DOI
https://doi.org/10.18849/ve.v5i3.317Abstract
PICO question
In horses with osteoarthritis, is mesenchymal stem cell therapy more effective at managing lameness than intra-articular corticosteroids?
Clinical bottom line
Category of research question
Treatment
The number and type of study designs reviewed
Nine papers were critically reviewed; seven experimental trials and two randomised controlled double-blinded trials.
Strength of evidence
Weak to moderate
Outcomes reported
There is moderate evidence to suggest that chondrogenically induced mesenchymal stem cells combined with equine allogenic plasma have a good efficacy at reducing lameness in the short-term, in horses with mild to moderate lameness associated with osteoarthritis. However, there is no definitive evidence directly comparing mesenchymal stem cell therapy and corticosteroids, to identify if mesenchymal stem cell therapy is more effective than intra-articular corticosteroids.
Conclusion
In horses with mild to moderate lameness associated with osteoarthritis, there is moderate evidence to suggest that mesenchymal stem cell therapies are effective at managing lameness. However, it is undetermined whether they are more effacious than intra-articular corticosteroids.
How to apply this evidence in practice
The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
Knowledge Summaries are a resource to help reinforce or inform decision-making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
References
Barrachina, L., Remacha, A. R., Romero, A., Vitoria, A., Albareda, J., Prades, M., Roca, M., Zaragoza, P., Vazquez, F. J. and Rodellar, C. (2018). 'Assessment of effectiveness and safety of repeat administration of proinflammatory primed allogeneic mesenchymal stem cells in an equine model of chemically induced osteoarthritis', BMC Veterinary Research, 14(1), pp. 241. DOI: http://dx.doi.org/10.1186/s12917-018-1556-3
Broeckx, S., Suls, M., Beerts, C., Vandenberghe, A., Seys, B., Wuertz-Kozak, K., Duchateau, L. and Spaas, J. H. (2014a). 'Allogenic mesenchymal stem cells as a treatment for equine degenerative joint disease: a pilot study', Current Stem Cell Research & Therapy, 9(6), pp. 497–503. DOI: http://dx.doi.org/10.2174/1574888X09666140826110601
Broeckx, S., Zimmerman, M., Crocetti, S., Suls, M., Mariën, T., Ferguson, S. J., Chiers, K., Duchateau, L., Franco-Obregón, A., Wuertz, K. and Spaas, J. H. (2014b). 'Regenerative therapies for equine degenerative joint disease: A preliminary study', PLoS ONE, 9(1). DOI: http://dx.doi.org/10.1371/journal.pone.0085917
Broeckx, S. Y., Martens, A., Spaas, J., Bertone, A. L., Van Brantegem, L., Duchateau, L., Van Hecke, L., Dumoulin, M., Oosterlinck, M., Chiers, K., Hussein, H. and Pille, F. E. A. (2019a). The use of equine chondrogenic-induced mesenchymal stem cells as a treatment for osteoarthritis: A randomised, double-blinded, placebo-controlled proof-of-concept study. Equine Veterinary Journal. 21(6), pp 787–794. DOI: http://dx.doi.org/10.1111/evj.13089
Broeckx, S. Y., Seys, B., Suls, M., Vandenberghe, A., Marien, T., Adriaensen, E., Declercq, J., Van Hecke, L., Braun, G., Hellmann, K. and Spaas, J. H. (2019b). 'Equine Allogeneic Chondrogenic Induced Mesenchymal Stem Cells Are an Effective Treatment for Degenerative Joint Disease in Horses', Stem Cells and Development, 28(6), pp. 410–422. DOI: http://dx.doi.org/10.1089/scd.2018.0061
Bryon, C. (2008). Effects of methylprednisolone acetate and glucosamine on proteoglycan production by equine chondrocytes in vitro. In: Benson, B., Stewart, A. and Pondenis, H. (eds.). American Journal of Veterinary Research. DOI: https://doi.org/10.2460/ajvr.69.9.1123
Caron, J. P. (2005). 'Intra-articular injections for joint disease in horses', Veterinary Clinics of North America: Equine Practice, 21(3), pp. 559–73. DOI: http://dx.doi.org/10.1016/j.cveq.2005.07.003
Clegg, P. and Booth, T. (2000). 'Drugs used to treat osteoarthritis in the horse', In Practice, 22(10), pp. 594–603. DOI: http://dx.doi.org/10.1136/inpract.22.10.594
Clutterbuck, A. L., Harris, P., Allaway, D. and Mobasheri, A. (2010). 'Matrix metalloproteinases in inflammatory pathologies of the horse', Veterinary Journal, 183(1), pp. 27–38. DOI: http://dx.doi.org/10.1016/j.tvjl.2008.09.022
Cockcroft, P. (2019). Grading the evidence and writing the clinical bottom line. Veterinary Evidence, 4(4). DOI: http://dx.doi.org/10.18849/VE.V4I4.305
de Grauw, J. C., Visser-Meijer, M. C., Lashley, F., Meeus, P. and van Weeren, P. R. (2016). 'Intra-articular treatment with triamcinolone compared with triamcinolone with hyaluronate: A randomised open-label multicentre clinical trial in 80 lame horses', Equine Veterinary Journal, 48(2), pp. 152–158. DOI: http://dx.doi.org/10.1111/evj.12383
de Souza, M. V. (2016). Osteoarthritis in horses - Part 2: a review of the intra-articular use of corticosteroids as a method of treatment. Brazilian Archives of Biology and Technology, 59. DOI: http://dx.doi.org/10.1590/1678-4324-2016150025
Donnell, J. R., Frisbie, D. D., King, M. R., Goodrich, K. K. and Haussler, K. K. (2015). Comparison of subjective lameness evaluation, force platforms and an inertial-sensor system to identify mild lameness in an equine osteoarthritis model. The Veterinary Journal, 206(2), pp.136–142. DOI: http://dx.doi.org/10.1016/j.tvjl.2015.08.004
Ferris, D. J., Frisbie, D. D., Kisiday, J. D., McIlwraith, C. W., Hague, A. B., Major, M. D., Schneider, R. K., Zubrod, C. J., Waktins, J. J., Kawack, C. E. and Goodrich, L. R. (2009). 'Clinical follow-up of horses treated with bone marrow derived mesenchymal stem cells for musculoskeletal lesions.', Proceedings American Association of Equine Practice, 55:59.
Foland, J., McIlwraith, C. W., Trotter, G. W., Powers, B. E. and Lamar, C. H. (1994). Effect of Betamethasone andExercise on Equine Carpal Joints With Osteochondral Fragments. Veterinary Surgery, 23(5), pp.369. DOI: http://dx.doi.org/10.1111/j.1532-950X.1994.tb00497.x
Frisbie, D. D. (2009). 'Evaluation of Adipose-Derived Stromal Vascular Fraction or Bone Marrow-Derived Mesenchymal Stem Cells for Treatment of Osteoarthritis.', Journal of Orthopaedic Research, 27(12). DOI: http://dx.doi.org/10.1002/jor.20933
Frisbie, D. D., Kawcak, C. E., Baxter, G. M., Trotter, G. W., Powers, B. E., Lassen, E. D. and McIlwraith, C. W. (1998). 'Effects of 6α-methylprednisolone acetate on an equine osteochondral fragment exercise model', American Journal of Veterinary Research, 59(12), pp. 1619–1628.
Frisbie, D. D., Kawcak, C. E., McIlwraith, C. W. and Werpy, N. M. (2009). 'Evaluation of polysulfated glycosaminoglycan or sodium hyaluronan administered intra-articularly for treatment of horses with experimentally induced osteoarthritis', American Journal of Veterinary Research, 70(2), pp. 203–209. DOI: http://dx.doi.org/10.2460/ajvr.70.2.203
Frisbie, D. D., Kawcak, C. E., Trotter, G. W., Powers, B. E., Walton, R. M. and McIlwraith, C. W. (1997). 'Effects of triamcinolone acetonide on an in vivo equine osteochondral fragment exercise model', Equine Veterinary Journal, 29(5), pp. 349–359. DOI: http://dx.doi.org/10.1111/j.2042-3306.1997.tb03138.x
Ghosh, P., Armstrong, S., Read, R., Numata, Y., Smith, S., McNair, P. and Marshall, R. (1993). 'Animal models of early osteoarthritis: their use for the evaluation of potential chondroprotective agents', Agents Actions Supplements, 39, pp. 195–206. DOI: http://dx.doi.org/10.1007/978-3-0348-7442-7_22
Howard, R. D. and McIlwraith, C. W. (1993). 'Sodium hyaluronate in the treatment of equine joint disease', Compendium on Continuing Education for the Practising Veterinarian, 15(3), pp. 473–481.
Kawcak, C. E., Norrdin, R. W., Frisbie, D. D., Trotter, G. W. and McIlwraith, C. W. (1998). 'Effects of osteochondral fragmentation and intra-articular triamcinolone acetonide treatment on subchondral bone in the equine carpus', Equine Veterinary Journal, 30(1), pp. 66–71. DOI: http://dx.doi.org/10.1111/j.2042-3306.1998.tb04090.x
Kidd, J. A., Fuller, C. and Barr, A. R. S. (2001). 'Osteoarthritis in the horse', Equine Veterinary Education, 13(3), pp. 160–168. DOI: http://dx.doi.org/10.1111/j.2042-3292.2001.tb00082.x
Labens, R., Mellor, D. J. and Voûte, L. C. (2007). 'Retrospective study of the effect of intra-articular treatment of osteoarthritis of the distal tarsal joints in 51 horses', Veterinary Record, 161(18), pp. 611–616. DOI: http://dx.doi.org/10.1136/vr.161.18.611
Little, C. and Ghosh, P. (1996). Potential use of pentosan polysulfate for the treatment of equine joint disease. In: McIlwraith, C. and Trotter, G. (eds.) Joint Disease In the Horse. Philadelphia: Saunders.
Marinas-Pardo, L., Garcia-Castro, J., Rodriguez-Hurtado, I., Rodriguez-Garcia, M. I., Nunez-Naveira, L. and Hermida-Prieto, M. (2018). 'Allogeneic Adipose-Derived Mesenchymal Stem Cells (Horse Allo 20) for the Treatment of Osteoarthritis-Associated Lameness in Horses: Characterization, Safety, and Efficacy of Intra-Articular Treatment', Stem Cells & Development, 27(17), pp. 1147–1160. DOI: http://dx.doi.org/10.1089/scd.2018.0074
McConnico, R. S. (2008). Pathophysiologic effects of phenylbutazone on the right dorsal colon in horses. In: Morgan, T., Williams, C., Hubert, J. and Moore, R. (eds.). American Journal of Veterinary Research, 69(11), pp. 1496–1505. DOI: http://dx.doi.org/10.2460/ajvr.69.11.1496
McIlrwaith, C. W. (2011). 'Principles and Practices of Joint Disease Treatment', Diagnosis and Management of Lameness in the Horse, pp. 840–852. DOI: http://dx.doi.org/10.1016/B978-1-4160-6069-7.00084-5
McIlwraith, C. W. (1987). Diseases of the joints, ligaments and related structures. In: Febiger, P. and Stashak, T. (eds.). Philadelphia: Adams Lameness in Horses, 4th Edition.
McIlwraith, C. W. (2010). 'The use of intra-articular corticosteroids in the horse: what is known on a scientific basis?', Equine veterinary journal, 42(6), pp. 563–71. DOI: http://dx.doi.org/10.1111/j.2042-3306.2010.00095.x
McIlwraith, C. W. 2011. Use of Corticosteroids. AAEP. Proceedings American Association Equine Practice. 57.
McIlwraith, C. W., Frisbie, D. D. and Kawcak, C. E. (2012). 'The horse as a model of naturally occurring osteoarthritis', Bone Joint Research, 1(11), pp. 297–309. DOI: http://dx.doi.org/10.1302/2046-3758.111.2000132
Neundorf, R., Lowerison, M., Cruz, R., Thomason, J., McEwen, B. and Hurtig, M. (2010). Determination of the prevalence and severity of metacarpophalangeal joint osteoarthritis in Thoroughbred racehorses via quantitative macroscopic evaluation. American Journal of Veterinary Research, 71(11), pp. 1284–1293. DOI: http://dx.doi.org/10.2460/ajvr.71.11.1284
Rossdale, P. D., Hopes, R., Digby, N. J. and offord, K. (1985). 'Epidemiological study of wastage among racehorses 1982 and 1983', Veterinary Record, 116(3), pp. 66–69. DOI: http://dx.doi.org/10.1136/vr.116.3.66
Trumble, T. (2008). Joint Disease Therarpies: What we inject and why. NAVC Conference 2008.
van Weeren, P. R. (2016). '1 - General Anatomy and Physiology of Joints', Joint Disease in the Horse (Second Edition). Edinburgh: W.B. Saunders, pp. 1–24. DOI: http://dx.doi.org/10.1016/B978-1-4557-5969-9.00001-2
Zayed, M. (2016). Effects of pro-inflammatory cytokines on chondrogenesis of equine mesenchymal stromal cells derived from bone marrow or synovial fluid. In: Schumacher, N. and Dhar, M. (eds.). The Veterinary Journal, 217, pp. 26–32. DOI: http://dx.doi.org/10.1016/j.tvjl.2016.05.014
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