Camilo J. Morales, Zachary C. Blakeney
Equine clinical pharmacology is entering a new era driven by advances in precision medicine and omics technologies. Genomics, proteomics, and pharmacogenetics are enabling individualized drug selection and dosing, supported by emerging biomarkers such as miRNA. Transporter biology, particularly P-glycoprotein, is reshaping understanding of drug absorption and resistance. Therapeutic innovation includes novel antimicrobial agents, monoclonal biologics, and next-generation vaccines, expanding options for equines. Transdermal delivery systems and precision immunization strategies promise improved outcomes. Regulatory emphasis on antimicrobial stewardship underscores responsible prescribing. Integration of systems biology and artificial intelligence facilitates predictive modeling and individualized therapy. Beyond equine medicine, horses serve as translational models for human conditions such as asthma and metabolic syndrome. Realizing these opportunities requires collaboration among academia, industry, and regulatory bodies. By integrating precision medicine, advanced technologies, and stewardship, equine clinical pharmacology can deliver safer therapies, expand treatment options, and advance translational research for animal and human health.