Outcomes of treatment of cats with feline infectious peritonitis using parenterally administered remdesivir, with or without transition to orally administered GS‐441524

Abstract

BackgroundNucleoside analog GS‐441524 is effective in treating cats with feline infectious peritonitis (FIP). Investigation into the use of parent nucleotide analog remdesivir (GS‐5734) is needed.ObjectivesTo assess efficacy and tolerability of remdesivir with or without transition to GS‐441524 in cats with FIP and document clinical and clinicopathologic progression over 6 months.AnimalsTwenty‐eight client‐owned cats with FIP.MethodsCats were prospectively recruited between May 2021 and May 2022. An induction dosage of remdesivir 10 to 15 mg/kg intravenously or subcutaneously q24h was utilized for 4 doses, with a maintenance dosage of remdesivir (6‐15 mg/kg SC) or GS‐441524 (10‐15 mg/kg per os) every 24 hours continued for at least 84 days. Laboratory testing, veterinary, and owner assessments were recorded.ResultsTwenty‐four cats survived to 6 months (86%). Three cats died within 48 hours. Excluding these, survival from 48 hours to 6 months was 96% (24/25). Remission was achieved by day 84 in 56% (14/25). Three cats required secondary treatment for re‐emergent FIP. Remission was achieved in all 3 after higher dosing (15‐20 mg/kg). Adverse reactions were occasional site discomfort and skin irritation with remdesivir injection. Markers of treatment success included resolution of pyrexia, effusions, and presenting signs of FIP in the first half of treatment and normalization of globulin concentration, and continued body weight gains in the latter half of the treatment period.Conclusions and Clinical ImportanceParenteral administration of remdesivir and oral administration of GS‐441524 are effective and well‐tolerated treatments for FIP. Early emphasis on clinical, and later emphasis on clinicopathologic response, appears prudent when monitoring treatment efficacy.

Efficacy of Oral Remdesivir Compared to GS-441524 for Treatment of Cats with Naturally Occurring Effusive Feline Infectious Peritonitis: A Blinded, Non-Inferiority Study

“…All other cats in both treatment groups have continued to remain in clinical remission of their disease. If it is assumed that this cat experienced a relapse of FIP, the relapse rate in this study (overall 8.3%) is similar to other studies that have a demonstrated relapse rate of 3.5-23% of cats treated with either GS-441524, remdesivir, or a combination of the medications [6,7,11,12].…”

Optionen zur Therapie der felinen infektiösen Peritonitis – früher und heute

“…Bei 11 Katzen wurde die Therapie verlängert; 3 Katzen wurden aufgrund eines Rückfalls der Symptome erfolgreich erneut therapiert. Auch die Katzen dieser Studie zeigten Reizungen an den Injektionsstellen [ 76 ] .…”

Measurement of Feline Alpha-1 Acid Glycoprotein in Serum and Effusion Using an ELISA Method: Analytical Validation and Diagnostic Role for Feline Infectious Peritonitis

“…If untreated, FIP is invariably fatal. Recently, antiviral treatments have been established and demonstrated to be effective [ 1 , 2 , 3 ], although a few side effects have been reported [ 4 , 5 , 6 , 7 ] and very little information is available about possible long-term effects [ 7 , 8 ]. Treatment is recommended where the drugs is legally available [ 3 ], but unfortunately, in the large majority of countries, the drug is not licensed; therefore, treatments are not allowed.…”