William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
Veterinary Center for Clinical Trials, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
Viruses. 2023 Aug 1;15(8):1680. doi: 10.3390/v15081680.
Nucleoside analogs GS-441524 and remdesivir (GS-5734) are effective in treating cats with feline infectious peritonitis (FIP). However, no studies have compared the efficacy between antiviral medications. The objective of this study was to evaluate the efficacy of orally administered GS-442514 (12.5-15 mg/kg) compared to orally administered remdesivir (25-30 mg/kg) in a double-blinded non-inferiority trial. Eighteen cats with effusive FIP were prospectively enrolled and randomly assigned to receive either GS-442514 or remdesivir. Cats were treated daily for 12 weeks and evaluated at week 0, 12, and 16. Survival and disease remission at week 16 were compared between groups. Five of 9 (55%) cats treated GS-441524 and 7/9 (77%) cats treated with remdesivir survived, with no difference in survival rate ( = 0.2). Remdesivir fulfilled the criteria for non-inferiority with a difference in survival of 22% (90% CI; -13.5-57.5%). Three of the 18 cats died within 48 h of enrollment. Excluding these cats, 5/6 (83%) of the cats treated with GS-441524 and 7/9 (77%) of the cats treated with remdesivir survived. These findings suggest that both orally administered GS-441524 and remdesivir are safe and effective anti-viral medications for the treatment of effusive FIP. Further optimization of the first 48 h of treatment is needed.
核苷类似物 GS-441524 和瑞德西韦（GS-5734）可有效治疗猫传染性腹膜炎（FIP）。然而，目前尚无研究比较抗病毒药物的疗效。本研究旨在评估口服 GS-442514（12.5-15mg/kg）与口服瑞德西韦（25-30mg/kg）的疗效，这是一项双盲非劣效性试验。18 只患有渗出性 FIP 的猫被前瞻性纳入并随机分为接受 GS-442514 或瑞德西韦治疗。猫每天接受治疗 12 周，并在第 0、12 和 16 周进行评估。比较两组第 16 周的生存率和疾病缓解率。接受 GS-441524 治疗的 9 只猫中有 5 只（55%）和接受瑞德西韦治疗的 9 只猫中有 7 只（77%）存活，生存率无差异（=0.2）。瑞德西韦符合非劣效性标准，生存率差异为 22%（90%CI；-13.5-57.5%）。18 只猫中有 3 只在入组后 48 小时内死亡。排除这些猫后，接受 GS-441524 治疗的 6 只猫中有 5 只（83%）和接受瑞德西韦治疗的 9 只猫中有 7 只（77%）存活。这些发现表明，口服 GS-441524 和瑞德西韦均为治疗渗出性 FIP 的安全有效的抗病毒药物。需要进一步优化前 48 小时的治疗。
