When will Galliprant be available?

RE: When will Galliprant be available?

Andrea Tarr — Sun, 19 Aug 2018 22:11:23 GMT

note that the review's authors are employees of the company that markets Galliprant in the USA. Presumably open access funded by the company.

RE: When will Galliprant be available?

Martin McDowell — Thu, 16 Aug 2018 11:22:57 GMT

From the data you pasted it would suggest albumin levels are their specific concerns although they also add the sentence "Similar monitoring is still recommended with grapipriant and is prudent in any patient on long term medications." as if giving us general advice to check bloods for any patients on any other meds. A little odd I agree to put into the datasheet. I presume the paste is from the datasheet.

RE: When will Galliprant be available?

dred.hall — Mon, 13 Aug 2018 23:10:20 GMT

I've heard the same. I understand the company wants to have sufficient stock available in the UK, and not have an Apoquel-type situation when they launch.

An open access review of the drug is available at https://doi.org/10.1002/vms3.13

RE: When will Galliprant be available?

Andrea Tarr — Thu, 02 Aug 2018 10:30:45 GMT

Early next year, I've heard.

RE: When will Galliprant be available?

Sarah Keir — Sun, 29 Jul 2018 10:03:54 GMT

[quote user="David Mills"]

[quote user="Sarah Keir"]Unlike the NSAIDs where pre-screening lab work is important[/quote]

How many people do this?

[quote user="Sarah Keir"]- is a sulpha drug so are we going to see a flurry of autoimmune conditions[/quote]

See my clinical research abstract from bsava this year

No, is the short answer (2pc side effects, gi only, over 1200 dogs from primary practice)

[/quote]

1. will depend what it says on the data sheet. And why do they have that if it is not supposed to affect the kidneys or liver?

2. Autoimmune conditions - good to know. I used to use a lot of TMP-S antibiotics until I convinced a colleague to use it in a case and it ended up with dry eye that was permanent and the owner couldn't get any eye meds in! Missed BSAVA entirely this year so will move your abstract to the top of the to read pile!

RE: When will Galliprant be available?

David Mills — Sat, 28 Jul 2018 21:11:03 GMT

[quote user="Sarah Keir"]Unlike the NSAIDs where pre-screening lab work is important[/quote]

How many people do this?

[quote user="Sarah Keir"]- is a sulpha drug so are we going to see a flurry of autoimmune conditions[/quote]

See my clinical research abstract from bsava this year

No, is the short answer (2pc side effects, gi only, over 1200 dogs from primary practice)

RE: When will Galliprant be available?

Sarah Keir — Sat, 28 Jul 2018 21:04:48 GMT

Does not seem to be a magic bullet:

"Enter the piprant class of anti-flammatory drugs. Grapiprant is the first priprant anti-inflammatory to come market with its release in 2017. Grapiprant does not suppress prostaglandin production; instead, it interferes with a specific prostaglandin receptor called the EP4 receptor. It is the receptor involved in generating pain and inflammation. By interfering with only the EP4 receptor, grapiprant suppresses pain with no effect on the kidney, blood clotting mechanisms, or GI tract. In this way, the side effects and drug reactions that have been concern for patients on NSAIDs should not be concerns with grapiprant.

How this Medication is Used

Grapiprant is used once a day to manage pain in dogs.

Unlike the NSAIDs where pre-screening lab work is important to be sure the patient does not have a kidney or liver condition that could be exacerbated by an NSAID, pre-screening labs are theoretically not necessary with grapiprant. With NSAIDs, periodic monitoring blood tests are recommended to be sure the patient's metabolic situation has not changed and that NSAIDs are still safe. Similar monitoring is still recommended with grapipriant and is prudent in any patient on long term medications.

Side Effects

Most side effects are GI related: diarrhea, appetite loss, vomiting. It is not uncommon for minor intestinal upset to be seen in patients starting grapiprant but symptoms were mild and transient.

Albumin is an important blood protein. It is involved in transporting materials through the body. Albumin levels can be reduced with grapiprant use. This is probably not an important side effect in a normal animal but if a patient already has a disease that lowers blood albumin, it is probably best not to lower albumin further.

Grapiprant is a sulfa-based medication. Sulfa-based medications of other types have been associated with reduced tear production as well as some immune-mediated conditions. No such conditions were seen in any of the test dogs studied prior to release of grapiprant.

Interactions with other Drugs

Grapiprant use in combination with corticosteroids (prednisolone, dexamethasone, triamcinolone, etc.) has not been studied and the manufacturer recommends against concurrent use of these medications. Similarly, grapiprant should not be used with NSAIDs.

Grapiprant is highly protein-bound and this is a potential problem when it is used with other highly protein-bound medications.

Grapiprant is a highly protein-bound medication. What that means is that in the bloodstream, 95 percent of grapiprant is transported bound to an albumin (carrier protein) molecule while the rest is floating free in the bloodstream. The five percent that is floating free is the active portion. As the free portion is removed from the body by the liver, the blood protein gives up what it is carrying to replace it. This continues until all of the drug has been removed by the liver. Problems can result when other highly protein-bound drugs are used concurrently. The drugs will "fight" over places on the albumin carrier molecule (imagine a bus with only a certain number of seats and too many passengers trying to fill them). The drug with the higher protein affinity will be carried and the other drug is left floating free and active, meaning there will be much more active drug than normal. This can lead to toxicity problems. Grapiprant has not been tested with other drugs in this way so how significant an issue this is remains to be seen.

Concerns and Cautions

Grapiprant should not be given with food. It will not absorb into the body predictably.

Grapiprant is not approved for dogs under nine months of age and cannot be accurately dosed in dogs under eight pounds of body weight.

Grapirant has also not been evaluated in breeding, pregnant, or nursing dogs.

Unlike NSAIDs, grapiprant has no use against fever.

Grapiprant has only been tested in healthy dogs, though in healthy dogs given 15 times the recommended dose for nine months no serious consequences resulted. This represents a broad safety margin.

Given that grapiprant does not interfere with kidney or GI blood flow, it should theoretically be safe to give in dogs with kidney insufficiency or with intestinal disease but theory is still theory. Again, grapiprant has only been tested in healthy dogs.

Grapirant has not been studied in dogs with heart disease. This is important because there are a lot of EP4 receptors in heart tissue. The consequences of this are unknown.

Monitoring blood tests are recommended when grapirant is used long term."

- only tested in healthy animals, not the target population of older animals with concurrent disease along with their osteoarthritis

- still need to do blood tests, why?

- is a sulpha drug so are we going to see a flurry of autoimmune conditions

- needs to be given without food - this may be a compliance problem

The drug rep is going to love our meeting!

RE: When will Galliprant be available?

Sarah Keir — Sat, 28 Jul 2018 20:52:50 GMT

Interesting! Thanks for the heads up! However will be eagerly awaiting the safety trials - as far as I am aware there is no evidence that COX-2 preferential NSAIDS are any safer than non-preferential COX inhibitors so would like to see where this fits in.

RE: When will Galliprant be available?

Martin McDowell — Fri, 27 Jul 2018 13:52:04 GMT

Exactly Chris Geddes, I'm presuming it will be promoted there.

RE: When will Galliprant be available?

Chris Geddes — Fri, 27 Jul 2018 13:31:24 GMT

LVS would be a good launch platform wouldn't it?