Clodronate improves lameness in horses without changing bone turnover markers

Clodronate is prescribed to performance horses with lameness. Despite its clinical popularity, little research has been done to understand the effects of clodronate in the horse.

Our objective was to determine if a single treatment with clodronate at the clinically approved dose altered bone remodelling, bone cell recruitment or lameness in the horse.

Twelve university-owned equestrian team competition horses with a history of forelimb lameness due to navicular syndrome were randomised to receive either 1.4 mg/kg clodronate (CLOD n = 6) or an equivalent volume of LRS (CONT; n = 6) in a blinded manner.

Blood was evaluated weekly for 8 weeks before and after drug administration (clodronate or placebo) for bone turnover markers CTX-I and osteocalcin. Lameness evaluations were performed to assess for change in lameness 1 week before and 1, 2, 3 and 8 weeks after drug administration. Coach questionnaires were performed to assess for change in ridden performance 1, 2, 3 and 8 weeks after drug administration. Bone cell recruitment was evaluated in vitro 2 weeks before and after drug administration.

There were no differences in in vitro bone cell recruitment from whole bone marrow or in bone turnover markers CTX-I or osteocalcin. A small but significant decrease in forelimb lameness was detected in CLOD treated horses 1 week after treatment (P = 0.005). There were no significant differences in hindlimb lameness. Coaches identified an improvement in performance significantly more often in CLOD vs. CONT (P = 0.01) at week 8.

Two CONT horses received intra-articular anti-inflammatory medication after treatment, which may have altered lameness results.

A single dose of clodronate appears to reduce lameness without producing detectable effects on bone turnover markers. Due to the long half-life of a bisphosphonate drug, the effect of multiple doses on bone remodelling and lameness should be investigated. The Summary is available in Portuguese - see Supporting Information.