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Difference between Adequan and Pentosan

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    Difference between Adequan and Pentosan

    I am finding that in applicable situations, it is not uncommon to hear the suggestion to "use Adequan or Pentosan"... almost implying they are equal alternatives. Yet further reading and homework on the topic is suggesting that there are actually somewhat different intended purposes for the drugs.

    For those of you who understand the drugs on a slightly more scientific level, can you please enlighten me? How do you determine which would be most suitable for a particular horse or diagnosis? Are they considered equal alternatives?

    Then bring into the picture Previcox. I understand the use and purpose of Previcox, basic difference between this and said injectibles... but at what point does one decide to move to an injection regimen vs. longer term Previcox? (I am sure this largely has to do with the diagnosis of the horse, but I see Previcox thrown out in suggestion frequently also).

    TIA.

    #2
    Originally posted by Senszuri View Post
    I am finding that in applicable situations, it is not uncommon to hear the suggestion to "use Adequan or Pentosan"... almost implying they are equal alternatives. Yet further reading and homework on the topic is suggesting that there are actually somewhat different intended purposes for the drugs.

    For those of you who understand the drugs on a slightly more scientific level, can you please enlighten me? How do you determine which would be most suitable for a particular horse or diagnosis? Are they considered equal alternatives?

    Then bring into the picture Previcox. I understand the use and purpose of Previcox, basic difference between this and said injectibles... but at what point does one decide to move to an injection regimen vs. longer term Previcox? (I am sure this largely has to do with the diagnosis of the horse, but I see Previcox thrown out in suggestion frequently also).

    TIA.

    bump! this is my question too!

    Comment


      #3
      I'd be curious to know more about this too...

      I have a new horse that was on Previcox and getting monthly hock injections with prior owner (both as a preventative rather than to address a specific issue).

      I have removed him from all of this (owned him 4 months now) and put him on 24/7 turn out and he is moving better than ever - HOWEVER is is not currently in work (I am super pregnant). I am very willing to put him back on whatever he needs once he goes back to work but would love to know more about the uses to make a more informed decision!

      Comment


        #4
        http://horseproducts101.com/2014/04/...nces-benefits/

        This may help.

        Comment


          #5
          Originally posted by Senszuri View Post
          I am finding that in applicable situations, it is not uncommon to hear the suggestion to "use Adequan or Pentosan"... almost implying they are equal alternatives. Yet further reading and homework on the topic is suggesting that there are actually somewhat different intended purposes for the drugs.
          Just wanted to say that when I say "OR", I often mean just that. Two different options to consider!

          Pentosan is off label use when you inject it IM (it is actually approved to lavage joints after surgery), but it has a similar mechanism of action as Adequan as far as (note: similar but not that same) stopping the release of inflammatory mediators.

          Adequan is polysulfated glycosaminoglycan (PSGAG) which has an anti-inflammatory effect. It is FDA approved for arthritis.

          Other avenues to consider include Legend (hyaluronan given intravenously). The way I understand it, Legend is more for acute problems (not prevention) and it only lasts a short time. Adequan is more for prevention with long term use.

          Yet other options are as bisphosphonates to prevent bone loss -- Osphos (clodronate disodium given intramuscularly) and Tildren (tiludronate disodium given intravenously).

          Previcox is a pain killer, more or less. It doesn't really treat anything in the body; just stops the pain transmittance.

          Of course, all this depends on what you are trying to treat.
          It is not enough to know how to ride; one must know how to fall.

          Comment


            #6
            Adequan is a more bioavailable delivery of glucosamine, which is useful for cartilage health by helping to prevent further deterioration. It is my understanding that Pentosan helps cartilage by acting on the blood supply factor. One theory on cartilage degeneration is poor blood supply to articular cartilage which does not exactly have "good" blood supply to begin with.

            Comment


              #7
              Originally posted by beau159 View Post
              Pentosan is off label use when you inject it IM (it is actually approved to lavage joints after surgery), but it has a similar mechanism of action as Adequan as far as (note: similar but not that same) stopping the release of inflammatory mediators.
              Are you sure you aren't thinking of Polyglycan? That is the "p" product that is used off label and only approved for lavage.

              I've never heard that about Pentosan. Everything I've ever read, including the literature from the manufacturers in Australian, talk about it being IM for inflammation and arthritis and don't say anything about lavage.

              Comment


                #8
                Originally posted by IPEsq View Post
                It is my understanding that Pentosan helps cartilage by acting on the blood supply factor. One theory on cartilage degeneration is poor blood supply to articular cartilage which does not exactly have "good" blood supply to begin with.
                Well, that's an interesting theory! Articular cartilage is an avascular tissue = no blood vessels, ever. Developmentally, vascularization is one factor that makes bone become bone. Where the blood vessels go, you have bone. Where they stop, you have cartilage.

                It is believed that Pentosan may help increase blood supply to the underlying subchondral bone any synovial lining due to its mild angiogenic (makes blood vessels grow) and anticoagulant (blood thinning)properties. Chemically, Pentosan polysulfate is similar to heparin.

                Some in vitro (culture) studies have shown that Pentosan may support anabolic (cartilage building) activities, such as increasing synthesis of extracellular matrix and inhibiting proteases responsible for cartilage breakdown. In the synovium, Pentosan might help to reduce production of proinflammatory mediators by synoviocytes.

                Note that these theories are based mostly on how chondrocytes behave in a culture dish or small animal model. There have been no studies, in horses, that confirm that all of this actually does happen in vivo. However, there was a study which suggested Pentosan Polysulfate reduced synovial inflammation and cartilage damage in response to an experimental surgically induced osteoarthritis model.

                Adequan (polysulfated glycosaminoglycan) is also structurally similar to heparin. It may act similarly to Pentosan by increasing cartilage synthesis, although it does so by increasing different matrix components than Pentosan. It may also help decrease breakdown of cartilage by inhibiting inflammation.

                I'm not aware of any research which shows that Adequan can actually repair damaged cartilage. The same group mentioned above used the same experimental arthritis model as above, and found no difference in horses treated with Adequan vs. control. Another study in horses found that treating joints with Adequan immediately after injury actually inhibited production of repair tissue.

                Which one to use (or not), and why, depends on the horse and the situation. When comparing these two drugs, you are also usually comparing compounded (Pentosan) vs. not (Adequan), and that is a whole 'nother can o worms.
                *Absolut Equestrian*

                "The plural of anecdote is not fact...except in the horse industry"

                Comment


                  #9
                  Sorry I meant the subchondral bone's blood supply. Incidentally, the OCD lesion I have in my hock was caused in theory not by acute injury (most common in human cases), but due to genetic predisposition plus poor blood supply in the tibia due to biomechanics factors which led to a weakening of the articulate cartilage and degeneration. What I've read about at least one possible effect of Pentosan based on original uses for the drug I understand to basically prevent joint degeneration in horses caused by factors similar to my own joint problems. I admit that I never quite followed my doctor's description of how blood supply to the bone could affect the cartilage which is not vascular, but it was something about the part where the cartilage attaches to the bone...and then my eyes start to glaze over

                  Comment


                    #10
                    Originally posted by beau159 View Post
                    Just wanted to say that when I say "OR", I often mean just that. Two different options to consider!

                    Pentosan is off label use when you inject it IM (it is actually approved to lavage joints after surgery), but it has a similar mechanism of action as Adequan as far as (note: similar but not that same) stopping the release of inflammatory mediators.

                    Adequan is polysulfated glycosaminoglycan (PSGAG) which has an anti-inflammatory effect. It is FDA approved for arthritis.

                    Other avenues to consider include Legend (hyaluronan given intravenously). The way I understand it, Legend is more for acute problems (not prevention) and it only lasts a short time. Adequan is more for prevention with long term use.

                    Yet other options are as bisphosphonates to prevent bone loss -- Osphos (clodronate disodium given intramuscularly) and Tildren (tiludronate disodium given intravenously).

                    Previcox is a pain killer, more or less. It doesn't really treat anything in the body; just stops the pain transmittance.

                    Of course, all this depends on what you are trying to treat.
                    Pentosan is now labeled for this use, see: http://www.allivet.com/p-6458-pentos...FQgUHwodCyQAMg

                    Comment

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