Clark T M, Coggins S J, Korman R, King J, Malik R
Veterinary Specialist Services, 24/34 Goggs Road, Jindalee, Queensland, 4074, Australia.
Sydney School of Veterinary Science, Faculty of Science, B14, The University of Sydney, Sydney, New South Wales, 2006, Australia.
Aust Vet J. 2025 Jun;103(6):339-353. doi: 10.1111/avj.13433. Epub 2025 Apr 15.
To evaluate the clinical applications and treatment outcomes using molnupiravir for the treatment of naturally occurring feline infectious peritonitis virus (FIPv).
Ninety-two client-owned cats with confirmed or presumptive FIP were retrospectively recruited from 35 veterinary practices, primarily in Australia, between February 2023 and March 2024. Cats were categorised based on treatment received: Cohort A: Molnupiravir treatment: monotherapy, maintenance or rescue therapy; Cohort B: Remdesivir and/or GS-441524 treatment. Seventy-eight cats were enrolled. Molnupiravir was administered orally for a median of 84 days, at a median dose of 13.3 mg/kg BID. Remission was defined as the resolution of FIP-related signs with (i) normalisation of serum globulin concentrations and A:G ratio (≥0.6), or (ii) sustained clinical remission for at least 100 days after stopping anti-viral therapy. Cure rate was defined as the percentage of cats achieving sustained remission, without requiring rescue therapy or experiencing a relapsed disease.
Molnupiravir monotherapy resulted in a cure rate of 72% (13/18) while molnupiravir maintenance therapy achieved a cure rate of 86% (25/29), and molnupiravir utilised as a rescue therapy achieved a cure rate of 100% (7/7). Treatment with remdesivir/GS-441524 resulted in a cure rate of 71% (17/24 cats). Survival analysis revealed no difference in outcomes between cats treated with molnupiravir monotherapy and those treated with remdesivir/GS-441524. Adverse events associated with molnupiravir therapy included neutropenia, and transient elevations in hepatic enzymes.
Molnupiravir demonstrated comparable survival outcomes to remdesivir/GS-441524 for treating FIP and serves as an accessible, effective option across various presentations, including ocular and neurologic forms.
评估莫努匹韦用于治疗自然发生的猫传染性腹膜炎病毒（FIPv）的临床应用及治疗效果。
2023年2月至2024年3月期间，主要从澳大利亚的35家兽医诊所回顾性招募了92只确诊或疑似患有猫传染性腹膜炎的宠物猫。根据接受的治疗将猫进行分类：A组：莫努匹韦治疗：单药治疗、维持治疗或挽救治疗；B组：瑞德西韦和/或GS-441524治疗。共纳入78只猫。莫努匹韦口服给药，中位疗程为84天，中位剂量为13.3mg/kg，每日两次。缓解定义为猫传染性腹膜炎相关体征消失，且（i）血清球蛋白浓度和白球比（≥0.6）恢复正常，或（ii）在停止抗病毒治疗后持续临床缓解至少100天。治愈率定义为实现持续缓解、无需挽救治疗且未出现疾病复发的猫的百分比。
莫努匹韦单药治疗的治愈率为72%（13/18），莫努匹韦维持治疗的治愈率为86%（25/29），莫努匹韦用作挽救治疗的治愈率为100%（7/7）。瑞德西韦/GS-441524治疗的治愈率为71%（17/24只猫）。生存分析显示，莫努匹韦单药治疗组与瑞德西韦/GS-441524治疗组的治疗效果无差异。与莫努匹韦治疗相关的不良事件包括中性粒细胞减少和肝酶短暂升高。
莫努匹韦在治疗猫传染性腹膜炎方面显示出与瑞德西韦/GS-441524相当的生存结果，是包括眼部和神经型在内的各种表现形式的一种可及、有效的选择。
