Randomized, Placebo Controlled Study of the Effect of Propentofylline on Survival Time and Quality of Life of Cats with Feline Infectious Peritonitis

Abstract

Background: Currently there is no drug proven to effectively treat cats with feline infectious peritonitis (FIP). Hypothesis: Propentofylline (PPF) can decrease vasculitis, and therefore prolong survival time in cats with FIP, and increase their quality of life.Animals: Twenty-three privately owned cats with FIP. Methods: Placebo-controlled double-blind trial. FIP was confirmed by histology or immunostaining of feline coronavirus (FCoV) antigen in effusion or tissue macrophages or both. The cats were randomly selected for treatment with either PPF or placebo. All cats received additional treatment with glucocorticoids, antibiotics, and low molecular weight heparin according to methods.Results: There was no statistically significant difference in the survival time of cats treated with PPF (8 days, 95% CI 5.4-10.6) versus placebo (7.5 days, 95% CI 4.4-9.6). The median survival time of all cats was 8 days (4-36 days). There was neither a difference in quality of life (day 7, P = .892), in the amount of effusion (day 7, P = .710), the tumor necrosis factor-alpha (TNF-a) concentration (day 7, P = .355), nor in any other variable investigated in this study, including a complete blood count, and a small animal biochemistry profile.Conclusions and Clinical Importance: This study did not detect an effect of PPF on the survival time, the quality of life, or any clinical or laboratory parameter in cats with FIP. Therefore, PPF does not appear to be an effective treatment option in cats with a late stage of the disease FIP.

The nucleoside analog GS-441524 strongly inhibits feline infectious peritonitis (FIP) virus in tissue culture and experimental cat infection studies

“…After two weeks of treatment all 10 cats were well back to normal health and the treatment stopped. Although no uninfected/untreated control cats were used in the study, spontaneous recovery is extremely uncommon among either experimentally induced (Pedersen et al, 2014) or naturally-occurring FIP (Ritz et al, 2007;Fischer et al, 2011). The results of this cat infection study mirrored our previous experience with a 3C-like protease (Kim et al, 2016).…”

Potent inhibition of feline coronaviruses with peptidyl compounds targeting coronavirus 3C-like protease

“…Other agents that have been used include interferons, tumor necrosis factor-α inhibitor, propentofylline, and polyprenyl immunostimulant (Ishida et al, 2004; Legendre and Bartges, 2009; Ritz et al, 2007). However, the therapeutic efficacy of those immune modulating agents was shown to be ineffective or needs further investigation in controlled trials (Fischer et al, 2011; Ritz et al, 2007). Ribavirin was reported to reduce the replication of FIPV with IC 50 of 10 μM and TC 50 of 69 μM, and a later study using specific pathogen free cats infected with FIPV showed that ribavirin treatment at 16.5 mg/kg was not effective at reducing fatality or severity of symptoms (Weiss et al, 1993).…”

An update on feline infectious peritonitis: Diagnostics and therapeutics

“…Tumor necrosis factor (TNF) inhibitors have been used for some time to alleviate some of the signs of FIP. One of the most popular of these drugs is pentoxyfilline (Fischer et al, 2011). Pentoxyfylline was widely used in FIP because of its use in controlling vasculitis in humans, vasculitis being an important component of the pathophysiology of FIP.…”

“…Pentoxyfylline was widely used in FIP because of its use in controlling vasculitis in humans, vasculitis being an important component of the pathophysiology of FIP. A study of 23 cats with proven FIP failed to detect an effect of pentoxyfylline on the survival time, the quality of life or any FIP-associated clinical or laboratory parameters (Fischer et al, 2011).…”