Double Blind Positive Control – 2.5% PAAG Hydrogel

Reasons for performing the study:

Intra-articular administration of a 2.5% polyacrylamide hydrogel (PAAG- Arthramid Vet) is shown to reduce or abolish lameness in distal interphalangeal (coffin) and metacarpo/ metatarso- phalangeal (fetlock) joints in horses undertaking equestrian disciplines. To date there had been no studies evaluating its’ efficacy in inter-carpal (knee) joints of racehorses conducted in a blinded fashion or up against standard treatments (controls).

Objectives:

To investigate the efficacy of a 2.5% PAAG (Arthramid Vet) in the management of inter-carpal joint lameness in racing Thoroughbreds.

Study design: 

Prospective double-blinded positive-control study.

Methods:

33 flat-racing Thoroughbreds in full training at a single training facility with lameness (AAEP 1-3/5) localised to the inter-carpal joint by intra-articular analgesia and radiological assessment were enrolled. Horses were randomly allocated to be treated intra-articularly with either 2ml of a 2.5% polyacrylamide hydrogel, 12mg of triamcinolone acetonide (cortisone) or 20mg of sodium hyaluron (Hyonate®- followed by 2 further intravenous treatments of 40mg, at weekly intervals), by the treating veterinarian. All horses were rested for 48 hours’ post-treatment and then re-entered an unaltered training regime. i.e. kept in full work. 

Subsequent examinations at 2, 4, and 6 weeks were performed by the blinded examining veterinarian for all groups. Horses treated with the 2.5% PAAG (Arthramid Vet) were monitored through to 12 weeks for reoccurrence of lameness in the treated joint.

Results:

Compared to horses that received triamcinolone acetonide or sodium hyaluron, horses treated with 2.5% PAAG (Arthramid Vet) showed a greater chance of resolution of lameness, joint effusion and reaction to passive flexion at four (p<0.05) and six (p<0.05) weeks, with no difference seen between groups at 2 weeks. There was no significant difference between the triamcinolone acetonide and sodium hyaluronate groups at any time point. Two-thirds (67%) of horses treated with the 2.5% PAAG hydrogel were still lame-free at 12 weeks. 

Conclusions:

This study indicates that a 2.5% PAAG (Arthramid Vet) hydrogel can be used in the management of inter-carpal joint lameness in flat-racing Thoroughbreds and was superior to and longer lasting than both Triamcinalone and Hyaluronic Acid. A reduction in joint effusion and reaction to passive flexion aligns with the proposed mode of action of Arthramid Vet.

Table 1: Pre-admission variables per treatment group. There was no statistically significant different between treatment groups.
  PAAG TA HA
Number 12 11 10
Age: range (mean) 2-5 (3.08) 2-4 (3) 2-6 (2.8)
Sprinter (%) 5 (42) 5 (45) 4 (40)
Miler (%) 5 (42) 4 (36) 4 (40)
Stayer (%) 2 (16) 2 (19) 2 (20)
Lameness range (mean) 1-3 (1.67) 1-4 (2.18) 1-3 (1.8)
Effusion range (mean) 0-2 (0.5) 0-1 (0.1) 0-2 (0.2)
Reaction to flexion range (mean) 0-2 (0.67)  0-2 (0.54) 0-2(0.6)
Radiological score range (mean) 0-2 (0.5) 0-2 (0.63) 0-2 (0.6)
Lameness Outcome By Treatment At 6 Weeks
Joint Effusion Outcome By Treatment At 6 Weeks
Reaction To passive Flexion Outcome By Treatment At 6 Weeks
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Arthramid Vet New Zealand

Registered in New Zealand to: Innovative Medical Solutions Limited NZBN: 9429041325544, 32 Hill Road, Cambridge 3494, New Zealand. Registered pursuant to the ACVM Act 1997 Number A11596. See www.foodsafety.govt.nz  for registration conditions.

32 Hill Road, Cambridge
PO Box 1083, Cambridge 3450
Phone +64 (09) 8013 253
sales@imsvet.com