b'BISPHOSPHONATESLarry J. Suva, PhD, suggests three ways the veterinary community can help pinpoint the exact role and optimal use of bisphosphonates in horses: While not illegal, off-label use of bisphos-phonates may or may not be effective andPush for more research and clinical trials, especially those focusing on long-term use and safety may potentially be harmful to the horse,1 that measure bone markers and bone density;said Suva. We simply do not have enough data to support widespread recommendationsOffer more continuing education opportunities to keep the equine community abreast of the for off-label use. 2 latest information on bisphosphonates; andIn addition, veterinarians have adminis-tered some nitrogen-containing bisphospho-nates to horses, such as zoledronic acid.3 Understand the rationale and potential mechanisms for bisphosphonate usage because, based Suva said that in a 2013 pharmacologyon available data, bisphosphonates positive effects might be more connected to non-bone-study, researchers gave a single zoledronicrelated effects rather than inhibiting bone resorption. acid dose (0.057 mg/kg, intravenous) via a 30-minute infusion. The infusion produced sustained decreases in total serum calciumspread (in osteoporosis and cancer patients),researchers did find a significant beneficial (at seven days), as expected for such a potentinclude osteonecrosis (abnormal breakdowneffect. bisphosphonate. It appears that zoledronicof the bone) of the jaw and atypical femoralWith the rampant bisphosphonate use in acid inhibits bone resorption and is safe in(thighbone) fractures. These are very rarethe equine industry, it is important to rec-healthy adult horses, he said, noting furtherevents, said Suva, often following long-termognize and follow the approved use of these studies evaluating potential benefits of zole- use of more potent nitrogen-containingpowerful molecules, said Suva. dronic acid in horses with orthopedic condi- bisphosphonates.The article, Bisphosphonate use in the tions are warranted. Current manufacturer recommendations horse: what is good and what is not, was are to use FDA-approved bisphosphonatesco-authored by Alexis Mitchell, Ashlee Watts, CONCERNS TO CONSIDER according to label instructions. In stud- and Frank Ebertino, all from Texas A&M Some adverse effects identified in humans,ies conducted to garner FDA approval inUniversitys College of Veterinary Medicine where bisphosphonate use is far more wide- 4-year-old horses with navicular syndrome,and Biomedical Sciences. This Special Report may be reprinted and distributed in this exact form for educational purposes only in print or electronically. It may not be used for commercial purposes in print or electronically or republished on a website, forum, or blog, unless specifically authorized by The Horse. For more horse health information on this and other topics visit TheHorse.com. Published by The Horse: Your Guide To Equine Health Care,Copyright 2019 The Horse Media Group. Contact [email protected] Learn more online Ewww.dechra-us.comQUIN www.osphos.comFOR EVERY E866-933-2472 For full prescribing information, visit www.dechra-us.comO_halfpage_hori_TheHorse_10.18.indd 1 10/16/18 8:50 AMSpecRprt_Bisphosphonates_Dechra_8x10.indd 2 10/29/19 3:08 PM'