Much less publicized than Covid-19, another type of coronavirus has also spread in recent years among our domestic felines. Feline infectious peritonitis, or FIP, is very common in cat-dense environments and is almost always fatal. But a new oral treatment has just been authorized on the French market, more than 60 years after the discovery of the disease.
Few tangible figures allow us to understand the state of the situation, but it is still possible to make an estimate. According to Karim Khoukh, director of the Delpech pharmacy in Paris, 80% of cats living in communities in shelters or catteries are likely to be healthy carriers of the FCoV, endemic and benign in most cases, and around 20% of those who live alone in private homes. Thus, it is estimated that more than 1 in 2 cats are affected.
However, the chances of a mutation appearing in the virus genome are minimal. Around 2% of infected felines develop FIP, which still corresponds to more than 150,000 individuals of the 15 million cats present in France. This causes a wide variety of symptoms (fever, apathy, weight loss, glued eyes, internal inflammation, etc.) and, therefore, causes the death of the carrier cat if no treatment is administered.
The latter specifies that the mutation is generally more likely to occur when the environment is more stressful, particularly on overcrowded farms. A certain genetic sensitivity also seems to come into play: studies show that Siamese, Abyssinians, Bengalis and Persians, for example, have genetic predispositions and are therefore overrepresented.
A new treatment finally authorized
And since there was no treatment, many were tempted to supply themselves on the black market with molecules not authorized in France, in particular supplied by China.
“It is estimated that approximately 1 in 2 medicines in the world are counterfeit and the business related to FIP treatments is very profitable, given the expected prevalence of the disease,” laments Nathalie Baillié, general director of the FrancePrep high school, which also calls veterinarians and breeder associations – such as Loof – to address the issue to avoid the use of black market products.
These sometimes questionable treatments are offered at high prices, which can inflate the bill to more than 2,000 euros to perform a complete treatment on a cat. On the other hand, these solutions offer varying levels of active ingredients, which can lead to overdose or underdose.
Fortunately, the National Veterinary Medicines Agency (ANMV) and the National Health Security Agency (ANSES) finally authorized the use of a new molecule, paving the way for the commercialization of a legal treatment in compounded preparation. The two leaders in veterinary compounds in France, FrancePrep and Delpech Paris, work together with the ANSES and specialists in this pathology for the correct use of this treatment that is already used in many countries such as the United States, the United Kingdom or Australia. since 2021.
The result of research by the American laboratory Gilead, “the molecule is used by the Australian laboratory Bova in the context of oral treatment,” adds Florence Tornabene, general director of FrancePrep.
GS-441524 is available in France as a medication in the form of an oral suspension. The chances of curing FIP with this treatment are around 85%.
Recently, all professionals in the sector participated in the latest congress of the French Association of Pet Veterinarians (AFVAC) organized in Lyon from November 21 to 23. The opportunity for pharmacists to raise awareness among veterinarians about the use and availability of the new treatment.
Since this summer, Delpech pharmacy has also been marketing a master preparation of this remdesivir analogue derivative, which remains to date the only molecule authorized for the treatment of feline infectious peritonitis (FIP). A very recent European regulation restricts, or even prohibits, the use of certain antimicrobials outside the AMM (Marketing Authorization). But exceptions are granted in the case of pets.
“Several studies since 2019 – mainly in the United States – have demonstrated the effectiveness of this molecule and the scientific council of the European Medicines Agency has issued a favorable opinion for the treatment of FIP,” explains Karim Khoukh.
Mutation risks not excluded.
If French veterinarians did not yet have authorization to use the molecule, it is because the Gilead laboratory preferred to use it in humans (the Covid-19 emergency was necessary). Therefore, no marketing authorization was requested and authorization for its operation was never issued.
If the side effects reported to date are minimal (some cases of mild diarrhea), the risks of developing mutations should not be taken lightly. “We have already treated more than 1,000 cats and we have no information about the lack of effectiveness,” says Karim Khoukh. There is also no evidence on the risks of transmission to humans, but we must monitor possible mutations, because the risk, although very high. low, it exists.”
Especially since this treatment created by Bova has not been subject to a Marketing Authorization (MMA).
Treatment should follow international recommendations regarding treatment duration (84 days), dosage depending on the typology of the FIP form and the weight of the cat.
“This must be supervised, because we must not interrupt the treatment during the course and, above all, avoid at all costs administering this treatment for preventive purposes,” warns Nathalie Baillié. Some catteries that have lost cats to this disease may be tempted by this practice. This medicine is now authorized with a prescription from a veterinarian and only on the basis of a certain diagnosis can the cat be treated.
“Joy and relief” among veterinarians
“The veterinarians were defenseless before the FIP and knew that there were illegal treatments on the black market,” describes Youcef Boukaache, veterinarian at Delpech Pharmacy. This would also have damaged the trust placed in certain veterinarians “who had to explain that this pathology is fatal and they have no treatment to offer.”
“This news was received with great joy and relief by veterinarians who had been in a very complicated situation for years,” confirms Maxime Kurtz, veterinarian and head of the “Feline Infectious Peritonitis” subcommittee of the Loof Scientific Committee.
He himself was faced with this type of case and advised resorting to treatments on the black market, being aware of the risk involved. “These substances are not recognized as medicines, I cannot prescribe them,” he explains. And it is this legal vagueness that allows them to be put on sale, although injecting it yourself into your own cat is still illegal.
Therefore, the treatments authorized in France are administered under a medical prescription, which makes therapeutic monitoring much more supervised. For Maxime Kurtz, the majority of French people, however, “trust veterinary professionals” and the phenomenon of administering preventive treatment should be minimal given its prohibitive cost.
It is still a prohibitive price
“It is a true therapeutic revolution and an opportunity for many owners of sick cats,” congratulates Maxime Kurtz, delighted to see that the veterinarian is finally once again at the center of the treatment of this disease. The only obstacle that could still convince some French to risk turning to the parallel market: the price.
“Resellers like CureFIP often buy molecules in China that are subject to fewer regulations than in Europe, which allows them to play with prices,” denounces Youcef Boukaache. A “very well organized network that has recently aligned with our lower prices” to remain competitive.
The Delpech pharmacy assures that it can keep the overall cost of the treatment “below 1,000 euros for a cat of average weight” and adds that it has “no limit” in terms of production capacity. “If necessary, we can reach 1,000 preparations a day,” promises Youcef Boukaache.
“The cost is still quite high, because access to the molecule is still very expensive,” says Nathalie Baillié. If FrancePrep does not rule out a price drop in the coming years, it should not be “significant.” Other avenues are also being considered with pet insurers to ensure that these costs are taken into account in their guarantees.
Source: BFM TV
