On November 15, 2022, the Food and Drug Administration (FDA) granted conditional approval for Panoquell-CA1 (fuzapladib sodium for injection), the first available medication for the management of clinical signs associated with acute onset of pancreatitis in dogs. Before this medication’s conditional approval, the disease was managed only via supportive care. Supportive care typically includes fluids, anti-emetics, and pain medication.
The prevalence of pancreatitis is unknown and causes vary widely. Mild forms of pancreatitis have a good prognosis when treated aggressively. Dogs that are not treated, however, may progress to the hemorrhagic form and suffer many serious consequences, including recurrent pancreatitis, diabetes mellitus, exocrine pancreatic insufficiency, and sudden death. Dogs that received Panoquell-CA1 had a statistically significant reduction in MCAI-5 scores as compared to the control group.
How Does Panoquell-CA1 Work?
Panoquell-CA1 (fuzapladib) is a leukocyte function-associated antigen-1 (LFA-1) activator inhibitor. LFA-1 plays an important role in the process by which leukocytes leave the bloodstream to enter the tissues. Activation of LFA-1 causes circulating neutrophils to remain at the site of inflammation by adhering to the blood vessel wall, allowing for the migration into tissues. Panoquell-CA1 inhibits the infiltration of neutrophilic inflammation within the pancreas that occurs in acute canine pancreatitis. The reduction of pancreatic inflammation that occurs when LFA-1 is inhibited leads to a less severe case and supports faster recovery.
What Are the Most Common Side Effects?
Adverse reactions that occurred most commonly during the pilot field study include anorexia, digestive tract disorders, respiratory tract disorders, hepatopathy, and jaundice. Swelling and bruising may occur at the injection site.
What Else Is Important to Know?
Panoquell-CA1 is available in a multi-dose vial as lyophilized powder that is reconstituted with the provided sterile diluent. Once reconstituted appropriately (4 mg/mL), the medication is stable for 28 days at refrigerated temperatures. Dosing is weight based: 0.4 mg/kg IV once a day for 3 days.
Panoquell-CA1 is highly protein bound and caution should be used with other medications that are highly protein bound (e.g., NSAIDs, anti-emetics, antibiotics, diuretics, behavior modifying medications).
By Alex Gochenauer, PharmD, DICVP, FSVHP, FACA