A “proof of concept” study has indicated a drug related to one used to treat human metabolic syndrome prevents ponies affected by insulin dysregulation from developing laminitis.
Velagliflozin, manufactured by Boehringer Ingelheim, is a sodium-glucose co-transport 2 inhibitor that reduces renal glucose reabsorption, promotes glucosuria, and, consequently, decreases blood glucose and insulin concentrations.

Novel study

In the novel study, scientists from the Queensland University of Technology (QUT) Earth, Environmental and Biological Sciences School, in Brisbane, set out to determine if velagliflozin reduced hyperinsulinaemia and prevented laminitis in insulin-dysregulated ponies fed a challenge diet high in NSC.
An oral glucose test was used to screen 75 ponies for insulin dysregulation, of which 49 ponies with the highest insulin concentrations were selected. These animals were assigned randomly to either a treated group of 12 that received velagliflozin throughout the study, or a control group of 37.
All ponies were fed a maintenance diet of alfalfa hay for three weeks, before transferring to a challenge diet.
The study authors stated: “The diet induced Obel grade 1 or 2 laminitis in 14 of the 37 controls (38 per cent), whereas no velagliflozin-treated pony developed laminitis (P = 0.011). Velagliflozin was well-tolerated, with no hypoglycaemia or any clinical signs of adverse effects.
“The main limitation of this study was the sample size. Velagliflozin shows promise as a safe and effective compound for treating insulin dysregulation and preventing laminitis by reducing the hyperinsulinaemic response to dietary NSC.”

Potential

Harry Carslake, senior lecturer in equine medicine at the University of Liverpool Equine Hospital – who was not involved in the QUT study – said: “This is a promising development, although probably not a panacea for laminitis. As the authors recognise in the paper, further research is required, including safety studies and a larger clinical trial.
“Everyone will agree there’s a bit more work to be done on the drug, but it definitely has potential to assist in the management of equine metabolic syndrome cases.”