Systematic review of the association between intrasynovial corticosteroid use and laminitis—What is the evidence?

Abstract

SummaryAnecdotal information has linked the clinical administration of intrasynovial corticosteroids with the development of laminitis in horses. This systematic review aims to compile and evaluate the level of current evidence from published works investigating this issue. A systematic search in PubMed, CAB Direct and Web of Science databases was conducted in February 2022. Studies were included if designed as experimental in vivo in horses, case series, observational cohorts (retrospective or prospective—with/without control group) or randomised clinical trials. A total of 237 studies were generated from the systematic search and after applying inclusion criteria, four were selected: two were designed as retrospective cohort studies, one included a retrospective and a prospective investigation, and the last one was a case series. Studies usually had a high risk of bias, and some also presented weaknesses such as a lack of controls or insufficient information (corticosteroid dose and treatment/follow‐up period). Reported incidence of laminitis following corticosteroid intrasynovial application was low, similar to controls, when these were included. The small number of articles that fitted the inclusion criteria of this systematic review highlights the lack of high‐quality evidence to draw conclusions. Current scientific information, mainly at a high risk of bias, suggests that there is no association between intrasynovial corticosteroid injection and laminitis in horses without concurrent risk factors.