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  Discussion on Research Summary: Hyaluronate and PSGAG effects on Arthritis
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DrO

Posted on Friday, Jun 5, 2009 - 2:41 pm:

You would think after several decades of widespread intraarticular use of hyaluronate (Legend® and many others) and PSGAG (Adequan®) that we would have a well established knowledge of their effects. But as Horseadvice.com has long preached, the clinical benefit of these medications remains largely anecdotal. Both hyaluronate and PSGAG have shown to benefit cartilage tissue in culture and have some experimental work to show that they are a benefit in equine arthritic joints but still what we don't know exceeds what we do know. This study increases our knowledge and continues to show a disease modifying benefit when used in the arthritic horse. The experiment did not find a improvement in lameness scores with their use.

It does not answer many important questions for the horseowner however. We discuss these questions and how they figure into the decision to use these products in the Overview of Arthritis and the articles on these specific medications.
DrO

Am J Vet Res. 2009 Feb;70(2):203-9.

Evaluation of polysulfated glycosaminoglycan or sodium hyaluronan administered intra-articularly for treatment of horses with experimentally induced osteoarthritis.

Frisbie DD, Kawcak CE, McIlwraith CW, Werpy NM.

Gail Holmes Equine Orthopaedic Research Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523-1678.

Objective-To assess clinical, biochemical, and histologic effects of polysulfated glycosaminoglycan (PSGAG) or sodium hyaluronan administered intra-articularly in treatment of horses with experimentally induced osteoarthritis. Animals-24 horses. Procedures-Osteoarthritis was induced arthroscopically in 1 middle carpal joint of all horses. Eight horses received hyaluronan (20 mg) and amikacin (125 mg) intra-articularly on study days 14, 21, and 28. Eight horses received PSGAG (250 mg) and amikacin (125 mg) intra-articularly on study days 14, 21, and 28. Eight control horses received 2 mL of saline (0.9% NaCl) solution and amikacin (125 mg) intra-articularly on study days 14, 21, and 28. Clinical, radiographic, synovial fluid analysis, gross, histologic, histochemical, and biochemical findings were evaluated. Results-No adverse treatment-related events were detected. Induced osteoarthritis caused a substantial change in lameness, response to flexion, joint effusion, and radiographic findings, and of these, synovial fluid effusion was reduced with PSGAG, compared with control horses. No changes in clinical signs were seen with PSGAG or hyaluronan, compared with control horses. Histologically, the degree of synovial membrane vascularity and subintimal fibrosis was significantly reduced with PSGAG treatment, compared with controls. Histologically, significantly less fibrillation was seen with hyaluronan treatment, compared with controls. Conclusions and Clinical Relevance-Results indicated that PSGAG and hyaluronan had beneficial disease-modifying effects and are viable therapeutic options for osteoarthritis in horses.
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