Beraprost and Overall Survival in Cats with Chronic Kidney Disease

SIMPLE SUMMARY: Chronic kidney disease (CKD) is a highly prevalent disorder in senior cats. CKD is commonly diagnosed together with other disorders; therefore, overall survival, based on all-cause death, including complications, is the most important outcome for treatment response in feline CKD. Although researchers have been seeking a pharmaceutical to improve overall survival, unfortunately, they have not discovered it yet. Beraprost (also called beraprost sodium or BPS) is a prostacyclin analogue that has a vasoprotective effect, which is unique and completely different from renin–angiotensin inhibitors. This study demonstrated that beraprost therapy was associated with better overall survival, and the findings shed light on cats suffering with CKD, their owners, and veterinarians in clinical practice. ABSTRACT: Background: Overall survival is the most important outcome for treatment response in feline chronic kidney disease (CKD). Beraprost has been shown to reduce the kidney function decline in cats with International Renal Interest Society (IRIS) stage 2 and 3 CKD. However, the association with prolonged survival has not yet been examined. Objective: To assess the relationship between beraprost and overall survival in cats with CKD in real clinical practice. Animals: Client-owned cats with IRIS stage 3 CKD (n = 134) were evaluated between 2017 and 2020. Methods: A retrospective cohort study based on data from electronic medical records of one hospital. Results: The cohort was divided into “beraprost therapy” and “no beraprost therapy” groups, and survival analyses revealed that overall survival was significantly longer in the beraprost therapy group, using Kaplan–Meier curves (p = 0.004). However, baseline phosphate is known to be an important prognostic indicator and was not well balanced between the two groups. Therefore, a subcohort of 97 cats was selected (those having baseline phosphate <6.0 mg/dL) that allowed for this parameter to be balanced between groups. The survival data in this subcohort were consistent with those of the overall study cohort. Conclusions: In feline patients with CKD, beraprost therapy is associated with better overall survival.