It is quite easy to imagine horses galloping across the field effortlessly with wind in their mane, becoming a potent symbol of power and grace. Despite their athleticism, 80 percent of horses suffer from mild asthma—a serious issue that often goes unnoticed by humans, simply due to their inability to convey their struggles.
Finally, with enough attention being paid to this issue, the Aservo EquiHaler is the first FDA approved inhalation therapy for the management of clinical signs associated with severe equine asthma. Developed after a decade of collaboration between Boehringer Ingelheim’s human pharmaceutical and animal health businesses, the Aservo EquiHaler offers the promise of relief to thousands of horses that suffer from severe equine asthma, which affects 11 to 17 percent of horses. It is caused by breathing in high concentrations of organic dust particles small enough to pass with air to the lower airways. Usually, horses with severe equine asthma have difficulty breathing due to 3 main reasons. Firstly, due to airway inflammation, which is accompanied by mucus hypersecretion leads to lower airway obstruction. Second is airway hyperresponsiveness which is when airways of patients narrow excessively in response to stimuli that would produce no effect on healthy patients. This is caused by inflammatory mediators and dysfunction in airway smooth muscle relaxation. Finally, airway remodeling and recurrent injury is one of the most severe and consistent symptoms with asthma. It occurs when abnormal changes happen in cells linings airways due to chronic inflammation. These changes are irreversible in longstanding or severe cases of equine asthma and are episodic and progressive, causing profound challenges. The Aservo EquiHaler includes an ergonomic handle and dosing lever for ease of user handling, and a nostril adaptor that fits inside the nostril of the horse, allowing them to easily inhale the medicated mist into their lungs. The main technology of the inhaler is the unique soft mist which is a unique inhalant delivery system thus it avoids the issue of medications being accidentally swallowed. It’s easy to inhale as the mist goes in at a low velocity, following the inhaled air. The soft miss contains fine particles with over 90 percent of these particles being below 5 microns in size, which is the optimal size for it to travel through the trachea and larger bronchi through to the smaller airways and the gas exchanging alveoli. It allows the drug to reach the deep peripheral lung, treating the disease at its root. The main active medication in the spray is ciclesonide, a glucocorticoid (steroid) that becomes activated in the lungs, which allows for the targeted delivery and activation of the medication. Studies in horses with severe asthma have demonstrated that administration of ciclesonide reversed airway obstruction associated with severe asthma, and to date, ciclesonide is the only glucocorticoid not associated with suppression of serum cortisol, a desired treatment outcome. Ciclesonide is a biologically inactive compound. Once a horse inhales the drug, it enters the airways’ epithelial cells and is broken down by enzymes inside the cells into its active metabolite des-ciclesonicde. This binds to the local glucocorticoid receptor because it has 100 times greater potency. This binding activates the anti-inflammatory pathways, reducing the inflammation in the lung and decreasing the mucus accumulation. The best part is that this technology was created with sustainability given priority as well. The Soft Mist technology delivers medication in a fine mist generated by tension, not propellants, so it does not produce any greenhouse gas emissions. Additionally, the body of the inhaler is made from up to 50% recycled materials and Boehringer Ingelheim Canada has partnered with TerraCycle to introduce a national recycling program for used Aservo EquiHaler devices. Veterinarians and horse owners can deliver their used Aservo EquiHaler to be processed and diverted from landfill sites. Once collected, the plastic material is melted down, formed into pellets and shaped into hard plastic to be used in items like shipping pallets and park benches. Such innovations have transformed animal welfare, ensuring quality lives for animals and a healthier lifestyle. “We now have the ability to design the reality we live in”
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