A Double-blind, Placebo-controlled, Multicenter, Prospective, Randomized Study of Beraprost Sodium Treatment for Cats with Chronic Kidney Disease

Background: Chronic kidney disease (CKD) is a common progressive and irreversible disease in cats. The efficacy and safety of beraprost sodium (BPS) in cats with CKD have not been evaluated. Hypothesis/Objectives: To evaluate the efficacy and safety of BPS in the treatment of cats with CKD, as compared to placebo. Animals: Seventy-four client-owned cats with naturally occurring CKD. Methods: Double-blind, placebo-controlled, multicenter, prospective, randomized trial. The cats received BPS (55 lg/cat) or a placebo PO q12 h for 180 days. The primary endpoint was prospectively defined as a change in the serum creatinine (sCr), serum phosphorus-to-calcium ratio or urine specific gravity (USG). Results: The sCr increased significantly (P = 0.0030) in the placebo group (mean +/- SD: 2.8 +/- 0.7 to 3.2 +/- 1.3 mg/dL) but not in the BPS group (2.4 +/- 0.7 to 2.5 +/- 0.7 mg/dL). The difference between the groups at day 180 was significant (0.8 mg/dL, 95% CI: 0.2 to 1.3 mg/dL, P = 0.0071). The serum phosphorus-to-calcium ratio was significantly (P = 0.0037) increased in the placebo group (0.46 +/- 0.10 to 0.52 +/- 0.21 mg/dL) but not in the BPS group (0.50 +/- 0.08 to 0.51 +/- 0.11 mg/dL). There was no significant change in the USG in either group. An adverse event judged as being treatment-related included vomiting that occurred in 1 case in the placebo group. No clinically relevant change was observed in the CBC and other blood chemistry tests. Conclusions and Clinical Importance: Beraprost sodium treatment was well tolerated and safe in cats with CKD. BPS inhibited the reduction in renal filtration function as measured by sCr increase.