BAPTEN is indicated for the treatment of tendinitis of the superficial digital flexor tendon (SDFT) in the adult horse where there is sonographic evidence of fiber tearing.
III. PRODUCT INFORMATION:
A. Background:
Superficial digital flexor tendinitis is a severe debilitating injury which is common in performance horses. In the following studies, tendon remodeling following BAPTEN treatment was evaluated using diagnostic ultrasound (DUS), primarily by the measurement of tendon cross-sectional area (CSA). The percent change in CSA for the total tendon, the total injured zone, and the maximum injured zone were evaluated over a four month period. Other parameters evaluated by DUS included echogenicity of the lesion, and parallelism of newly formed collagen fiber bundles. Following BAPTEN injections, a low level exercise program was initiated during the four month studies. Increases in exercise were scheduled to occur only after improvement in ultrasound parameters. The studies conducted support the treatment of equine tendon injuries with BAPTEN to enhance scar collagen remodeling as evaluated by DUS.
During tendon healing, an early increase in tensile strength occurs as a result of random collagen deposition (as layed down by migrating fibroblasts)1. During tendon repair, maximal crosslinking of collagen occurs from approximately day 10 to day 352. BAPTEN inhibits covalent crosslinking of collagen by irreversibly blocking the enzyme lysyl oxidase3,4. Collagen synthesis proceeds at the same rate; however, tensile strength is weak since early random crosslinking does not occur5,6. A closely regulated low impact exercise program facilitates longitudinal collagen fiber alignment (remodelling)1. Once the effects of BAPTEN dissipate, active enzyme is once again able to crosslink collagen. The collagen fibers are then more longitudinally aligned for better tensile strength. Although the healing process is not shortened by the use of BAPTEN, the healed tendon should be stronger due to remodelling. …
