Lavoie
author_sort	Selena deWasseige
title	Nebulized dexamethasone sodium phosphate in the treatment of horses with severe asthma
title_short	Nebulized dexamethasone sodium phosphate in the treatment of horses with severe asthma
title_full	Nebulized dexamethasone sodium phosphate in the treatment of horses with severe asthma
title_fullStr	Nebulized dexamethasone sodium phosphate in the treatment of horses with severe asthma
title_full_unstemmed	Nebulized dexamethasone sodium phosphate in the treatment of horses with severe asthma
title_sort	nebulized dexamethasone sodium phosphate in the treatment of horses with severe asthma
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/c9dcda3be03640c7bf30ef53e11d7340
work_keys_str_mv	AT selenadewasseige nebulizeddexamethasonesodiumphosphateinthetreatmentofhorseswithsevereasthma AT khristinepicotte nebulizeddexamethasonesodiumphosphateinthetreatmentofhorseswithsevereasthma AT jeanpierrelavoie nebulizeddexamethasonesodiumphosphateinthetreatmentofhorseswithsevereasthma
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Nebulized dexamethasone sodium phosphate in the treatment of horses with severe asthma

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