Use of GS-441524 in FIP

RE: Use of GS-441524 in FIP

Bob Russell — Mon, 06 Jul 2020 09:57:31 GMT

https://ccah.vetmed.ucdavis.edu/sites/g/files/dgvnsk4586/files/inline-files/Inappropriate%20use%20of%20GS.pdf

This suggests that feline coronavirus is able to develop resistance to the drug. I was surprised to find it is closely related to Remdesivir.

If we are 'allowing' a largely untested antiviral drug that could promote resistance to the main drug thought to be helpful in COVID-19 then perhaps we need to be reporting its use/misuse in a similar way we would antibiotics.

RE: Use of GS-441524 in FIP

David Mills — Mon, 06 Jul 2020 09:30:52 GMT

Fairly freely available in London from some clinics apparently, assume imported from the US, but not had the time or inclination to find out fully.

RE: Use of GS-441524 in FIP

Bob Russell — Mon, 06 Jul 2020 09:02:34 GMT

The vet is out of order and the client is committing an offence by importing it.

It should be reported to the VMD for action but obviously this is not going to make you the clients friend! Up to you really but the VMD will act if they have enough information. I have been surprised how seriously they deal with these situations when they have the right deatails.

RE: Use of GS-441524 in FIP

Anthony Dennison — Sat, 04 Jul 2020 17:52:41 GMT

Hi everyone,

Just resurrecting this thread as we have had a client that has sourced this drug herself through a vet in the US and has started administering it herself. Told the branch vet about it and gave them information she had received with the medication. It has only come to my attention now as I was completing insurance paperwork for the cat.

What are the legalities regarding this? We did not provide a written prescription for the drug, so if a US vet has prescribed it remotely this is against RCVS guidelines, also the importation of a drug such as this needs to be looked in to also.

Can we just turn a blind eye and let it happen or should we investigate further and speak to the client about her source of the drug?

RE: Use of GS-441524 in FIP

Christopher Saul — Wed, 04 Dec 2019 14:19:36 GMT

There is some evidence for efficacy in the case of GS-441524. There is some hope that in the future a commercially available FDA approved product might become available for import under license from the USA, though of course that takes time.

https://journals.sagepub.com/doi/epub/10.1177/1098612X19825701

The main problem is obtaining GS-441524 that is not from a black market source.

I think for my case we will now not be going down that route anyway!

RE: Use of GS-441524 in FIP

Bob Russell — Wed, 04 Dec 2019 13:03:39 GMT

Not sure that availability gets round the fact that these are experimental treatments without proper clinical trials.

A desperate client does not get round the massive problems associated with trying something because someone else has tried it and thinks it may work. This stuff is being used experimentally on Ebola patients. It is available on the black market, manufactured in China. As far as I can see there has been one study. This may turn out to be a game changer as are some cancer treatments but this needs proper trials not client demand. The internet is peddling this as the saviour of all FIP cats. There is not even a formulated drug formulation and it does not even have a proper name.

It is not our place to experiment on our patients without very solid evidence that clearly offers benefit.

(Edit: It is not our place to experiment on our patients, full stop!)

RE: Use of GS-441524 in FIP

Christopher Saul — Wed, 04 Dec 2019 12:20:32 GMT

Hello everyone.

Sorry for bringing an old thread to the fore but I have an owner of a highly suspicious effusive FIP case, and she would desperately like to use a novel treatment (don't they all; it is understandable)...

I was wondering if anyone has any experience of ether of these sources...

http://glixxlabs.com/chemical-products/bioactive-screen-leads-p6/GLXC-12904

https://aobious.com/aobious/search?controller=search&orderby=position&orderway=desc&search_query=GS-441524&submit_search=

I'd be grateful of any thoughts.

Best wishes,

Chris

RE: Use of GS-441524 in FIP

Tom Ward — Fri, 17 May 2019 19:47:19 GMT

Oo thanks for that Kate. The abdo mass is granulomatous inflammation so we’re running a Zeihl Neillson stain as we speak. Pleural fluid was PCR positive for FCoV though... Cat seems much improved though a week after chest draining!

RE: Use of GS-441524 in FIP

Kate Richardson — Tue, 14 May 2019 12:06:31 GMT

Hot off the press

https://journals.sagepub.com/doi/pdf/10.1177/1098612X19848455

RE: Use of GS-441524 in FIP

Wren — Tue, 14 May 2019 08:53:32 GMT

Also, we haven't been able to get hold of DMSO for the last 18mths or so.

RE: Use of GS-441524 in FIP

Tom Ward — Mon, 13 May 2019 22:13:22 GMT

Thanks all for your help and advice. Thought it was dodgy ground!

RE: Use of GS-441524 in FIP

Evelyn Barbour-Hill — Mon, 13 May 2019 13:58:57 GMT

[quote user="Tom Ward"]"We supply this particular compound as a solid (powder) as a purity of 98% for R&D purposes only. [/quote]

So to use it would be experimentation, which would require a Home Office licence.

RE: Use of GS-441524 in FIP

Kate Richardson — Mon, 13 May 2019 13:52:57 GMT

I believe it is imported from China and think you would be on very dodgy ground from discussions we have been having on the ISFM forum. A couple of quotes from the discussion:

"can I urge caution and refer people to Pedersen’s statement below. I do not feel it is ethical to treat with drugs via this route given the current evidence. I think we must be patient.

‘We have also published our initial research studies on a second compound (nucleoside analog GS-441524- Gilead Sciences, Inc.) and these results can be found at the Veterinary Microbiology journal open access article website (https://eur02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.sciencedirect.com%2Fscience%2Farticle%2Fpii%2FS0378113518301603&data=02%7C01%7C%7C2bd8bfb073954ef794b508d6ccc4c5ba%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C636921542828209802&sdata=5SPn1RJev48iUVE5zjhVRwkbUhI5u%2BbNVTDkeVWYLL0%3D&reserved=0). We are in the process of publishing field trial results with this very promising viral RNA inhibitor in the Journal of Feline Medicine and Surgery. Similar reports will be forthcoming as other drugs go through experimental and field testing. We are convinced based on our research that anti-viral drugs of the type currently used for HIV/AIDS and hepatitis C virus (HCV) infection, and in test phase for Ebola, Marburg, MERS, SARS, and bat coronavirus infections will provide the best chance for curing this terrible disease of cats. These drugs include protease inhibitors, nucleoside analogs, RNA polymerase inhibitors, as well as other classes of anti-viral drugs that might target specific aspects of RNA virus replication.
Unfortunately, the research phase for these drugs has ended and no more field trials are contemplated at this time and no drug is legally available for veterinarians or owners. The processes involved in getting these new drugs FDA approved and commercialized is long and it may be 2-5 years before these or similar drugs find their way to veterinarians for use in the treatment of cats with FIP. This delay has created a vigorous and growing black-market for drugs like GC376 and GS-441524. GC376 is being illegally produced in China and sold through subsidiaries in Europe and US. GS-441524 is also being produced illegally in China but has not yet appeared on the market. Manufacturers and secondary suppliers state that these drugs are to be used for research purposes only and not for use veterinary or human applications but are well- aware of their great demand and willingness of many cat owners to pay an extremely high price for them. We have no idea of the purity or biological activity of these black-market compounds and veterinarians have no experience with preparing them for treatment or using them to treat cats with FIP. The treatment period for naturally occurring FIP is a minimum of 12 weeks, not the two weeks based on treating cats with experimental FIP. Many owners have spent thousands of dollars on black-market drugs and have had to stop treatment before this time, even though their cats are responding, due to the cost. The FIP will relapse if treatment is stopped too
soon. Owners and veterinarians using should be also aware of possible legal and ethical consequences arising from the use of black-market drugs"

"rather expensive , 1gm ballpark £5k + vat to us - enough for 100 day course at 2mg kg for
> 5kg cat "

RE: Use of GS-441524 in FIP

Tom Ward — Mon, 13 May 2019 13:20:37 GMT

[quote user="Kate Richardson"]

Not available in the UK yet and very expensive I believe

[/quote]

Hi, thanks. I received this from a company in Berkshire:

"We supply this particular compound as a solid (powder) as a purity of 98% for R&D purposes only. We cannot give any recommendations about reconstitution (although it is soluble in DMSO) or dosage or even effectiveness.

What I can tell you, however, is that we have sold this to a number of vets for the treatment of FIP in cats. One customer bought over 2 g and has been very happy with the results."

so the powder is available in the UK, but needs re-formulating into an injectable - not sure where the VMD would stand on this also.

RE: Use of GS-441524 in FIP

Kate Richardson — Mon, 13 May 2019 11:25:33 GMT

Not available in the UK yet and very expensive I believe