EXPRESS: High-dose induction therapy and treatment termination criteria for feline infectious peritonitis with remdesivir and GS-441524.

High-dose FIP induction therapy with biomarker monitoring may enable treatment termination before 12 weeks.

This study evaluated high-dose induction therapy for feline infectious peritonitis (FIP) using remdesivir and GS-441524, with focus on early treatment termination criteria. Thirty cats received high-dose induction (≥20 mg/kg) followed by maintenance therapy (12-15 mg/kg), with treatment duration guided by clinical signs and biomarker normalization. Serum amyloid A (SAA) and alpha-1 acid glycoprotein (α1AG) were monitored as indicators of disease improvement. Treatment was discontinued when clinical signs resolved and both SAA <6 mg/L and α1AG ≤0.5 g/L were maintained for two consecutive weeks before or at 12 weeks. Twenty-nine of 30 cats (96.7%) survived, with 22 cats (75.9%) meeting termination criteria before 12 weeks (median: 54 days). No relapses occurred during treatment or 3-month follow-up. Results suggest that high-dose induction therapy and biomarker-guided treatment termination may allow shortened treatment duration while maintaining efficacy, though adverse effects were not observed.

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