Thursday, November 03, 2011

Prascend® PPID (Equine Cushings Disease) Treatment Approved by FDA for US Horses

Maybe I'm biased, but I thought that the CSI (Cushings Scene Investigation) ad run by Boehringer-Ingelheim Vetmedica in British horse magazines was the most clever horse ad so far this year. It heralded the introduction of Prascend to treat Cushings-suffering horses; Prascend will soon be available in the USA.

The following press release is not an ad, it is published here as a "heads up". Anyone involved in the world of Hoofcare + Lameness is going to hear about this. Farriers and veterinarians will be asked questions by horseowners about this medication, and you need to know about how pergolide has evolved into Prascend®.

Prascend has been available in the United Kingdom for a few months, and Boehringer-Ingelheim Vetmedica has launched an awareness campaign there to urge horse owners to have their horses tested for PPID. I don't know yet what B-I has planned in the USA, but I feel confident in saying that "this is news".

In 2007, this blog reported that a potential crisis loomed for horseowners who were treating the symptoms of their horses' PPID condition with Permax (pergolide). (See links at end of this blog post.) The medication was taken from the market temporarily because of problems with human prescriptions. Before long, it became available again in the compounded form, which many horse owners ordered directly and in different forms.

Compounding pharmacies have been at the center of a controversy in the veterinary industry. At this time, it is too early to give a reliable answer whether compounded (and less expensive) pergolide will remain an option for horseowners as pill-only Prascend enters the marketplace. Ideally, horseowners will have safe and multiple alternatives to keep their horses comfortable.

Much more information will be available at or following the AAEP Convention in San Antonio later this month.

Everyone can recognize the advanced PPID (Cushing disease) horse. But laminitis and stretched white lines in younger horses may not seem to be related to PPID until much later, when a definitive diagnosis is made. Only careful testing will discern if horses without obvious signs suffer from PPID. (photo provided by Dr. Christian A. Bingold)

Boehringer Ingelheim’s Prascend® Approved for PPID in Horses
Product is the first and only FDA-approved treatment for the management of PPID.

ST. JOSEPH, Mo. (November 2, 2011) – Boehringer Ingelheim Vetmedica, Inc. (BIVI), has received approval from the Food and Drug Administration (FDA) to market Prascend® (pergolide mesylate), for treatment of clinical signs associated with pituitary pars intermedia dysfunction (PPID), also known as equine Cushing’s disease.

PRASCEND is the first and only FDA-approved product for the management of PPID in horses. (1) Administered in tablet form, treatment with PRASCEND can improve the quality of life for PPID-affected horses by managing clinical signs and decreasing the risk of complications of the disease, including those that have the potential to be life-threatening.

It is estimated that one in seven horses over the age of 15 has PPID (2) and horses as young as seven years of age have been diagnosed with the disease (3). In addition, up to 70 percent of clinical laminitis cases also may be affected with underlying PPID4. The most common clinical signs of advanced-stage PPID that occur in horses are hirsutism (hypertrichosis) or an abnormal amount of hair growth, abnormal sweating, weight loss, muscle wasting, abnormal fat distribution, lethargy, laminitis, polyuria/polydipsia and chronic/recurrent infections.

“Unfortunately, PPID is not a curable disease,” says Dr. John Tuttle, BIVI equine technical services veterinarian. “However, PRASCEND does offer a safe and efficacious treatment option to veterinarians and horse owners that can help reduce the clinical signs of the disease and effectively improve the quality of life of infected horses.”

While PPID is typically considered a late-stage-of-life disease in the horse, Tuttle adds that with horse owner vigilance and regular veterinary care, the disease may be detected earlier.

“Because the early symptoms of PPID may be difficult to recognize, some horses with PPID may go undiagnosed until the disease becomes more advanced,” says Tuttle. “Through regular veterinary wellness exams, oftentimes the disease can be caught earlier. By beginning treatment in the earlier stages of the disease, we are able to reduce the risk of some of the potential complications associated with PPID, such as laminitis, recurring infections, dental disease and other potential issues of uncontrolled PPID.”

Farriers often notice the early signs of PPID in horses' feet while trimming. As Cushings diseases advances, farriers are challenged to keep PPID sufferers comfortable and manage any flare-ups of chronic lamiitis. (Massachusetts farrier Allie Hayes trimming a Cushings-affected pony, photo © Hoofcare Publishing)

Not only can PRASCEND aid in the management of clinical signs of disease, the FDA approval also assures the product has been thoroughly evaluated for safety and efficacy. In addition, PRASCEND has met the standards set forth by the FDA in regard to production to preserve its identity, strength, quality, purity and consistency from batch to batch, and the product has demonstrated stability and effectiveness over time through a variety of environmental conditions.

“We are excited to offer a treatment option for horses suffering from PPID,” says Tuttle. “We encourage horse owners to continue to work with their veterinarians to find the best treatment for their horse and are confident that PRASCEND can help make a difference in the lives of horses suffering from this disease.”

PPID horses may be quite thin under all that hair. Cushings sufferers are also believed to be more highly perceptible to worms than non-sufferers. Many people clip their long-haired horses to be more aware of body condition. (photo © Hoofcare Publishing)
PRASCEND is for use in horses only. PRASCEND has not been evaluated in breeding, pregnant or lactating horses. Refer to the package insert for complete product information or contact Boehringer Ingelheim Vetmedica at 800-325-9167.

(Hoof Blog note: A web address should be available soon.)

  1.  PRASCEND® (pergolide mesylate) [Freedom of Information Summary]. St. Joseph, MO: Boehringer Ingelheim Vetmedica, Inc.; 2011.
  2. McGowan TW, Hodgson DR, McGowan CM. The prevalence of equine Cushing’s syndrome in aged horses. In: Proceedings from the 25th American College of Veterinary Internal Medicine Forum; June 6–9, 2007; Seattle, WA. Abstract 603.
  3. Schott HC. Pars pituitary intermedia dysfunction: challenges of diagnosis and treatment. In: Proceedings from the 52nd American Association of Equine Practitioners Annual Convention; December 2–6, 2006; San Antonio, TX.
  4. Donaldson MT. Evaluation of suspected pituitary pars intermedia dysfunction in horses with laminitis. J Am Vet Med Assoc. 2004;224(7):1123–1127.

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