Drugs That Have Been Suggested for Use in Feline Infectious Peritonitis Cases
Drugs That Have Been Suggested for Use in Feline Infectious Peritonitis Cases
Druga | Comment | ABCD Recommendation (EBM Levelb) |
|---|---|---|
Antivirals | ||
Ribavirin | Active in vitro but toxic in cats | Not recommended (2) |
Vidarabin | Active in vitro but toxic in cats | Likely ineffective (4) |
Human interferon-α, SC, high dose | Although effective in vitro against FCoV, SC treatment did not work in an experimental trial | Ineffective (2) |
Human interferon-α, PO, low dose | No trials. Only acts as immunostimulant if given orally; immune stimulation should be avoided in cats with FIP | Contraindicated (4) |
Feline interferon-ω | Single placebo-controlled study of naturally occurring cases and one uncontrolled study | No benefit was observed (level 1 study); may require further studies in view of anecdotal clinical evidence (4) |
Polyprenyl immunostimulant (investigational drug) | Upregulation biosynthesis of mRNA of TH1 cytokines, uncontrolled study treating three noneffusive cases, long survival | May have some beneficial effect in noneffusive FIP (3); controlled studies required |
Immunosuppressants | ||
Prednisolone/dexamethasone (immunosuppressive doses) | No controlled studies; some cats improved during treatment and survived for several months; does not cure FIP | Currently supportive treatment of choice (3); if effusion is present, dexamethasone intrathoracic or intraperitoneal may be helpful |
Pentoxyfylline | Aimed at treating vasculitis | Ineffective in one case study (4) |
Ozagrel hydrochloride | Thromboxane synthesis inhibitor aimed at treating inflammatory response; only used in two cases with beneficial effect | Controlled studies needed (3) |
Cyclosporin A | Immunosuppressive; no published studies | Not recommended; more directed against cellular immunity than humoral (lack of data) (4) |
Cyclophosphamide | Immunosuppressive; no published studies | Might be considered in combination with glucocorticoids (4) |
Chlorambucil | Immunosuppressive; no published studies | Might be considered in combination with glucocorticoids (4) |
Azathioprine | Toxic in cats; immunosuppressive; no published studies | Not recommended (4) |
Acetylsalicylic acid (aspirin), platelet inhibitory dosage | To treat inflammatory response as well as vasculitis; no published studies | May have some beneficial effect, but adverse effects possible if used in combination with high-dose glucocorticoids |
a Many of the treatments listed represent extra-label use for treatment of FIP. | ||
b Evidence-based medicine (EBM) level 1 = confirmed by randomized controlled clinical trials in target species; EBM level 2 = confirmed by randomized controlled experimental studies in target species; EBM level 3 = supported by case series, other experimental studies, nonrandomized clinical trials; EBM level 4 = based on expert opinion, case reports, studies in other species. Modified, with permission, from Feline infectious peritonitis. Guidelines of The European Advisory Board on Cat Diseases (ABCD), © 2012 Advisory Board on Cat Diseases. | ||