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Tierarztl Prax Ausg K Kleintiere Heimtiere 2023; 51(05): 351-360.
DOI: 10.1055/a-2147-3999
Übersichtsartikel

Optionen zur Therapie der felinen infektiösen Peritonitis – früher und heute

Options for treatment of feline infectious peritonitis – previously and today
Daniela Krentz
1   Medizinische Kleintierklinik der Ludwig-Maximilians-Universität München
,
Michèle Bergmann
1   Medizinische Kleintierklinik der Ludwig-Maximilians-Universität München
,
Sandra Felten
1   Medizinische Kleintierklinik der Ludwig-Maximilians-Universität München
,
Katrin Hartmann
1   Medizinische Kleintierklinik der Ludwig-Maximilians-Universität München
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Zusammenfassung

Die feline infektiöse Peritonitis (FIP) ist eine der häufigsten Infektionskrankheiten bei Katzen und verläuft unbehandelt tödlich. Bisher gibt es in Deutschland keine legal verfügbare wirksame Therapie. Therapieoptionen reichen von der symptomatischen Therapie (z. B. Glukokortikoide, Propentofyllin) über immunmodulatorische Ansätze (z. B. Interferone, Polyprenyl-Immunstimulanz) bis hin zur antiviralen Therapie mit einem Protease-Inhibitor (z. B. GC376) oder Nukleosid-Analoga (z. B. GS-441524, Remdesivir). Die symptomatische Therapie führt nicht zur Heilung der FIP, sondern nur zu einer kurzzeitigen Verbesserung der klinischen Symptome bei wenigen Katzen. Auch eine immunmodulatorische Therapie stellte sich als wenig erfolgversprechend heraus. Die antiviralen Medikamente GS-441524 und GC376 waren in mehreren Studien hochwirksam und konnten das Leben vieler an FIP erkrankten Katzen retten. Beide Wirkstoffe sind aktuell in Deutschland nicht zugelassen und können von Tierärzten nicht legal angewendet werden. Katzen dürfen aktuell nur in wenigen Ländern (z. B. Großbritannien und Australien) legal mit GS-441524 therapiert werden. GS-441524 wird daher von Katzenbesitzern in vielen anderen Ländern über den Schwarzmarkt bestellt und in Eigenregie angewendet. Dieser Artikel gibt eine Übersicht über verfügbare Therapieoptionen und einen Ausblick zur legalen Anwendung wirksamer antiviraler Medikamente.

Abstract

Feline infectious peritonitis (FIP) is one of the most common infectious diseases in cats that is fatal when untreated. So far, there is no legally available effective treatment in Germany. Treatment options include only symptomatic treatment (e. g. glucocorticoids, propentofylline), immunomodulatory approaches (e. g. interferons, polyprenyl immunostimulant), and antiviral chemotherapy with protease inhibitors (e. g. GC376) or nucleoside analogues (e. g. GS-441524, remdesivir). Symptomatic treatment does not cure FIP but may lead to a short-term improvement of clinical signs in a subset of cats. Immunomodulatory treatment has also not shown to be very promising. In contrary, the antiviral compounds GS-441524 and GC376 exhibited significant efficacy in several studies and their use saved the lives of many cats suffering from FIP. However, both agents are currently not licensed and thus cannot be legally administered by veterinarians in Germany. Legally, cats may only be legally treated with GS-441524 in a few countries (e.g. Great Britain and Australia). In other countries, GS-441524 is imported by cat owners via the black market and administered on their own. This article provides an overview of the available treatment options and an outlook on the legal use of effective antiviral drugs.

Schlüsselwörter

FIP - Behandlung - antivirale Chemotherapie - GS-441524 - FCoV - felines Coronavirus

Key words

FIP - treatment - antiviral chemotherapy - GS-441524 - FCoV - felines Coronavirus


Publikationsverlauf

Eingereicht: 11. Februar 2023

Angenommen: 31. März 2023

Artikel online veröffentlicht:
13. November 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
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