FEI President HRH Princess Haya welcomed the FEI initiative to hold a Congress on Non-Steroidal Anti-Inflammatory Drugs (NSAID) Usage and Medication in the Equine Athlete, declaring it as long overdue and the first real opportunity to bring together all the new science on NSAIDs since the FEI’s 1993 ban on their use in competition.
“Knowledge and an understanding of all aspects in the debate on NSAIDs is key to an informed decision”, the FEI President stated in her opening address. “What we all most want from this Congress above all else is to give us, the FEI family, the tools and the confidence to have the wisdom to do what we all so clearly have shown we want to do – that is what is right for our partner, the horse”, she said, emphasising the universal message of the Congress and the paramount principle of the sport, the welfare of the horse.
The President was speaking at the first day of the Congress, which is being held in the Olympic Museum in Lausanne, Switzerland. During today’s three sessions, 12 leading research experts outlined the current state of knowledge on NSAIDs to over 200 Congress participants representing 29 nationalities.
Congress participants heard that there is a substantial amount of new scientific evidence on the nature of NSAIDs, including improved ways of detecting them, their effect on the body and their side effects, as well as the effect of low levels of intake and combining different NSAIDs.
Sven Holmberg, FEI first Vice President and Congress Chairman, expressed his pleasure that so many leading experts had agreed to speak and also stressed the importance of the two-day conference for the external perception of equestrian sport. “The way our sport is perceived is fundamental to our ability to attract interest from the general spectator, from the media and from future sponsors. The outcome of this Congress should not only guide us in future discussions but also give the outside world the right message.”
Pierre-Louis Toutain (FRA), Professor of Physiology and Therapeutics at the National Veterinary School of Toulouse, suggested that the FEI should first express formally whether its priority was horse welfare or a level playing field . Professor Toutain also presented a paper on the possible side effects of long-term use of NSAIDs on behalf of Professor Johanna Fink-Gremmels (GER), who was unable to attend the Congress.
Pain control
Dr Wayne McIlwraith (NZL), Director of the Orthopaedic Research Center at Colorado State University (USA) and former President of the American Association of Equine Practitioners, gave an overview of existing studies on the effectiveness of NSAIDs in pain control. These show that the most commonly used NSAIDs, phenylbutazone and flunixin, both have significant effects on lameness, with results depending on the timing and duration of dosage. A combination of both drugs has demonstrated an even greater clinical improvement, but with proven side effects, he warned. He also described how more specific types of NSAIDs had less risk of slowing healing processes in the joint.
Professor Ken Hinchcliff, Dean of the Faculty of Veterinary Science at the University of Melbourne (AUS), said that studies to date had insufficient sample numbers to provide a high level of confidence in the findings.
Peter Kallings, Director of Research at the Swedish-Norwegian Foundation for Equine Research, supported that argument but added that other studies show that NSAIDs allow a horse with a musculoskeletal condition to compete better despite injury. “This type of therapeutic use could threaten the welfare of the equine athlete” he stated.
Jon Foreman, Associate Dean of the University of Illinois (USA), stated that recent preliminary data has shown that the analgesic benefits of half-doses wane rapidly and, if used as per the proposed timeline, have no masking effect at the time of competition. He suggested that it was logical to allow half doses to be used after one competition to promote equine welfare through improved recovery before the horse was asked to compete again the following day if required.
Dr Martial Saugy, Director of the Swiss Laboratory for Doping Analyses who outlined the World Anti-Doping Agency (WADA) perspective on NSAIDs, complimented the FEI on the impressive level interest and the quality of the questions that had been asked at the Congress. He clarified that NSAIDs are not prohibited in human sports, but are an area of concern. He questioned whether the increasing intake of medication, particularly NSAIDs, in human athletes was purely for therapeutic reasons.
World Horse Welfare
Roly Owers Chief Executive of World Horse Welfare, (GBR), referred to the FEI Code of Conduct, which states: “Participation in competition must be restricted to fit horses” and that “no horse showing lameness should compete”. He questioned whether a horse that requires treating with NSAIDs in order to be ‘fit’ or ‘to alleviate signs of lameness’ should compete in an FEI competition. The stakes are high, both for the FEI and horse sport globally, he concluded, asking if the general public was ready to accept the use of NSAIDs in competition and if it was the right message to give to the ordinary rider.
The first day’s programme concluded with a panel discussion on the different approaches to the use of NSAIDs in FEI competition. Chaired by John McEwen, Chair of the FEI Veterinary Committee, the panelists were Yves Rossier (CAN), Phillipe Benoit (FRA), Yogi Breisner (SWE), Rodrigo Pessoa (BRA) and Richard Davison (GBR).
The second day’s programme will focus more on the non-scientific angle of NSAIDs and their use in competition. The legal perspective from nine European jurisdictions that restrict the use of NSAIDs under national law will be outlined and Congress participants will also hear the sponsors and media viewpoints, enabling a full overview of the subject.
The perspective from other sports on the in-competition use of NSAIDs will be discussed in the first panel session and the pros and cons of reintroducing NSAIDs to FEI sport will be the subject of the afternoon’s debate, with Tim Ober (USA) and Mike Gallagher (CAN) speaking in favour of using NSAIDs in competition and Christian Paillot (FRA) and Peter Kallings (SWE) speaking against their use.
The Congress is a means of providing up-to-date information on all aspects of the debate to allow for an informed decision when the National Federations vote on the use of NSAIDs in competition at the FEI General Assembly in Chinese Taipei, 1-6 November 2010.
Summaries for all speeches can be found in the Congress program.