Off-Label Bisphosphonate Use in Racehorses

Bisphosphonates are FDA-approved for controlling clinical signs associated with navicular syndrome in horses ages 4 and older. Some veterinarians use them off-label to treat other equine bone issues. But could this off-label use be detrimental? One equine veterinarian recently gave a rundown on what research says.
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off-label bisphosphonate use in racehorses
McLellan said that, based on the existing knowledge, off-label bisphosphonate use in racehorses could be putting both the patient and the practitioner at risk. | Photo: iStock

In 2014 the U.S. Food and Drug Administration approved two bisphosphonate drugs—clodronate and tiludronate—for controlling clinical signs associated with podotrochlosis (more commonly known as navicular syndrome) in horses ages 4 and older. Since then, some veterinarians have started using these products off-label to treat other equine bone issues, such as bucked shins or osteoarthritis. But could this off-label use be detrimental? One equine veterinarian recently gave a rundown on what research says.

“With the increasing awareness of bisphosphonates among racehorse trainers, owners, and veterinarians, it is prudent to examine the existing evidence to determine if this class of drugs has a place in the off-label treatment of orthopedic disorders in racehorses,” said Jonathan McLellan, BVMS, Dipl. ACVSMR, of Florida Equine Veterinary Associates, in Ocala.

He reviewed some of the available information at the 2018 American Association of Equine Practitioners (AAEP) Convention, held Dec. 1-5 in San Francisco, California

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Erica Larson, former news editor for The Horse, holds a degree in journalism with an external specialty in equine science from Michigan State University in East Lansing. A Massachusetts native, she grew up in the saddle and has dabbled in a variety of disciplines including foxhunting, saddle seat, and mounted games. Currently, Erica competes in eventing with her OTTB, Dorado.

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