Nucleoside analogue EIDD-1931 in the treatment of naturally occurring feline infectious peritonitis

ObjectivesCurrent antiviral therapy for feline infectious peritonitis (FIP) has limited availability and can be cost-prohibitive. The nucleoside analogue EIDD-1931 is an effective inhibitor against FIP virus serotype I and II in vitro. Our objective was to determine whether EIDD-1931 is an effective treatment option for cats with naturally occurring FIP.MethodsA prospective clinical trial was conducted with nine client-owned cats diagnosed with effusive or non-effusive FIP including neurological involvement. Cats were administered EIDD-1931 orally twice daily for 12 weeks. A complete response was defined as resolution of all abnormalities associated with FIP. Clinical variables, haematology, biochemistry and imaging findings were monitored during treatment and after discontinuing treatment.ResultsSix cats with effusive FIP and three cats with non-effusive FIP (median age 1.0 year, range 0.5-7.9) were treated with EIDD-1931 (median dose 16.2 mg/kg PO q12h, range 12.0-20.5) for 12 weeks in eight cats and 14 weeks in one cat. All cats showed a complete response to treatment. Adverse effects included transient neutropenia (three cats), elevated alanine transaminase (transient in three cats, persistent in one cat), broken whiskers (one cat) and suspected treatment-induced relative hyporexia (six cats). Adverse effects were not dose dependent. Follow-up was available for more than 12 months after treatment discontinuation. One cat relapsed on two occasions, responding to repeat treatment at escalating dosages before subsequent development of treatment-resistant lymphoma, resulting in euthanasia 545 days after study enrolment. No other relapse events or diseases were observed.Conclusions and relevanceEIDD-1931 administered at 15-20 mg/kg PO q12h for 12 weeks is a feasible treatment option for naturally occurring FIP. Adverse effects may be more common than treatment with GS-441524.