학술논문

Outcomes of treatment of cats with feline infectious peritonitis using parenterally administered remdesivir, with or without transition to orally administered GS‐441524
Document Type
article
Source
Journal of Veterinary Internal Medicine, Vol 37, Iss 5, Pp 1772-1783 (2023)
Subject
antiviral
clinical trial
feline coronavirus
nucleoside analog
Veterinary medicine
SF600-1100
Language
English
ISSN
1939-1676
0891-6640
Abstract
Abstract Background Nucleoside 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. Objectives To 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. Animals Twenty‐eight client‐owned cats with FIP. Methods Cats 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. Results Twenty‐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 Importance Parenteral 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.