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Efficacy of GS-441524 for Feline Infectious Peritonitis: A Systematic Review (2018-2024).

Emma Gokalsing¹, Joana Ferrolho¹, Mark S Gibson¹

¹Vasco da Gama Research Centre (CIVG), Department of Veterinary Sciences, Vasco da Gama University School, Avenida José R. Sousa Fernandes 197 Lordemão, 3020-210 Coimbra, Portugal.

Pathogens (Basel, Switzerland)

|July 30, 2025

Summary

GS-441524 shows promise for treating feline infectious peritonitis (FIP), achieving an 84.6% success rate in a systematic review. Combination therapy and adjusted dosages improved outcomes, but more research is needed.

Keywords:

GS-441524 antiviral treatment efficacy feline coronavirus feline infectious peritonitis molnupiravir remdesivir

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Area of Science:

Veterinary Medicine
Virology
Pharmacology

Background:

Feline infectious peritonitis (FIP) is a severe and often fatal viral disease in cats.
GS-441524, an adenosine analogue, demonstrates antiviral properties and potential for FIP treatment.
Commercial availability of GS-441524 is limited in certain regions.

Purpose of the Study:

To systematically review and evaluate the published literature on the efficacy of GS-441524 for treating FIP.
To assess treatment success rates based on FIP form, clinical signs, and dosage regimens.
To identify optimal dosing strategies and potential benefits of combination therapy.

Main Methods:

A systematic review was conducted using PubMed, ScienceDirect, and Google Scholar for studies from 2018 onwards.
Eleven studies encompassing 650 FIP cases treated with GS-441524 were included, adhering to PRISMA guidelines.
Efficacy was analyzed based on FIP presentation, clinical outcomes, and administered dosages.

Main Results:

The overall treatment success rate for GS-441524 was 84.6%.
Higher success rates were observed with combination antiviral therapy and lower rates in wet FIP or neurological cases.
Optimal dosages ranged from 5-10 mg/kg daily, with adjustments for severity and complications; higher doses or split dosing may be necessary.

Conclusions:

GS-441524 is a highly effective treatment for FIP with a significant success rate.
Combination therapy may enhance outcomes in complicated FIP cases.
Further randomized controlled trials are essential to establish evidence-based treatment protocols for diverse FIP presentations.