Clinical outcomes of legal antiviral therapy for FIP

Legal treatment of feline infectious peritonitis in the Netherlands

S. Knies et al.

Introduction

Feline infectious peritonitis (FIP) was historically fatal until the advent of antivirals. Following legalization of GS-441524 in the Netherlands, prospective data on real-world treatment outcomes were needed to assess efficacy, safety, and prognostic factors.

Materials and Methods

Prospective multicentre clinical study of 127 client-owned cats with confirmed or suspected FIP treated with oral GS-441524 ± intravenous remdesivir. Standardized diagnostic criteria, dosing protocols, monitoring schedules, and outcome measures were applied across centers.

Results

Overall survival was ~78–80%, with survival strongly dependent on early response. Cats surviving the first 8 days had a 98% one-year survival rate. Ocular FIP carried the best prognosis, while neurological FIP had lower survival. Elevated bilirubin and creatinine at presentation were negative prognostic indicators. Adverse effects were mild and primarily gastrointestinal.

Limitations

Short follow-up in some cases, heterogeneous disease severity, and reliance on clinical rather than virologic confirmation in all suspected relapses.

Conclusion

Legally prescribed GS-441524 is highly effective and well tolerated. Early disease severity, rather than treatment failure, determines outcome. Structured monitoring is critical to distinguish relapse from transient abnormalities.

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