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Publication
Eficácia Do GS-441524 No Tratamento Da Peritonite Infeciosa Felina: Revisão Sistemática De Bibliografia
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Advisor(s)
Abstract(s)
A Peritonite infeciosa felina (PIF) é uma doença de origem viral severa, apresentando uma taxa de letalidade muito elevada. O GS-441524 é um análogo de adenosina, que atua como antiviral, e que constitui uma esperança no tratamento da doença. Porém, a sua comercialização na Europa não está ainda autorizada. A utilização de GS-441524 no tratamento da PIF tem sido reportada em artigos científicos, sobretudo na forma de estudos de caso. Com o objetivo de avaliar, com base em literatura científica publicada, a eficácia do tratamento com a molécula GS-441524, foi desenvolvida uma revisão bibliográfica sistemática. Seguindo as orientações PRISMA para este tipo de estudo, foram selecionados 12 artigos que estudam a eficácia do GS-441524. Os dados de 650 felinos com PIF tratados com o GS-441524 como tratamento único ou em associação foram compilados, e foi avaliada a eficácia da terapêutica em função do tipo de PIF, dos sinais clínicos e das dosagens administradas. A taxa de sucesso global do tratamento nos 650 casos foi de 84,6%. Esta taxa é influenciada positivamente pela administração de outros fármacos em associação com o GS-441524. É influenciada negativamente pelos quadros de PIF húmida e pelos quadros complicados com sinais neurológicos, e com sinais neurológicos em conjunto com sinais oculares. O tratamento em associação com outros antivirais poderá ser mais eficiente nos casos complicados, mas serão necessários mais estudos para o confirmar. As dosagens de GS-441524 com os melhores resultados de eficácia são de 5 a 10mg/kg por via oral (ou dosagem equivalente por via subcutânea), mas dependem do tipo de PIF, da gravidade dos sinais clínicos e da presença de sinais clínicos agravantes. Dosagens mais elevadas podem ser utilizadas no sentido de evitar recaídas, sobretudo em casos com quadros agravantes, mas a dosagem deve ser dividida em duas tomas diárias para evitar diminuição da absorção.
Esta síntese permitiu verificar, entre os estudos analisados, que GS-441524 é uma molécula promissora para o tratamento da PIF tendo-se verificado que a taxa de sucesso é elevada. Porém, estudos randomizados são necessários para permitir a implementação de orientações terapêuticas objetivas e adaptadas a cada quadro clínico.
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 it seems promising in FIP treatment. However, its commercialization in Europe is not yet authorized. The use of GS-441524 in FIP treatment has been reported in scientific articles, particularly in case studies. With the aim of evaluating the efficacy of GS-441524 treatment based on published scientific literature, a systematic literature review was conducted. Following PRISMA guidelines for this type of study, 12 articles studying the efficacy of GS-441524 were selected. Data from 650 cats with FIP and treated with GS-441524, as a single treatment or in combination, were compiled. The therapeutic efficacy was assessed based on the type of FIP, clinical signs, and administered dosages. The overall treatment success rate in the 650 cases was 84.6%. This rate is positively influenced by the administration of other drugs in combination with GS-441524. It is negatively influenced by cases of wet FIP and complicated cases with neurological signs, as well as cases with both neurological and ocular signs. Combination treatment with other antivirals may be more effective in complicated cases, but further studies are needed to confirm this. The GS-441524 dosages yielding the best efficacy results are 5 to 10 mg/kg orally (or equivalent dosage subcutaneously), but they depend on the type of FIP, severity of clinical signs, and presence of aggravating clinical signs. Higher dosages may be used to prevent relapses, especially in severe cases, but the dosage must be divided in two daily takes to avoid decreased absorption. This synthesis revealed that among the analysed studies, GS-441524 is a promising molecule for FIP treatment, with a high success rate. However, randomized trials are necessary to enable the implementation of objective therapeutic guidelines and tailored to each clinical presentation.
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 it seems promising in FIP treatment. However, its commercialization in Europe is not yet authorized. The use of GS-441524 in FIP treatment has been reported in scientific articles, particularly in case studies. With the aim of evaluating the efficacy of GS-441524 treatment based on published scientific literature, a systematic literature review was conducted. Following PRISMA guidelines for this type of study, 12 articles studying the efficacy of GS-441524 were selected. Data from 650 cats with FIP and treated with GS-441524, as a single treatment or in combination, were compiled. The therapeutic efficacy was assessed based on the type of FIP, clinical signs, and administered dosages. The overall treatment success rate in the 650 cases was 84.6%. This rate is positively influenced by the administration of other drugs in combination with GS-441524. It is negatively influenced by cases of wet FIP and complicated cases with neurological signs, as well as cases with both neurological and ocular signs. Combination treatment with other antivirals may be more effective in complicated cases, but further studies are needed to confirm this. The GS-441524 dosages yielding the best efficacy results are 5 to 10 mg/kg orally (or equivalent dosage subcutaneously), but they depend on the type of FIP, severity of clinical signs, and presence of aggravating clinical signs. Higher dosages may be used to prevent relapses, especially in severe cases, but the dosage must be divided in two daily takes to avoid decreased absorption. This synthesis revealed that among the analysed studies, GS-441524 is a promising molecule for FIP treatment, with a high success rate. However, randomized trials are necessary to enable the implementation of objective therapeutic guidelines and tailored to each clinical presentation.
Description
Keywords
Peritonite Infeciosa Felina GS-441524 Tratamento Eficácia Antivirais Coronavírus Análogo De Nucleósidos Feline Infectious Peritonitis Treatment Efficacy Antivirals Coronavirus Analogue Of Nucleoside