New Research | NR Perspective

Evidence in Action: Research-Guided Use of Orthobiologics

By Liberty Getman DVM, DACVS

As the use of orthobiologics for equine lameness management has expanded, questions remain around how different devices perform, how best to use them, and which factors may influence their clinical output. Recent equine specific research has begun to address common clinical questions, helping veterinarians better understand when and how regenerative medicine devices may be used across a broader range of patients.

EARLIER USE OF ACUTE SYNOVITIS
Orthobiologics are commonly thought of as treatments for horses with moderate to advanced OA, but emerging research suggests potential benefits when these therapies are used earlier in the disease process.

In an experimental model of acute interleukin‑1ß–induced synovitis, researchers examined the effects of a single injection of a Pro-Stride® APS device compared with saline or no treatment. The findings suggested that a Pro-Stride therapy may modify the progression of joint disease when used early, supporting consideration of these therapies as a first‑line option rather than reserving them solely for advanced cases.1

USE OF BLOOD BASED ORTHOBIOLGICS IN HORSES WITH PPID
An important area of investigation has focused on whether metabolic conditions such as pituitary pars intermedia dysfunction (PPID) may impact the end solution produced by blood based orthobiologic devices. It has been hypothesized that blood from horses with metabolic dysfunction may not produce the same cytokine and growth factor profiles as blood from metabolically normal horses, potentially influencing treatment selection.

To address this question, researchers evaluated cytokine profiles generated by two commonly used blood-based orthobiologic systems—Pro-Stride APS (Autologous Protein Solution) and IRAP (Interleukin-1 Receptor Antagonist Protein)—using blood from clinically normal horses and horses with PPID. In both metabolically normal and PPID horses, blood based orthobiologics demonstrated comparable biological output, providing reassurance that the biological mechanisms required for these therapies to function remain intact even in horses with endocrine disease. These findings help inform treatment decisions in PPID horses with osteoarthritis and support consideration of orthobiologic therapies in these populations.2

NSAIDs AND RMD PROCESSING
Some veterinarians recommend avoiding NSAIDs prior to blood collection for blood-based orthobiologic processing out of concern that these medications could alter platelet, cytokine or growth factor concentrations, but without having the data to support this assumption in horses.

To evaluate this concern, researchers examined the effects of both a single-dose NSAID administration (phenylbutazone, flunixin meglumine, ketoprofen and firocoxib) and a 6-day course of the most commonly used daily NSAIDs (phenylbutazone and firocoxib) on the final output of Pro-Stride APS and Restigen® PRP devices. Results showed that NSAID use, whether short- or long-term, did not impact the concentrations of key cytokines or growth factors before or after 6 days.3, 4 Results confirmed there is no need to stop NSAID administration prior to blood collection for Pro-Stride or Restigen.

PUTTING THE DATA INTO PRACTICE
As equine regenerative medicine continues to evolve, the importance of clinically relevant, equine‑specific research continues to grow. For more information on these studies, download this PDF detailer and visit Zoetis’ Performance Horse Care portfolio webpage.

References
1. Usimaki A, Ciamillo SA, Barot D, et al. Single injection of intra-articular autologous protein solution in horses with acute interleukin-1B-induced synovitis decreases joint pathology scores. Equine Vet J. 2025;57(3):806-816. doi: 10.1111/evj.14203.
2. Moorman VJ, Hart KA, Gordon J, et al. Cytokine profiles of autologous conditioned serum (ACS) and autologous protein solution (APS) from horses with pituitary pars intermedia dysfunction (PPID) and unaffected controls. VCOT Open. 2024;7(S 01):A1-A12. doi: 10.1055/s-0044-1786215.
3. Brown KA, Gregorio EN, Barot D, et al. Single-dose nonsteroidal anti-inflammatory drugs in horses have no impact on concentrations of cytokines or growth factors in autologous protein solution and platelet-rich plasma. Am J Vet Res. 2024;85(4). doi: 10.2460/ajvr.23.11.0258.
4. Brown KA, Gregorio EN, Barot D, et al. Prolonged administration of oral phenylbutazone and firocoxib in horses has no impact on selected cytokine and growth factor concentrations in platelet-rich plasma and autologous protein solution. Am J Vet Res. 2024;85(9). doi: 10.2460/ajvr.24.04.0098.

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