Donnell Josh R, Frisbie David D
Department of Clinical Sciences, Orthopedic Research Center, Colorado State University, Fort Collins, CO, USA.
Vet Med (Auckl). 2014 Nov 4;5:159-168. doi: 10.2147/VMRR.S70207. eCollection 2014.
This review presents the pathogenesis and medical treatment of equine osteoarthritis (OA), focusing on firocoxib. Inhibition of prostaglandin E remains a fundamental treatment for decreasing clinical symptoms (ie, pain and lameness) associated with OA in horses. Nonsteroidal anti-inflammatory drugs (NSAIDs), which inhibit the production of prostaglandin E from the arachidonic acid pathway, continue to be a mainstay for the clinical treatment of OA. Firocoxib is a cyclooxygenase (COX)-2-preferential NSAID that has been shown to be safe and to have a 70% oral bioavailability in the horse. Three clinical reports identified symptom-modifying effects (reduction in pain and/or lameness) in horses with OA administered the once-daily recommended dose (0.1 mg/kg) of oral firocoxib following 7 days of administration. Other reports have suggested that a one-time loading dose (0.3 mg/kg) of firocoxib provides an earlier (1-3 days) onset of action compared to the recommended dose. It is noteworthy that OA disease-modifying effects have been reported in horses for other COX-2-preferential NSAIDs (meloxicam and carprofen), but have not been attributed to firocoxib due to a lack of investigation to date.
本综述介绍了马骨关节炎（OA）的发病机制和药物治疗，重点是氟罗昔布。抑制前列腺素E仍然是减轻马OA相关临床症状（即疼痛和跛行）的基本治疗方法。非甾体抗炎药（NSAIDs）通过抑制花生四烯酸途径中前列腺素E的产生，仍然是OA临床治疗的主要手段。氟罗昔布是一种环氧化酶（COX）-2选择性NSAID，已证明在马体内安全且口服生物利用度为70%。三项临床报告表明，给予马口服氟罗昔布每日推荐剂量（0.1mg/kg），连续给药7天后，OA马匹的症状得到改善（疼痛和/或跛行减轻）。其他报告表明，与推荐剂量相比，一次性负荷剂量（0.3mg/kg）的氟罗昔布起效更早（1-3天）。值得注意的是，其他COX-2选择性NSAIDs（美洛昔康和卡洛芬）在马身上已报告有改善OA疾病的作用，但由于迄今为止缺乏研究，氟罗昔布尚未被证实有此作用。
