Gokalsing Emma, Ferrolho Joana, Gibson Mark S, Vilhena Hugo, Anastácio Sofia
Vasco da Gama Research Centre (CIVG), Department of Veterinary Sciences, Vasco da Gama University School, Avenida José R. Sousa Fernandes 197 Lordemão, 3020-210 Coimbra, Portugal.
Department of Veterinary Clinics, School of Medicine and Biomedical Sciences, ICBAS-UP, University of Porto, 4050-313 Porto, Portugal.
Pathogens. 2025 Jul 19;14(7):717. doi: 10.3390/pathogens14070717.
Feline infectious peritonitis (FIP) is a severe viral disease with a very high fatality rate. GS-441524 is an adenosine analogue that acts as an antiviral and has shown promise in FIP treatment. However, its commercialization in some regions is not yet authorized. To evaluate the efficacy of GS-441524 based on the published literature, a systematic review was conducted. This systematic review was conducted using PubMed, ScienceDirect, and Google Scholar for studies published from 2018 onwards. Following PRISMA guidelines, 11 studies (totaling 650 FIP cases treated with GS-441524 alone or in combination) were included. Therapeutic efficacy was assessed by FIP form, clinical signs, and dosage. The overall treatment success rate was 84.6%. This rate was higher when GS-441524 was combined with other antivirals and lower in cases of wet FIP or those with neurological complications. Combination therapy with other antivirals may improve outcomes in complicated FIP cases, although further studies are needed. The GS-441524 dosages associated with the best outcomes were 5-10 mg/kg once daily (or equivalent subcutaneous dose), adjusted for FIP type, severity, and presence of neurological/ocular signs. Higher dosages can be used for severe cases or to prevent relapse, but splitting into twice-daily dosing may be necessary to avoid absorption issues. In summary, this synthesis indicates that GS-441524 is a highly promising treatment for FIP, with a high success rate among treated cases. Nevertheless, randomized controlled trials are needed to establish evidence-based therapeutic protocols tailored to different FIP presentations.
猫传染性腹膜炎（FIP）是一种致死率极高的严重病毒性疾病。GS-441524是一种腺苷类似物，具有抗病毒作用，在FIP治疗中显示出前景。然而，它在一些地区尚未获得商业化授权。为了根据已发表的文献评估GS-441524的疗效，进行了一项系统综述。该系统综述使用PubMed、ScienceDirect和谷歌学术搜索2018年以后发表的研究。遵循PRISMA指南，纳入了11项研究（共650例单独或联合使用GS-441524治疗的FIP病例）。通过FIP类型、临床症状和剂量评估治疗效果。总体治疗成功率为84.6%。当GS-441524与其他抗病毒药物联合使用时，该成功率更高；在湿性FIP或伴有神经并发症的病例中，成功率较低。与其他抗病毒药物联合治疗可能会改善复杂FIP病例的治疗结果，不过仍需要进一步研究。与最佳治疗效果相关的GS-441524剂量为每日一次5-10 mg/kg（或等效皮下剂量），根据FIP类型、严重程度以及神经/眼部症状进行调整。对于严重病例或预防复发可使用更高剂量，但可能需要分成每日两次给药以避免吸收问题。总之，该综述表明GS-441524是一种非常有前景的FIP治疗方法，在治疗病例中成功率很高。然而，需要进行随机对照试验来建立针对不同FIP表现的循证治疗方案。
