Dept. of Drug Discovery and Biomedical Sciences, College of Pharmacy, Medical University of South Carolina, 70 President St, Charleston, SC 29425, USA.
Charleston Veterinary Referral Center, 3484 Shelby Ray Court, Charleston, SC, USA.
J Pharm Biomed Anal. 2024 Sep 1;247:116248. doi: 10.1016/j.jpba.2024.116248. Epub 2024 May 22.
GS-441524 is an adenosine nucleoside antiviral demonstrating significant efficacy in the treatment of feline infectious peritonitis (FIP), an otherwise fatal illness, resulting from infection with feline coronavirus. However, following the emergence of COVID-19, veterinary development was halted, and Gilead pursued clinical development of a GS-441524 pro-drug, resulting in the approval of Remdesivir under an FDA emergency use authorization. Despite lack of regulatory approval, GS-441524 is available without a prescription through various unlicensed online distributors and is commonly purchased by pet owners for the treatment of FIP. Herein, we report data obtained from the analytical characterization of two feline renal calculi, demonstrating the propensity for GS-441524 to cause renal toxicity through drug-induced crystal nephropathy in vivo. As definitive diagnosis of drug-induced crystal nephropathy requires confirmation of the lithogenic material to accurately attribute a mechanism of toxicity, renal stone composition and crystalline matrix were characterized using ultra-performance liquid chromatography photodiode array detection (UPLC-PDA), ultra-performance liquid chromatography mass spectrometry (LCMS), nuclear magnetic resonance (NMR) spectroscopy, X-ray powder diffraction (XRD), and Fourier-transform infrared spectroscopy (FTIR). This work serves to provide the first analytical confirmation of GS-441524-induced crystal nephropathy in an effort to support toxicologic identification of adverse renal effects caused by administration of GS-441524 or any pro-drug thereof.
GS-441524 是一种腺苷核苷抗病毒药物,在治疗猫传染性腹膜炎(FIP)方面具有显著疗效,FIP 是一种由猫冠状病毒感染引起的致命疾病。然而,随着 COVID-19 的出现,兽医开发工作停止了,吉利德公司开始对 GS-441524 的前药进行临床开发,最终瑞德西韦获得了 FDA 的紧急使用授权。尽管没有监管批准,但 GS-441524 未经许可通过各种在线分销商提供,并且常被宠物主人购买用于治疗 FIP。在此,我们报告了从两个猫肾结石的分析特征中获得的数据,这些数据表明 GS-441524 有通过药物诱导的晶体肾病在体内引起肾毒性的倾向。由于药物诱导的晶体肾病的明确诊断需要确认结石形成物质以准确归因于毒性机制,因此使用超高效液相色谱光电二极管阵列检测(UPLC-PDA)、超高效液相色谱质谱(LCMS)、核磁共振(NMR)光谱学、X 射线粉末衍射(XRD)和傅里叶变换红外光谱(FTIR)对肾结石成分和晶体基质进行了表征。这项工作首次对 GS-441524 诱导的晶体肾病进行了分析确认,旨在支持对 GS-441524 或其任何前药给药引起的不良肾脏影响进行毒理学鉴定。