Advances in the treatment of osteoarthritis in horses

Osteoarthritis is a common and debilitating disease affecting horses across breeds and disciplines. Although the cornerstone of therapy among equine practitioners remains systemic and local anti-inflammatory medications, this approach only addresses the symptoms of osteoarthritis, rather than modifying the progression of the disease itself.There has been great interest in various biologic and cell-based therapies, such as autologous conditioned serum, platelet-rich plasma, and mesenchymal stem cells, as potentially being disease-modifying osteoarthritis drugs. In vitro and experimental results for these novel modalities are promising. However, although the use of these therapies is now widespread, scientific evidence supporting their efficacy in clinical cases is limited to date. Gene therapy for delivery of anti-inflammatory cytokines or growth factors has also been investigated experimentally with good results but has not entered widespread clinical practice. Standardized definitions of disease and large randomized controlled trials, organized across institutions, are needed improve evidence-based recommendations for osteoarthritis treatment. This review provides a brief overview of what is known about the pathophysiology of osteoarthritis and addresses the current literature for medical treatment of osteoarthritis in the horse.