Hello. I’m Avi Blake, a technical services veterinarian with American Regent Animal Health.
My colleagues and I have the pleasure of talking with a lot of veterinarians about Adequan i.m. (polysulfated glycosaminoglycan), and we often get into conversations about the dosing regimen. So today we’re going to take a closer look at the approved dosage and administration of Adequan i.m.
The FDA-approved label dosing for Adequan i.m. is one 500 milligram injection every four days for seven doses. We refer to this as “one, four, seven dosing,” and it takes place over the course of 28 days. At early signs of degenerative joint disease or ostoeoarthritis, administering the one, four, seven series helps achieve the reduced lameness and improved flexion shown in scientific studies.
Let’s dig into why the approved one, four, seven series is recommended. To begin with, as the only FDA-approved equine polysulfated glycosaminoglycan (or PSGAG), Adequan i.m. has a mode of action that helps treat degenerative joint disease in multiple ways.
In addition to reducing inflammation associated with degenerative joint disease, it also restores synovial joint lubrication, repairs cartilage and reverses the disease process.
After intramuscular administration of Adequan i.m., peak levels are achieved in the joints within two hours. Hyaluronic acid (or HA) nearly doubles in the joints at 48 hours, with significant increases noted from 24 to 96 hours. At 96 hours, which is four days, Adequan i.m. is detected in the cartilage and subchondral bone.
To achieve the clinical improvement and changes in cartilage and other joint tissues that’s associated with use of a PSGAG, it’s important to adhere to the recommended regimen of giving one 500 mg dose every four days for a total of seven doses.
The proof is in the data. In a dose response study, all horses improved with use of Adequan i.m. After the first four injections at the approved label dose of 500 mg, the average improvement was 19 percent. After completing the seven-dose series, the average improvement was 71 percent for a total of over 50 percent improvement in maximum flexion.
This is why the approved one, four, seven series is the only label-approved regimen for dosing Adequan i.m. Like I mentioned earlier, treatment with the complete series helps achieve improvement shown in the studies.
After the initial one, four, seven series, the interval for retreatment with Adequan i.m. is at the veterinarian’s discretion based on clinical impression.
To determine how often to retreat, it is valuable for veterinarians and horse owners to work together. The veterinarian’s evaluation combined with the horse owner’s frequent observations help identify subtle changes indicating recurrence of clinical signs of degenerative joint disease and thus the recommended interval for retreatment.
When a horse is being treated with the seven-dose series of Adequan i.m., the dosing card tool helps track the date of each injection.
To get more information about Adequan i.m., visit adequan.com. Thank you for tuning in. And remember, as we like to say: anything worth dosing is worth dosing right.
Adequan® i.m. is recommended for the intramuscular treatment of non-infectious degenerative and/or traumatic joint dysfunction and associated lameness of the carpal and hock joints in horses.
IMPORTANT SAFETY INFORMATION
There are no known contraindications to the use of intramuscular Polysulfated Glycosaminoglycan (PSGAG). Studies have not been conducted to establish safety in breeding horses. WARNING: Do not use in horses intended for human consumption. Not for use in humans. Keep this and all medications out of the reach of children. CAUTION: Federal law restricts this drug to use by or on the order of a licensed veterinarian. For additional safety information, please see full prescribing information at adequan.com.