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Knych HK, McKemie DS, Kass PH, Stanley SD, Blea J. Ketoprofen in horses: Metabolism, pharmacokinetics, and effects on inflammatory biomarkers. Drug Test Anal 2024; 16:289-302. [PMID: 37439283 DOI: 10.1002/dta.3543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/23/2023] [Accepted: 06/26/2023] [Indexed: 07/14/2023]
Abstract
Ketoprofen is an anti-inflammatory drug that is commonly administered to racehorses for the alleviation of musculoskeletal pain and inflammation. This study represents a comprehensive examination of the metabolism (in vivo and in vitro), pharmacokinetics and ex vivo pharmacodynamics, of ketoprofen in horses. The in vitro metabolism as well as specific enzymes responsible for metabolism was determined by incubating liver microsomes and recombinant CYP450 and UGT enzymes with ketoprofen. For the in vivo portion, 15 horses were administered a single intravenous dose of 2.2-mg/kg ketoprofen. Blood and urine samples were collected prior to and up to 120 h post-drug administration. Additional blood samples were collected at select time points and were stimulated with calcium ionophore or lipopolysaccharide, ex vivo, to induce eicosanoid production. Drug, metabolite, and eicosanoid concentrations were determined using LC-MS/MS. Incubation of ketoprofen with equine liver microsomes generated 3-hydroxy ketoprofen, an unidentified hydroxylated metabolite, and ketoprofen glucuronide. Recombinant equine CYP2C23 produced the greatest amount of hydroxylated ketoprofen and recombinant equine UGT1A2 generated ketoprofen glucuronide. Dihydro, 3-hydroxy, and glucuronide metabolites were identified in blood and urine samples. The Vdss was 0.280, 0.385, and 0.319 L/kg for total ketoprofen, S (+) ketoprofen, and R (-) ketoprofen, respectively. The mean half-life was 6.01 h for total ketoprofen, 2.22 h for S (+) ketoprofen, and 1.72 h for R (-) ketoprofen. Stimulation of ketoprofen-treated blood with lipopolysaccharide and calcium ionophore resulted in an inhibition of TXB2 , PGE2 , PGF2alpha , LTB4 , and 15(s)-HETE production for up to 120 h post-drug administration.
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Affiliation(s)
- Heather K Knych
- K.L. Maddy Equine Analytical Pharmacology Laboratory, School of Veterinary Medicine, University of California, Davis, California, USA
- Department of Veterinary Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Daniel S McKemie
- K.L. Maddy Equine Analytical Pharmacology Laboratory, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Philip H Kass
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Scott D Stanley
- MH Gluck Equine Research Center, University of Kentucky College of Agriculture, Lexington, Kentucky, USA
| | - Jeff Blea
- School of Veterinary Medicine, University of California, Davis, California, USA
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Mercer MA, Davis JL, McKenzie HC. The Clinical Pharmacology and Therapeutic Evaluation of Non-Steroidal Anti-Inflammatory Drugs in Adult Horses. Animals (Basel) 2023; 13:ani13101597. [PMID: 37238029 DOI: 10.3390/ani13101597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 04/19/2023] [Accepted: 04/21/2023] [Indexed: 05/28/2023] Open
Abstract
This review firstly examines the underlying pathophysiology of pain and inflammation associated with orthopedic disease and endotoxemia. Then, it reviews the clinical pharmacology (pharmacokinetics and pharmacodynamics) of both conventional and non-conventional NSAIDs in the adult horse, and finally provides an overview of different modalities to evaluate the therapeutic efficacy of NSAIDs in research.
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Affiliation(s)
- Melissa A Mercer
- Department of Biological Sciences and Pathobiology, Virginia Maryland College of Veterinary Medicine, Blacksburg, VA 24061, USA
| | - Jennifer L Davis
- Department of Biological Sciences and Pathobiology, Virginia Maryland College of Veterinary Medicine, Blacksburg, VA 24061, USA
| | - Harold C McKenzie
- Department of Large Animal Clinical Sciences, Virginia Maryland College of Veterinary Medicine, Blacksburg, VA 24061, USA
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3
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Lemonnier LC, Thorin C, Meurice A, Dubus A, Touzot-Jourde G, Couroucé A, Leroux AA. Comparison of Flunixin Meglumine, Meloxicam and Ketoprofen on Mild Visceral Post-Operative Pain in Horses. Animals (Basel) 2022; 12:ani12040526. [PMID: 35203234 PMCID: PMC8868280 DOI: 10.3390/ani12040526] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/15/2022] [Accepted: 02/19/2022] [Indexed: 02/06/2023] Open
Abstract
Simple Summary Pain management following surgical intervention is key. In horses, several anti-inflammatories (flunixin meglumine, meloxicam and ketoprofen) are available for the management of pain following castration. However, their analgesic efficacy remains unclear for mild visceral pain. The aim of this study was to compare the analgesic efficacy of the above-mentioned anti-inflammatory drugs, following a simple surgery (inguinal castration). Horses were administered a randomly assigned anti-inflammatory drug before and after surgery. A pain score was recorded using a previously described pain assessment scale (PASPAS) before administration, and after the first and second administrations by a senior clinician and a veterinary student. Thirty horses were evaluated, and there was no significant effect of the drug administered on the pain score. Horse welfare was not compromised regardless of drug assigned. Horses showed mild pain post-operatively, which decreased significantly within 24 h. Pain scores were significantly different when assessed by a veterinary student and a senior clinician. The authors found that the anti-inflammatory drug studied provided a similar level of analgesia for the management of mild visceral pain in horses, but that the pain scale used is not suitable for junior evaluators or, by extension, owners. Abstract The analgesic efficacy of meloxicam and ketoprofen against equine visceral pain is unclear. The aim of this study was to compare the analgesic efficacy of meloxicam (M) and ketoprofen (K) to flunixin meglumine (F) following inguinal castration. Horses undergoing inguinal castration under general anesthesia were randomly assigned F (1.1 mg/kg), M (0.6 mg/kg) or K (2.2 mg/kg) intravenously two hours pre-operatively and 24 h later. A pain score (out of 31) was recorded blindly by a senior clinician and veterinary student before NSAIDs administration (T0), and after the first (T1) and second (T2) administrations, using a modified post-abdominal surgery pain assessment scale (PASPAS). Pain was classified as mild (score ≤ 7), moderate (score = 8–14) or severe (score > 14). Thirty horses (12 F, 10 M, 8 K) aged 6.2 ± 4.9 years, mostly warmbloods, were included. Horse welfare was not compromised regardless of the drug assigned. There was no statistically significant effect of NSAIDs on pain score. Mean pain scores were significantly higher at T1 than T0 for each NSAID (F: 5.08 ± 2.50 vs. 1.58 ± 1.38 (p < 0.001); M: 4.60 ± 2.32 vs. 1.10 ± 1.20 (p < 0.001); K: 5.25 ± 1.39 vs. 1.50 ± 1.51 (p < 0.0001)) and lower at T2 than T1 for F (2.92 ± 2.423 vs. 5.08 ± 2.50 (p < 0.001)) and M (2.90 ± 1.37 vs. 4.60 ± 2.32 (p < 0.0325)). At T1, senior pain scores were significantly different than for junior (5.56 ± 0.54 vs. 3.22 ± 0.62, p = 0.005). This study indicates that meloxicam and ketoprofen provide a similar level of analgesia to flunixin meglumine for the management of mild visceral pain in horses. PASPAS is not reliable for junior evaluators.
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Affiliation(s)
- Louise C. Lemonnier
- Department of Clinical Sciences, Equine Veterinary Teaching Hospital (CISCO), Oniris, Route de Gachet, F-44000 Nantes, France; (A.M.); (G.T.-J.); (A.C.); (A.A.L.)
- Correspondence: ; Tel.: +33-(0)2-40-68-76-64
| | - Chantal Thorin
- Nutrition PhysioPathologie et Pharmacologie, University of Nantes, Oniris, F-44000 Nantes, France;
| | - Antoine Meurice
- Department of Clinical Sciences, Equine Veterinary Teaching Hospital (CISCO), Oniris, Route de Gachet, F-44000 Nantes, France; (A.M.); (G.T.-J.); (A.C.); (A.A.L.)
| | - Alice Dubus
- Clinique Vétérinaire de Bel Air, Allée Marcel Doret, F-41000 Blois, France;
| | - Gwenola Touzot-Jourde
- Department of Clinical Sciences, Equine Veterinary Teaching Hospital (CISCO), Oniris, Route de Gachet, F-44000 Nantes, France; (A.M.); (G.T.-J.); (A.C.); (A.A.L.)
- UMR Inserm U1229–Regenerative Medecine and Skeleton, Department of Veterinary Clinical Sciences, University of Nantes, Oniris, F-44000 Nantes, France
| | - Anne Couroucé
- Department of Clinical Sciences, Equine Veterinary Teaching Hospital (CISCO), Oniris, Route de Gachet, F-44000 Nantes, France; (A.M.); (G.T.-J.); (A.C.); (A.A.L.)
- Biotargen, Normandie University, Unicaen, F-14000 Caen, France
| | - Aurélia A. Leroux
- Department of Clinical Sciences, Equine Veterinary Teaching Hospital (CISCO), Oniris, Route de Gachet, F-44000 Nantes, France; (A.M.); (G.T.-J.); (A.C.); (A.A.L.)
- l’Institut du Thorax, Université de Nantes, CHU Nantes, CNRS, INSERM, F-44000 Nantes, France
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Greene W, Mylniczenko ND, Storms T, Burns CM, Lewbart GA, Byrd L, Papich MG. Pharmacokinetics of Ketoprofen in Nile Tilapia ( Oreochromis niloticus) and Rainbow Trout ( Oncorhynchus mykiss). Front Vet Sci 2020; 7:585324. [PMID: 33134366 PMCID: PMC7579418 DOI: 10.3389/fvets.2020.585324] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 08/18/2020] [Indexed: 12/20/2022] Open
Abstract
The objective of this study was to document the pharmacokinetics of ketoprofen following 3 mg/kg intramuscular (IM) and intravenous (IV) injections in rainbow trout (Oncorhynchus mykiss) and 8 mg/kg intramuscular (IM) injection in Nile tilapia (Oreochromis niloticus). Plasma was collected laterally from the tail vein for drug analysis at various time intervals up to 72 h following the injection of ketoprofen. In trout, area under the curve (AUC) levels were 115.24 μg hr/mL for IM and 135.69 μg hr/mL for IV groups with a half-life of 4.40 and 3.91 h, respectively. In both trout and tilapia, there were detectable ketoprofen concentrations in most fish for 24 h post-injection. In tilapia, there was a large difference between the R- and S-enantiomers, suggesting either chiral inversion from R- to S-enantiomer or more rapid clearance of the R-enantiomer. AUC values of the S- and R-enantiomers were 510 and 194 μg hr/Ml, respectively, corresponding to a faster clearance for the R-enantiomer. This study shows that there were very high plasma concentrations of ketoprofen in trout and tilapia with no adverse effects observed. Future studies on the efficacy, frequency of dosing, analgesia, adverse effects, and route of administration are warranted.
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Affiliation(s)
- Whitney Greene
- Mote Marine Laboratory and Aquarium, Sarasota, FL, United States
| | | | | | - Charlene M Burns
- Mote Marine Laboratory and Aquarium, Sarasota, FL, United States
| | - Gregory A Lewbart
- College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
| | - Lynne Byrd
- Mote Marine Laboratory and Aquarium, Sarasota, FL, United States
| | - Mark G Papich
- College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
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Rangel-Nava A, Ramírez-Uribe JM, Recillas-Morales S, Ibancovichi-Camarillo JA, Venebra-Muñoz A, Sánchez-Aparicio P. Pharmacological Regulation in the USA and Pharmacokinetics Parameters of Firocoxib, a Highly Selective Cox-2, by Pain Management in Horses. J Equine Vet Sci 2019; 77:36-42. [PMID: 31133314 DOI: 10.1016/j.jevs.2019.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 02/12/2019] [Accepted: 02/12/2019] [Indexed: 02/02/2023]
Abstract
The objective of the study was to conduct a review of the pharmacological regulation and pharmacokinetic parameters of firocoxib when administered orally or intravenously in horses. A search for literature was done in SCOPUS and PubMed for studies that had to evaluate the pharmacological regulation as well as the pharmacokinetic parameters of firocoxib when administered in horses. The nonsteroidal anti-inflammatory drugs have analgesic, anti-inflammatory, antipyretics, and antiendotoxic effects. The newly developed is selective to COX2 characterized by less adverse effects in veterinary patients when administered at the recommended doses and do not exceed the established prescribed time. Firocoxib is authorized by the Food and Drug Administration for the treatment of pain in horses, whereas for humans, there is still no approval. Controversy has arisen because the administration of the same pharmaceutical presentation in horses and dogs has pharmacokinetic differences between animal species. However, special attention must be paid to pharmacokinetic differences between species like in horses and dogs. In the case of the horse, the dosage is 0.1 mg/kg in single dose or up to 14 days in oral paste formulation and can keep maintained on the same concentration for a period of 7-14 days in oral tablet formulation. Thorough knowledge of pharmacological regulations and pharmacokinetic parameters, it allows the posology and effective application of firocoxib in pathologies associated with chronic pain, avoiding the indiscriminate use by owners and in some cases veterinarians, thus reducing the negative impacts on horse's health.
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Affiliation(s)
- Ana Rangel-Nava
- Student of Licenciatura en Medicina Veterinaria y Zootecnia, Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma del Estado de México, Toluca, México
| | - José Manuel Ramírez-Uribe
- Permited Treating Veterinarian and Official Veterinarian, International Equestrian Federation for Eventing, Endurance and Dresagge, Lausanne, Switzerland
| | - Sergio Recillas-Morales
- Department of Pharmacology, Anaesthesia and Analgesia, Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma del Estado de México, Toluca, México
| | - José Antonio Ibancovichi-Camarillo
- Department of Pharmacology, Anaesthesia and Analgesia, Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma del Estado de México, Toluca, México
| | - Arturo Venebra-Muñoz
- Laboratory of Brain Plasticity and Neurobiology of Adiction, Faculty of Science, Universidad Autónoma del Estado de México, Toluca, México
| | - Pedro Sánchez-Aparicio
- Department of Pharmacology, Anaesthesia and Analgesia, Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma del Estado de México, Toluca, México.
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Abstract
Nonsteroidal anti-inflammatory drugs (NSAIDs) are effective anti-inflammatory and analgesic agents and are arguably the most commonly used class of drugs in equine medicine. This article provides a brief review of the mechanism of action, therapeutic uses, pharmacokinetics, and adverse effects associated with their use in horses. The use of COX-2 selective NSAIDs in veterinary medicine has increased over the past several years and special emphasis is given to the use of these drugs in horses. A brief discussion of the use of NSAIDs in performance horses is also included.
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Affiliation(s)
- Heather K Knych
- K.L. Maddy Equine Analytical Chemistry Laboratory, School of Veterinary Medicine, University of California, Davis, 620 West Health Science Drive, Davis, CA 95616, USA.
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