FDA Approved Treatment Options
FDA Approved Treatment Options Overview1
These four therapeutic categories for degenerative joint disease (DJD) are commonly used in the management of pain and lameness associated with DJD or osteoarthritis (OA) and include products approved by the FDA.
*There have not been any published head to head comparisons with regard to superiority/efficacy.
Polysulfated glycosaminoglycan (PSGAG): PSGAG is a naturally-occurring complex molecule that is an essential building block of the cartilage matrix. Adequan® is the only FDA-approved equine PSGAG and is available in two presentations, Adequan® I.A. and Adequan® i.m. The most commonly used presentation, Adequan® i.m. is the ONLY FDA-approved equine PSGAG recommended for the intramuscular treatment of non-infectious degenerative and/or traumatic joint dysfunction and associated lameness of the carpal and hock joints in horses. After intramuscular injection, Adequan® diffuses into the bloodstream, which transports the drug into synovial fluid, where it is absorbed by articular cartilage at therapeutic levels that inhibit cartilage degrading enzymes within the joint. Adequan® diminishes the destructive processes of DJD, reverses the processes which result in loss of cartilage, and improves overall joint function and associated lameness.1 Sodium Hyaluronate products, or Hyaluronic Acid (HA) products, restore the lubricating properties of the synovial fluid within the joint, have anti-inflammatory properties, and are thought to stimulate enhanced natural production of HA. They may be administered IA or IV. Corticosteroids are powerful anti-inflammatory agents that rapidly decrease pain and inflammation when given IV, IM, or IA. They are beneficial in significantly reducing the initial inflammation that occurs with joint injury but should be used judiciously in certain cases. BetaVet® (betamethasone sodium phosphate & betamethasone acetate) is the ONLY dual ingredient intraarticular corticosteroid approved by the FDA for the control of pain and inflammation associated with osteoarthritis. Non-steroidal anti-inflammatory drugs (NSAIDs) act rapidly and are easily administered for the short term potent relief of pain and inflammation as occurs with joint injury, disease in multiple joints, as well as other systemic medical conditions. They may be administered orally, IV, IM, or topically. High doses, chronic use, or use in compromised animals may potentiate systemic side effects involving the blood, GI, renal, or hepatic systems. NSAIDs should be used judiciously in certain cases.


References:
1. McIlwraith CW. Traumatic arthritic and posttraumatic osteoarthritis in the horse. In: McIlwraith CW, Frisbie DD, Kawcak CE, van Weeren PR, eds. Joint Disease in the Horse. 2nd ed. St. Louis, MO: Elsevier, 2016;33-48.


Adequan® i.m. INDICATIONS For the intramuscular treatment of non-infectious degenerative and/or traumatic joint dysfunction and associated lameness of the carpal and hock joints in horses. IMPORTANT SAFETY INFORMATION Studies have not been conducted to establish safety in breeding horses. WARNING: Do not use in horses intended for human consumption. Not for use in humans. Keep this and all medications out of the reach of children. CAUTION: Federal law restricts this drug to use by or on the order of a licensed veterinarian.
Adequan® I.A. INDICATIONS For the intra-articular treatment of non-infectious degenerative and/or traumatic joint dysfunction and associated lameness of the carpal joint in horses. IMPORTANT SAFETY INFORMATION Inflammatory joint reactions and septic arthritis have been reported following administration of Adequan® I.A. Joint sepsis, a rare but potentially life threatening complication, can occur after intra-articular injection. Use only in the carpal joint of horses. WARNING: Do not use in horses intended for human consumption. Keep this and all medications out of the reach of children. CAUTION: Federal law restricts this drug to use by or on the order of a licensed veterinarian.
BetaVet® INDICATIONS BetaVet® is indicated for the control of pain and inflammation associated with osteoarthritis in horses. IMPORTANT SAFETY INFORMATION For Intra-articular (I.A.) use in Horses. CONTRAINDICATIONS: BetaVet® is contraindicated in horses with hypersensitivity to betamethasone. Intra-articular injection of corticosteroids for local effect is contraindicated in the presence of septic arthritis. WARNINGS: Do not use in horses intended for human consumption. Clinical and experimental data have demonstrated that corticosteroids administered orally or parenterally to animals may induce the first stage of parturition when administered during the last trimester of pregnancy and may precipitate premature parturition followed by dystocia, fetal death, retained placenta, and metritis. Additionally, corticosteroids administered to dogs, rabbits and rodents during pregnancy have resulted in cleft palate in offspring and in other congenital anomalies including deformed forelegs, phocomelia and anasarca. Therefore, before use of corticosteroids in pregnant animals, the possible benefits to the pregnant animal should be weighed against potential hazards to its developing embryo or fetus. Human Warnings: Not for use in humans. For use in animals only. Keep this and all medications out of the reach of children. Consult a physician in the case of accidental human exposure. PRECAUTIONS: Corticosteroids, including BetaVet®, administered intra-articularly are systemically absorbed. Do not use in horses with acute infections. Acute moderate to severe exacerbation of pain, further loss of joint motion, fever, or malaise within several days following intra-articular injection may indicate a septic process. Because of the anti-inflammatory action of corticosteroids, signs of infection in the treated joint may be masked. Due to the potential for exacerbation of clinical signs of laminitis, glucocorticoids should be used with caution in horses with a history of laminitis, or horses otherwise at a higher risk for laminitis. Use with caution in horses with chronic nephritis, equine pituitary pars intermedia dysfunction (PPID), and congestive heart failure. Concurrent use of other anti-inflammatory drugs, such as NSAIDs or other corticosteroids, should be approached with caution. Due to the potential for systemic exposure, concomitant use of NSAIDs and corticosteroids may increase the risk of gastrointestinal, renal, and other toxicity. Consider appropriate wash out times prior to administering additional NSAIDs or corticosteroids. ADVERSE REACTIONS: Adverse reactions reported during a field study of 239 horses of various breeds which had been administered either BetaVet® (n=119) or a saline control (n=120) at five percent (5%) and above were: acute joint effusion and/or local injection site swelling (within 2 days of injection), 15% BetaVet® and 13% saline control; increased lameness (within the first 5 days), 6.7% BetaVet® and 8.3% saline control; loose stool, 5.9% BetaVet® and 8.3% saline control; increased heat in joint, 2.5% BetaVet® and 5% saline control; and depression, 5.9% BetaVet® and 1.6% saline control. DOSAGE AND ADMINISTRATION: Shake well immediately before use. Use immediately after opening, then discard any remaining contents. Use immediately after opening, then discard any remaining contents. RX ONLY


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Or Call Customer Service Today! (800) 458-0163


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