Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Quebec, Canada.
J Vet Intern Med. 2021 May;35(3):1604-1611. doi: 10.1111/jvim.16113. Epub 2021 Apr 4.
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.
Nebulized dexamethasone is as effective as PO administration for the treatment of severe asthma in horses.
Twelve horses with severe asthma from a research herd.
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.
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).
Oral, but not nebulized dexamethasone is an effective therapy for horses with severe asthma and both treatment modalities inhibit the hypothalamic-pituitary-adrenal axis.
一项研究报道，使用 Flexineb 面罩对健康马匹雾化注射用地塞米松，其全身生物利用度较低。当在患有严重哮喘的马匹和使用不同的雾化器时，观察到疗效不佳和皮质醇抑制。
雾化地塞米松与 PO 给药一样有效治疗马匹的严重哮喘。
来自研究群体的 12 匹患有严重哮喘的马。
随机临床试验。马匹分为 2 组，每天 2 次通过 Flexineb 面罩（NE，n = 6）或 PO（OR，n = 6）给予 5mg 地塞米松磷酸钠，共 7 天。在基线、治疗第 4 天（D4）和最后一次治疗后第 1 天（D8）评估肺功能和血清皮质醇浓度。使用带有 Benjamini-Hochberg 调整的线性混合模型进行数据分析。
仅 OR 组在 D4（平均降低±SD，-1.5±0.45cmH₂O/L/s；95%置信区间[CI]，-2；-0.6）和 D8（-1.4±0.45cmH₂O/L/s；95% CI，-2.4；-0.5）与基线相比，肺阻力显著改善（P =.004 和.01）。两组的血清皮质醇浓度在 D4 和 D8 时均显著降低（最大降低，-1.2±0.3μg/dL；95% CI，-1.9；-0.6 在 NE 组和-2.2±0.3μg/dL；95% CI，-2.8；-1.6 在 OR 组；P<.001）。
口服而非雾化地塞米松是治疗严重哮喘马匹的有效疗法，两种治疗方式均抑制下丘脑-垂体-肾上腺轴。
