What is Known About the Safety of Intraarticular Corticosteroid Injections and How Might This Impact Safety in Thoroughbred Racehorses?

There is continuous scrutiny of intraarticular medications used in horses, especially around the use of intraarticular corticosteroids. The objective of this study was to perform a systematic review to assess the evidence available relating to the question “In Thoroughbred Racehorses with naturally occurring joint disease, what is known about the safety of intraarticular medications in horses?” A systematic review was carried out, and 537 articles were identified; 17 were identified for qualitative analysis. This study aims to allow equine veterinary practitioners to assess the available literature for evidence of the potential complications from intraarticular use of corticosteroids in horses. A search strategy was formulated to identify available evidence on the safety of intraarticular corticosteroids in Thoroughbred racehorses. Studies were retrieved from literature search engines, and titles and abstracts were screened for full text inclusion. Studies with the highest evidence quality underwent qualitative analysis with a standardized questionnaire. The results show that there are multiple studies that look at the effect of intraarticular medications from experimental animals, but there are few studies of the highest quality of evidence that address clinical scenarios. Two cohort studies have explored some issues around intraarticular medications. In conclusion, practitioners should be aware that the use of intraarticular corticosteroids may be associated with negative consequences. Only a selection of articles was available, therefore the review is at risk of selection bias associated with the articles that are selected from the literature. An application of this study is it should inform equine practitioners over the status of the current literature on the use of corticosteroids in Thoroughbred racehorses.