IRAP

[moribelle]

IRAP anyone? Does anyone use it or advocate it for arthritic issues except for me? (Interleukin-1 Receptor Antagonist Protein). Is anyone familiar with it? I ask because I've not seen it mentioned in any of these threads., just Legends, Adequan, steroids, HA...
Moribelle

[deltawave]

Seems to me that this technology, while enormously promising, has gone the way of so many other things: marketing VASTLY outpacing the actual research.

A corollary is the multi-year juggernaut of "Sports Medicine Boots": the product was developed, sold for YEARS with minimal studies and no real, solid data. Then, just this last year (approximately 20 years after the product came out) the data finally came out: they don't do very much. :no:

I sincerely hope it's different with IRAP and other "designer therapies" for chronic diseases like DJD, but unless I had an animal where all other therapies had been exhausted and I was desperate, I'd want to hold off on the IRAP until more data are available.

[Simkie]

I did a course of IRAP for my mare at the end of last year.

She had surgery in June to remove a bone chip in the fetlock. During that surgery, two "depo-deposits"--areas of calicified cartilage--were discovered in the joint. One was debrided with healthy cartilage underneath, the other was debrided to the bone with failing bone underneath. Several weeks after surgery, the joint was injected with adequan, per CSU, and the horse was started on monthly adequan IM. Before bringing the horse back into work, she was returned to CSU, where it was observed that she was still VERY sore in the joint. We injected it with HA and steroid. The horse was brought back into work, and was sound, for several weeks. Perhaps 10? Then she went lame and we returned to CSU. It was observed that she was, again, very sore in the joint. It was suggested at that time that we may want to consider IRAP. At the very least, we would need to do the HA again.

I opted for IRAP. Blood was drawn, and I returned the next day (I think?) for the first injection. Blush was not allowed to come out of her stall for three weeks, with three injections spaced one week apart. That was really hard, because she was really quite fit. No work, no walking, no nothing.

At this time, she is still pretty sound. When she really starts to RUN at the trot, I can see a tiny bit of unevenness. Right now, I'd consider her an IRAP success story. We'll see how she does in the future. I do keep her on Adequan, Legend and MSM.

[moribelle]

Seems to me that this technology, while enormously promising, has gone the way of so many other things: marketing VASTLY outpacing the actual research.

A corollary is the multi-year juggernaut of "Sports Medicine Boots": the product was developed, sold for YEARS with minimal studies and no real, solid data. Then, just this last year (approximately 20 years after the product came out) the data finally came out: they don't do very much. :no:

I sincerely hope it's different with IRAP and other "designer therapies" for chronic diseases like DJD, but unless I had an animal where all other therapies had been exhausted and I was desperate, I'd want to hold off on the IRAP until more data are available.


We are really confused about your reference to "designer therapies". There is so much literature published about this wonderful product from the people who engineered it, Orthogen, and the people at CSU in the Equine Research Department, Ft. Collins, Colo. who have used it successfully for the last 7years for equine DJD, Osteoarthritis, etc., among other universities. I suggest you go to the CSU website, VETERINARIAN department/Equine Research, Dr's Frisbee and McIlraeth, and peruse all their published articles about this product. As well, my horse is one of the great success stories coming from the IRAP.
As well, we have documented successful use of this product on the canine for the last 2.5years here in Colorado.
Where is it that you live that you are not aware of the most cutting edge technology?
If you are in the East, Tufts University would be a great place to start for you there, there are many Veterinary University's and private clinics that have made successful use of this product.
I would be glad to share with you all that I can if you wish. Starting with the mechanism of how it works.
Moribelle

[Appassionato]

We are really confused about your reference to "designer therapies". There is so much literature published about this wonderful product from the people who engineered it, Orthogen, and the people at CSU in the Equine Research Department, Ft. Collins, Colo. who have used it successfully for the last 7years for equine DJD, Osteoarthritis, etc., among other universities. I suggest you go to the CSU website, VETERINARIAN department/Equine Research, Dr's Frisbee and McIlraeth, and peruse all their published articles about this product. As well, my horse is one of the great success stories coming from the IRAP.
As well, we have documented successful use of this product on the canine for the last 2.5years here in Colorado.
Where is it that you live that you are not aware of the most cutting edge technology?
If you are in the East, Tufts University would be a great place to start for you there, there are many Veterinary University's and private clinics that have made successful use of this product.
I would be glad to share with you all that I can if you wish. Starting with the mechanism of how it works.
Moribelle

We? Not to mention, LSM asked several times about IRAP and you just kept building up to some...finish. Not trying to be rude, just being honest.

[Hampton Bay]

This may be a bit OT, but do they ever use this kind of stuff in people with arthritis? Not just IRAP, but Adequan, Legend. I know they use cortisone shots into the joint, but what about the rest?

[moribelle]

We? Not to mention, LSM asked several times about IRAP and you just kept building up to some...finish. Not trying to be rude, just being honest.

I'm sorry, I was not aware someone was asking me about IRAP. Could you refresh my memory?
Moribelle:(

[Appassionato]

I'm sorry, I was not aware someone was asking me about IRAP. Could you refresh my memory?
Moribelle:(

Check your last posts. It was to LSM### (# = numbers behind "LSM" that mean nothing to me).

[moribelle]

This may be a bit OT, but do they ever use this kind of stuff in people with arthritis? Not just IRAP, but Adequan, Legend. I know they use cortisone shots into the joint, but what about the rest?

You know, I'm not sure about the use of Adequan and Legend in humans. I've not heard of it. BUT, HA (hyaluronic acid) IS! And yes, IRAP is used on humans in Europe, and has been used successfully there for 12years. I know the group who developed it, etc. IRAP is approved by their gov't, and they are in the process of application for licensure to apply for FDA approval here in the states, but it's going to be awhile.

Actually, my own 80year old mother had her knees injected a year ago with HA, YES!, I said a year ago, and she's walking 3mi. a day , swimming, so very active.
I'll warn you now about cortisone shots, they ultimately dry out and attribute to destruction of the joint. None of my family is allowed to let their doctor give them, although the doctors try! My aunt who is 83 is getting the HA injected into her knees now that my mother has had such success with hers.
Why do you ask?
Moribelle

[LSM1212]

Check your last posts. It was to LSM### (# = numbers behind "LSM" that mean nothing to me).

It was me. You posted on my thread about my horse's hocks. I asked a few times for more details on IRAP when you posted about it.

I did a google search. So got some information on it.

Side note: numbers are 1212.... 12 is my lucky number. :D And it's a "handle" that I use everywhere for screen names.

[Appassionato]

It was me. You posted on my thread about my horse's hocks. I asked a few times for more details on IRAP when you posted about it.

I did a google search. So got some information on it.

Side note: numbers are 1212.... 12 is my lucky number. :D

No offense meant and no problem on the clarification on your name...I was irritated not only at the lame advertisement from some company with IRAP (which put quite a character online for advertising) but also irritated at the fact it hasn't been that long since "they" responded to someone with "LSM" in the name, yet didn't know who on earth I was talking about...but at least they asked who they JUST spoke to with a smile plastered on their face! Hey, I "felt" the smile in that post, and from all of "them"!!! BRAVO!!!! :rolleyes:

[moribelle]

It was me. You posted on my thread about my horse's hocks. I asked a few times for more details on IRAP when you posted about it.

I did a google search. So got some information on it.

Side note: numbers are 1212.... 12 is my lucky number. :D And it's a "handle" that I use everywhere for screen names.


Ok, I remember posting to you about hocks, but I swear, I didn't get anything from you further. So sorry, is there any way I can help now, or are you all educated on the subject?
Moribelle

[LSM1212]

No offense meant and no problem on the clarification on your name...I was irritated not only at the lame advertisement from some company with IRAP (which put quite a character online for advertising) but also irritated at the fact it hasn't been that long since "they" responded to someone with "LSM" in the name, yet didn't know who on earth I was talking about...but at least they asked who they JUST spoke to with a smile plastered on their face! Hey, I "felt" the smile in that post, and from all of "them"!!! BRAVO!!!! :rolleyes:

No offense taken.... me and you go way back. :D Can you say hoof? :lol: Just clarification as I've been asked before. Heck, LSM is fine... my initials of course. Or just Linda. :winkgrin:

I'm not saying IRAP doesn't work. But just like everything else.... works for some, doesn't work for others. And I'd rather go "lower risk" for now and with things that are more known. I truly feel that once the weather settles down (see my post in Off Course on our CRAZY weather) and things warm up, he'll be better. Along w/ the "plan" we have for him.

[Snapdragon]

Moribelle, you seem a bit defensive. You posted a question seemingly to get information on IRAP but then went on to proselytize about it.

Anyway, my mare fractured her coffin bone (marginally involving the joint). IRAP was used to hopefully fend off arthritic changes in the joint. The jury is still out. She's being legged up at the moment and is sound.

A friend has a horse who had navicular bursitis. She was in a clinical study of IRAP. Mare is now completely sound and successfully doing prelim (eventing). Definitely, a very positive experience.

Another friend has a horse whose knee cartilage is shot. Tried the IRAP in a last-ditch effort. Horse is sound (but worked sensibly and not as high stress as before), but no real improvement in the cartilage, so it seems IRAP was not successful in this case.

[LSM1212]

Ok, I remember posting to you about hocks, but I swear, I didn't get anything from you further. So sorry, is there any way I can help now, or are you all educated on the subject?
Moribelle

Go check the thread... I quoted you a few times asking for more information.

And yes, I read what I found on google. I'm good.

I figured you started this seperate thread because of my original thread so you would remember who I was.

Again, I'm not saying it doesn't work. But from what I've seen (via google) and posted here... it seems more for serious issues. I don't think this is as serious.

[moribelle]

I'm all for whatever works best for you and your horse. I will, however, interject one other comment.
The efficacy (effectiveness) of the IRAP depends WHOLLY upon 3 things in our / my experience.
1. Pureness of the blood sample when drawn. (no medications of any kind or other products in the blood system for at least 2-3 weeks prior to draw).
2. The Laboratory processing the blood. It is very technique sensitive.
3. The veterinarian injecting the product, (makes sure it is actually injected into the joint capsule). Hey, some people miss!

The IRAP lasts for one year in my horse, and her fetlock is fusing, it looks like a train wreck in there., but she's sound and happy, and so am I. So are my dogs.

Good Luck to you, and Godspeed. Let me know if I can help further. It's been a pleasure talking with you.

Moribelle

[Calena]

Seems to me that this technology, while enormously promising, has gone the way of so many other things: marketing VASTLY outpacing the actual research.

A corollary is the multi-year juggernaut of "Sports Medicine Boots": the product was developed, sold for YEARS with minimal studies and no real, solid data. Then, just this last year (approximately 20 years after the product came out) the data finally came out: they don't do very much. :no:

I sincerely hope it's different with IRAP and other "designer therapies" for chronic diseases like DJD, but unless I had an animal where all other therapies had been exhausted and I was desperate, I'd want to hold off on the IRAP until more data are available.

???? DW - what marketing? IRAP isn't a product, it's a procedure. SMB's are marketed by a company. Who would market IRAP? I'm confused (again).

http://www.acvs.org/ID=3164/TYPE=1130/Hague%20IRAP.pdf

Orthokine is interleukin-1 receptor protein antagonist (IRAP). The mechanism by which
it is hypothesized to work is by binding to the IL-1 receptor thus preventing the interaction of IL-
1 with the receptor. IL-1 is a major player in the inflammatory cascade causing synovitis and
joint pain. By blocking this interaction we hopefully can decrease pain and inflammation in the
joint creating an environment more conducive to healing and function.
The process for obtaining IRAP is relatively easy but does require some special
equipment such as a centrifuge that accommodates 60 ml syringes and an incubator. The
orthokine kit provides a 60 ml syringe containing glass beads to stimulate monocyte production
of the antagonist protein and anticoagulant. A jugular vein is aseptically prepared and 60 ml of
blood is harvested. The syringes are then incubated at 37 degrees C for 24 hours (+ 5 hours).
The syringes are then centrifuged to separate IRAP rich plasma from the blood. The plasma is
then harvested in 4 ml aliquots in a 6 ml syringe and frozen until use. Prior to injecting into a
joint, the IRAP plasma is passed through a 0.2 micro millipore filter. Typically 4 ml is injected
once a week for 3 treatments. In large volume joints such as the stifle, we have used an 8 ml
dose. Depending on the condition being treated, most horses are rested until they receive the
second injection and then allowed to go back to training.From what little I've learned about it, the vets consider it one more tool in the arsenal rather than a magic wand.

ETA: My apologies, Deltawave. I did some more digging and discovered someone applied for a patent on the procedure.

http://www.freepatentsonline.com/6759188.html

I guess it is sort of a 'product' in the sense that someone is making money by selling the tools needed to do this. I still don't see where it's in the same arena as SMB's being marketed to the general public. The procedure costs $$$$thousand's to perform.

[Appassionato]

No offense taken.... me and you go way back. :D Can you say hoof? :lol: Just clarification as I've been asked before. Heck, LSM is fine... my initials of course. Or just Linda. :winkgrin:

I'm not saying IRAP doesn't work. But just like everything else.... works for some, doesn't work for others. And I'd rather go "lower risk" for now and with things that are more known. I truly feel that once the weather settles down (see my post in Off Course on our CRAZY weather) and things warm up, he'll be better. Along w/ the "plan" we have for him.

Oh yeah, I remembered. Can't remember exactly where and what the original injury was, but I remember an injury and some hard times over the hooves (hard times with hooves here). I just couldn't remember the numbers in your name to save my life. :lol:

Moribelle, you seem a bit defensive. You posted a question seemingly to get information on IRAP but then went on to proselytize about it.

The word that came to my mind was "prophesy"...but close enough! :winkgrin: IRAP sure doesn't pay much for "cold-callers", eh?

[moribelle]

Moribelle, you seem a bit defensive. You posted a question seemingly to get information on IRAP but then went on to proselytize about it.

Anyway, my mare fractured her coffin bone (marginally involving the joint). IRAP was used to hopefully fend off arthritic changes in the joint. The jury is still out. She's being legged up at the moment and is sound.

A friend has a horse who had navicular bursitis. She was in a clinical study of IRAP. Mare is now completely sound and successfully doing prelim (eventing). Definitely, a very positive experience.

Another friend has a horse whose knee cartilage is shot. Tried the IRAP in a last-ditch effort. Horse is sound (but worked sensibly and not as high stress as before), but no real improvement in the cartilage, so it seems IRAP was not successful in this case.

Does being sorry I missed someone's post seem defensive to you? Curious.
To answer your statement about IRAP failing because there was no improvement in the cartilage, is grossly incorrect.
IRAP does not regrow cartilage, and anyone who makes that claim is not familiar with what the product really is used for.
Nothing is going to replace or regrow cartilage, and the fellow or ma'am who does accomplish that can retire yesterday, know what I mean? But it's not like'ly to happen in our lifetime.
From what you state about your horse's condition, I'd say you had a successful story.

Good luck to you.
Moribelle

[LSM1212]

Oh yeah, I remembered. Can't remember exactly where and what the original injury was, but I remember an injury and some hard times over the hooves (hard times with hooves here). I just couldn't remember the numbers in your name to save my life. :lol:


No worries.... I did a quick run down of the injury on my hock thread for those who didn't know or needed a refresher. :D And some days... I forget my own name. :lol:

How is Bo? I need to search your thread I saw the other day... BTW, Stitch's feet look great!

[LSM1212]

Good Luck to you, and Godspeed. Let me know if I can help further. It's been a pleasure talking with you.

Moribelle

Thank you. I do appreciate your input. Hence why I asked for more details. :)

[AKB]

We injected our older horse who has navicular bursitis and a history of laminitis with IRAP in the coffin joints last summer. He had been lame for months, so I was delighted when he became sound in 24 hours and continued to be sound until recently. Now, he is lame again, so the vet is supposed to come out tomorrow. I am reluctant to do IRAP again because of the cost, but last year, steroid injections, Polyglycan injections, etc did not help him. Does anyone have any great ideas of where to get IRAP at a reasonable price?

[Appassionato]

No worries.... I did a quick run down of the injury on my hock thread for those who didn't know or needed a refresher. :D And some days... I forget my own name. :LOL:

How is Bo? I need to search your thread I saw the other day... BTW, Stitch's feet look great!

I hear you! When you have ongoing and complex issues, sometimes the run-downs are good and sometimes more info is needed. Nature of the game.

Bo is doing MUCH better on pergolide, I'm hoping to hear back soon on his dosage testing (retesting ACTH) and results of other blood tests. He had been on and off laminitic (no real diagnostic kind of signs other than soreness during shoeing). His general malaise has lifted, but I'm still concerned since his past ACTH test gave such a high value. I'm trying to get his soreness out of the way to better help the farriers! :winkgrin:

[moribelle]

???? DW - what marketing? IRAP isn't a product, it's a procedure. SMB's are marketed by a company. Who would market IRAP? I'm confused (again).

http://www.acvs.org/ID=3164/TYPE=1130/Hague%20IRAP.pdf

From what little I've learned about it, the vets consider it one more tool in the arsenal rather than a magic wand.

This is an article from one vet in Oklahoma who may or may not have processed the blood correctly to obtain the proper efficacy. And the article reflects his opinion only.
You should read much more that is available to you, and to everyone who is interested .
Have a good evening.
Moribelle

[Appassionato]

I did some more digging and discovered someone applied for a patent on the procedure.

http://www.freepatentsonline.com/6759188.html

I guess it is sort of a 'product' in the sense that someone is making money by selling the tools needed to do this. I still don't see where it's in the same arena as SMB's being marketed to the general public. The procedure costs $$$$thousand's to perform.

And it's now in the "Help" forum here at COTH if you had any other questions:

http://www.chronicleforums.com/Forum/showthread.php?t=135533

:winkgrin::lol:

[Snapdragon]

Moribelle, I got the defensive from your posting of "IRAP anyone?" to "We are really . . . ," but I'll always admit I can be wrong (don't tell my husband I just wrote this!).

Anyway, thanks for your good wishes for my mare. I wouldn't have had IRAP done if I didn't think it would have done some good.

As far as the cartilage thing. I don't know all the specifics of this horse, so there may have been other issues involved. I only know that the main issue was the cartilage.

[Calena]

And it's now in the "Help" forum here at COTH if you had any other questions:

http://www.chronicleforums.com/Forum/showthread.php?t=135533

:winkgrin::lol:

OMG!!!! :lol::lol: That's just plain weird.

[moribelle]

???? DW - what marketing? IRAP isn't a product, it's a procedure. SMB's are marketed by a company. Who would market IRAP? I'm confused (again).

http://www.acvs.org/ID=3164/TYPE=1130/Hague%20IRAP.pdf

From what little I've learned about it, the vets consider it one more tool in the arsenal rather than a magic wand.

ETA: My apologies, Deltawave. I did some more digging and discovered someone applied for a patent on the procedure.

http://www.freepatentsonline.com/6759188.html

I guess it is sort of a 'product' in the sense that someone is making money by selling the tools needed to do this. I still don't see where it's in the same arena as SMB's being marketed to the general public. The procedure costs $$$$thousand's to perform.

There are 3 patents. The procedure of obtaining the product is written within the guidelines of the patents. What is actually patented is the syringe used to produce the product. And no, it does not cost thousands for the IRAP. Truth is indeed stranger than fiction. Have a good evening ladies.
Moribelle

[moribelle]

We injected our older horse who has navicular bursitis and a history of laminitis with IRAP in the coffin joints last summer. He had been lame for months, so I was delighted when he became sound in 24 hours and continued to be sound until recently. Now, he is lame again, so the vet is supposed to come out tomorrow. I am reluctant to do IRAP again because of the cost, but last year, steroid injections, Polyglycan injections, etc did not help him. Does anyone have any great ideas of where to get IRAP at a reasonable price?

Dear AKB, where do you live? and where did you have the IRAP treatment done? I may be able to help.
Moribelle

[Calena]

There are 3 patents. The procedure of obtaining the product is written within the guidelines of the patents. What is actually patented is the syringe used to produce the product. And no, it does not cost thousands for the IRAP. Truth is indeed stranger than fiction. Have a good evening ladies.
Moribelle

How much does it cost on average? While it sounds promising and we already have 3 people on the thread that have used the therapy, it seems to be in a different class than more conventional treatments (ie, less expensive treatments).

Also, why did you post this question in the help forum? (Just curious :)).

[moribelle]

because I'm almost computer illiterate , and the other times my high speed broadband kicks me off, and I can't get back to the bulletin board, and sometimes the Chronicle's AOL ISP interferes where I can't stay online,,,,, so I was trying to post where I thought it would at least be viewable if someone took the time to open it, it's a very laughable situation. why do you ask?
Moribelle

[Simkie]

How much does it cost on average? While it sounds promising and we already have 3 people on the thread that have used the therapy, it seems to be in a different class than more conventional treatments (ie, less expensive treatments).

IIRC, it was about $700 at CSU. Less than I expected, honestly.

[moribelle]

like just now Calena!! I got kicked off. I was writing you this long discertation, be patient with me, I'll try again!!
Moribelle

[moribelle]

About $650-750.00 for processing., depending on where you get it done . You have to remember the cost of your vet drawing the blood, and the cost of him/her injecting the blood is totally separate.

BUT, the upside is this. Probably altogether with the other treatments you may do, and how frequent you do them, the cost is the same or less.
Example:

[Calena]

why do you ask?
Moribelle


Just curious, it looks weird. I'm forever wondering about things - I'm not certain if that's a blessing or a curse. I guess both depending on the situation :uhoh:.

Simkie:
IIRC, it was about $700 at CSU. Less than I expected, honestly.Hmm, that's not too outrageous. According to what I've read, IRAP sometimes works where Adequan doesn't, though it sounds to me like they're both giving the same net result - preventing further deterioration of the cartilage.

[moribelle]

Example: My horse yielded enough product from her blood through proper processing to do more than one round. Her next round is coming up, almost a year to the day, and I have product stored ready for use. So actually, I got two for one. SHe is not on ANY other products, nor has she been since I started this therapy with her over 3years ago.
Not every horse will have this kind of yield, but again, one of the secrets to this is the processing.

Does this answer your questions?

Moribelle

[moribelle]

Just curious, it looks weird. I'm forever wondering about things - I'm not certain if that's a blessing or a curse. I guess both depending on the situation :uhoh:.

Simkie:
Hmm, that's not too outrageous. According to what I've read, IRAP sometimes works where Adequan doesn't, though it sounds to me like they're both giving the same net result - preventing further deterioration of the cartilage.

Calena, I hate to be the bearer of bad news, but Adequan doesn't prevent deterioration of the cartilage. Honey, where did you hear or read that?
Moribelle

[Simkie]

About $650-750.00 for processing., depending on where you get it done . You have to remember the cost of your vet drawing the blood, and the cost of him/her injecting the blood is totally separate.


I am *pretty* sure that my $700 included drawing blood and the three joint injections.

I KNOW that just the syringe/incubation/centrifuge part was quite a bit less than $700. I was surprised at how little it was, as I expected all of it to be about a grand.

[moribelle]

I am *pretty* sure that my $700 included drawing blood and the three joint injections.

I KNOW that just the syringe/incubation/centrifuge part was quite a bit less than $700. I was surprised at how little it was, as I expected all of it to be about a grand.

Hey Simkie, you might want to check that bill again. My horse was done the first time at CSU as well, and my bill was over $1200.00 with the injecting being done there. It was $650.00 for the processing at that time, in 2004.

Hey, are you here in Colorado still?
Moribelle

[moribelle]

hey ladies, it has been great talking with you. I may be back on in the morning for awhile before I leave for SUNNY CALIFORNIA until Monday. Have a good evening.
Moribelle

[RAyers]

IRAP anyone? Does anyone use it or advocate it for arthritic issues except for me? (Interleukin-1 Receptor Antagonist Protein). Is anyone familiar with it? I ask because I've not seen it mentioned in any of these threads., just Legends, Adequan, steroids, HA...
Moribelle

There have been numerous threads and discussion about IRAP over the years. Do a simple search using IRAP and you will find 20 or so threads about it.

I am exceedingly familiar with it in both medicine and research. IRAP's use for arthritis is very up in the air. Several human studies in Europe show slight reduction in the rate of cartilage degradation. Most likely it is due to that Il-1ra has a very short life in the joints, unlike in tendons. A 2007 study that used the Orthokin, (the same process from which what you advocate came from) concluded that the efficacy of the treatment was not sufficient to recommend it for treatment of osteoarthritis (Autologous interleukin-1 receptor antagonist improves function and symptoms in osteoarthritis when compared to placebo in a prospective randomized controlled trial. Yang KG, et al.)

In my own personal work we published a study in 2002 that showed Il-1ra does little to prevent the resorption of bone in inflammatory responses due to the multiple metabolic pathways by which inflammation operates.

So at this time, I, like others who have posted, look at it as a possible tool but not a cure nor a preventative in arthritic conditions. I would advocate its use only based on individual cases.

It is my feeling that at this point in time, much of the IRAP work is as a procedure that is looking for a disease to treat because the reality is the basic inflammatory pathways in specific tissues have not yet been fully described.

Reed

[deltawave]

The whole "we" thing strikes me as a bit of either self-aggrandizement or advertising. Sorry if I'm taking that "we" part the wrong way. :lol: As I said, I think the procedure is enormously PROMISING, but I have a pretty high standard for what I consider GOOD DATA. Papers, even published ones, ain't necessarily the same thing. I've done quite a bit more "homework" on this subject than you think. :)

[RAyers]

I suggest you go to the CSU website, VETERINARIAN department/Equine Research, Dr's Frisbee and McIlraeth, and peruse all their published articles about this product.


If you read the work by Dave Frisbie and Wayne McIlwraith on the CSU website, you will first note that they work on viral vector introduction of a COMBINATION of IGF-1/Il-1ra. You will also note that they state, and I quote, "However, PG levels in AdIGF-I and AdIGF-I/ AdIL-1ra combination therapy were similar, indicating the need for IL-1ra presence at the time of the IL-1 flux to prevent PG depletion, rather than after IL-1 actions had started." In other words they even say that once inflammation has started, the administration of Il-1ra, using their method, has a very reduced effect (http://www.equineortho.colostate.edu/pdf/enhanced_cart_repair.pdf).

Reed

[Simkie]

Hey Simkie, you might want to check that bill again. My horse was done the first time at CSU as well, and my bill was over $1200.00 with the injecting being done there. It was $650.00 for the processing at that time, in 2004.

Hey, are you here in Colorado still?
Moribelle

Yeah, I'm still here.

I know the first part was significantly less than I thought it would be. I figured it would be 6-700, so it was definitely less than that.

This was in 2007, so perhaps they dropped the price. I'll see if I can find the paperwork tonight. If I can, I'll spell out the costs for everyone.

[moribelle]

If you read the work by Dave Frisbie and Wayne McIlwraith on the CSU website, you will first note that they work on viral vector introduction of a COMBINATION of IGF-1/Il-1ra. You will also note that they state, and I quote, "However, PG levels in AdIGF-I and AdIGF-I/ AdIL-1ra combination therapy were similar, indicating the need for IL-1ra presence at the time of the IL-1 flux to prevent PG depletion, rather than after IL-1 actions had started." In other words they even say that once inflammation has started, the administration of Il-1ra, using their method, has a very reduced effect (http://www.equineortho.colostate.edu/pdf/enhanced_cart_repair.pdf).

Reed

And modest too.
Moribelle

[moribelle]

The whole "we" thing strikes me as a bit of either self-aggrandizement or advertising. Sorry if I'm taking that "we" part the wrong way. :lol: As I said, I think the procedure is enormously PROMISING, but I have a pretty high standard for what I consider GOOD DATA. Papers, even published ones, ain't necessarily the same thing. I've done quite a bit more "homework" on this subject than you think. :)

As it should be. Forarmed is forwarned!
Moribelle

[deltawave]

I think it's "forewarned is forearmed", but I'm in a quibbling mood. :p

My point is that there might be a lot of "research" out there, but for IRAP the amount that is in good, peer-reviewed journals is in the "little to none" category.

Gonzo marketing ahead of documentation of efficacy is very rarely a good thing. :no: The annals of medicine (not talking about the journal but the reality of it) are RIFE with examples of how something that sounded like a really good idea and was extremely promising turned out to be useless or, worse, dangerous. Which is why the idea is to have the proof of efficacy FIRST, prior to the advertising and widespread use of a technique or treatment.

[RAyers]

Which is why the idea is to have the proof of efficacy FIRST, prior to the advertising and widespread use of a technique or treatment.

You bring up a good point. The IRAP discussed here was licensed as a process, side-stepping the FDA requirement of efficacy in drugs. Thus, they only needed to prove safety. Hence my comment about "looking for a disease to cure." Sadly this is how many new biologic agents are getting to market now.

Reed

[SpiritN]

I used IRAP on a gelding last year who was 7 years old. He had broken his coffin bone the year before and was developing ringbone in two joints as a result. Using regular joint injections had started to lose efficacy, so we did IRAP. It worked very well on him and definitely reduced his pain and gave him some weeks of soundness with each shot.

Ultimately an MRI showed that he also had two damaged collateral ligaments and very little cartilage left in one of the joints. As a result, I discontinued the treatments and retired him. The lack of cartilage is a deal breaker - you aren't going to get that back. IRAP could be used to squeak out a few more months (year?) of riding on him but it wasn't worth the cost and the physical toll on him.

[moribelle]

I think it's "forewarned is forearmed", but I'm in a quibbling mood. :p

My point is that there might be a lot of "research" out there, but for IRAP the amount that is in good, peer-reviewed journals is in the "little to none" category.

Gonzo marketing ahead of documentation of efficacy is very rarely a good thing. :no: The annals of medicine (not talking about the journal but the reality of it) are RIFE with examples of how something that sounded like a really good idea and was extremely promising turned out to be useless or, worse, dangerous. Which is why the idea is to have the proof of efficacy FIRST, prior to the advertising and widespread use of a technique or treatment.

That's ok deltawave, just show your stuff. by the way, where did you come up with that name?
Just curious!:lol::lol::lol:

[deltawave]

Read these threads long enough and you'll see my "stuff". I am an enormous proponent of solid, well-done research and the scientific method. My personal pet peeve is pseudoscience and massive marketing hype of products based on crappy conclusions and preliminary studies.

As to the username, it's the name I gave to an OTTB I bought ages and ages ago, (1993?) obviously with a cardiologic "slant". I also had a dog named Brady and a horse named Isorhythmic. I've gotten over that phase of my life, naming poor defenseless animals after cardiology stuff, but deltawave has "stuck". :p

[Calena]

Gonzo marketing ahead of documentation of efficacy is very rarely a good thing. :no: The annals of medicine (not talking about the journal but the reality of it) are RIFE with examples of how something that sounded like a really good idea and was extremely promising turned out to be useless or, worse, dangerous. Which is why the idea is to have the proof of efficacy FIRST, prior to the advertising and widespread use of a technique or treatment.

One of the (few?) advantages of getting old is that I recognize the truth more often when I see it. This is it :yes:.

We're asking for documented proof and forgetting that it can take decades of research and evaluation to discover the total effects and/or side effects of any given therapy.

Reading through all this, I've at the very least gotten a better understanding of the difference between palliative, preventative, and restorative therapies along with gaining a higher respect for the value of a long term record of safety and broad spectrum efficacy.

At this point, my understanding would be: IRAP is a promising new therapy that appears to work to minimize cartilage damage and also offers some palliative effects. It does not have the same effect on all horses. It is not as well studied as Adequan, which offers similar results at a lower cost and has a longer safety record, though it has helped some horses that did not respond well to Adequan.

And an ounce of prevention is still worth a pound of cure ;) .

[RAyers]

At this point, my understanding would be: IRAP is a promising new therapy that appears to work to minimize cartilage damage and also offers some palliative effects. It does not have the same effect on all horses. It is not as well studied as Adequan, which offers similar results at a lower cost and has a longer safety record, though it has helped some horses that did not respond well to Adequan.

And an ounce of prevention is still worth a pound of cure ;) .


BINGO!! WE HAVE A WINNER!! :D

Reed

[deltawave]

Why can't I be so succinct? :sigh: ;) Well said, Calena.

[potteryshop]

Well, in two months we will have another result to check. After my guy recovers from arthroscopy and the drugs to keep him in his stall wear off, we will be trying IRAP. He is too good to not spend that last $1000. I know he will never be 100%, but at 10 yrs he still has many years to give it a try.
And yes, we have tried all the rest before we got to this point.
Will report later.

[moribelle]

Well, in two months we will have another result to check. After my guy recovers from arthroscopy and the drugs to keep him in his stall wear off, we will be trying IRAP. He is too good to not spend that last $1000. I know he will never be 100%, but at 10 yrs he still has many years to give it a try.
And yes, we have tried all the rest before we got to this point.
Will report later.

You go girl!:yes::yes::yes:

[LisaW-B]

I was just talking with someone who had both of her horse's front feet treated with IRAP, and she said it cost about $2K, or $1K per foot, FWIW. Her horse was a little bit NQR but still competing in upper-level dressage before the IRAP. It is something that I am curious about for own navicular, young horse, but at this point in time, I really can't justify any more thousands of dollars spent toward "things to try" with him.

[AKB]

We are having IRAP done on both front feet this week for about $1000. That will include injecting both front foot coffin joints once and saving the second set of serum for future injections, as needed. We were quoted $1200 by a local clinic, but I think that included injecting both feet twice. Other clinics in our area are far more expensive, but I comparison shopped by price, as well as by which clinics have more experience with the IRAP. Our horse did well with navicular bursa injections of steroid and HA for several years. Last year, nothing we did worked until we finally did the IRAP last summer. The IRAP lasted 6 months. Now, he is lame again. I hope the IRAP works again, as I am running out of ideas for keeping the big guy sound.

[Simkie]

Okay, I found some paperwork from CSU. We started the IRAP process on 10/4/07. Here is what I was charged:

Orthokin ACS Kit/50 mil: $403
Orthokin ACS Processing: $144

Exams-Brief/recheck: $36
Intra-synovial injection/block: $50
Large Animal Professional Fee: $45
Butorphanol: $3.42
Xylazine: $3

I am missing the paperwork from the next two injections, but I suppose we can assume it's the same as the first.

That does total $959.26. I'd really thought it was a couple hundred less.

[moribelle]

Okay, I found some paperwork from CSU. We started the IRAP process on 10/4/07. Here is what I was charged:

Orthokin ACS Kit/50 mil: $403
Orthokin ACS Processing: $144

Exams-Brief/recheck: $36
Intra-synovial injection/block: $50
Large Animal Professional Fee: $45
Butorphanol: $3.42
Xylazine: $3

I am missing the paperwork from the next two injections, but I suppose we can assume it's the same as the first.

That does total $959.26. I'd really thought it was a couple hundred less.



So, $959.26 plus the charges for 2nd and 3rd treatment
137.42
137.42
________________
$ 1234.10

so, yeah we're right in line with you for the treatment we received from them
back in 2004.

But I don't think they are doing it anymore. You know those research centers, finish one, move on to the next.:cool:;)

[Simkie]

Um. NO.

$959.26 IS the whole thing. Initial plus the three joint injections. I recommend you check your math.

It's fairly obvious that 403+144+36+50+45+3.42+3 !=959.26.

403+144+36+50+45+3.42+3 = 684.42. That included the blood draw, processing and first injection.

TOTAL WITH ALL THREE INJECTIONS = 959.26.

And of course CSU is still doing IRAP. I'm really not sure what you're talking about when you say that they're not. My horse had this therapy less than 6 months ago.

[AKB]

Simkie,
Thanks for digging out your CSU bill. It helps me know that what I am paying for the IRAP this week is in ball park of what it should cost.

[moribelle]

Um. NO.

$959.26 IS the whole thing. Initial plus the three joint injections. I recommend you check your math.

It's fairly obvious that 403+144+36+50+45+3.42+3 !=959.26.

403+144+36+50+45+3.42+3 = 684.42. That included the blood draw, processing and first injection.

TOTAL WITH ALL THREE INJECTIONS = 959.26.

And of course CSU is still doing IRAP. I'm really not sure what you're talking about when you say that they're not. My horse had this therapy less than 6 months ago.

So testy! The info. you gave me added up properly to what I came up with. But no matter, this isn't a contest.
As well, alot can change in 6mo. You should check it out.