Adeno-associated virus-vectored erythropoietin gene therapy for anemia in cats with chronic kidney disease

J Vet Intern Med. 2023 Nov-Dec;37(6):2200-2210. doi: 10.1111/jvim.16900. Epub 2023 Oct 17.

Abstract

Background: A treatment of chronic kidney disease (CKD)-associated anemia in cats is needed. SB-001 is an adeno-associated virus-vectored (AAV)-based gene therapeutic agent that is administered intramuscularly, causing the expression of feline erythropoietin.

Hypothesis/objective: We hypothesized that SB-001 injection would lead to a sustained increase in PCV in cats with CKD-associated anemia.

Animals: Twenty-three cats with International Renal Interest Society (IRIS) Stage 2 to 4 CKD-associated anemia were enrolled at 4 veterinary clinics.

Methods: In a prospective clinical trial, cats were treated with 1 of 3 regimens of SB-001 (Lo 1.2 × 109 genome copies [GCs] on Day 0; Lo ± Hi [supplemental 2nd dose of 3.65 × 109 GC on Day 42]; Hi 3.65 × 109 GC IM on Day 0) and followed for 70 days.

Results: A response to SB-001 at any time between Day 28 and Day 70 was seen in 86% (95% confidence interval 65, 97%) of all cats. There was a significant (P < .003) increase in PCV from Day 0 to Day 28 (mean increase 6 ± 6 percentage points [pp]; n = 21), Day 42 (8 ± 9 pp; n = 21), Day 56 (10 ± 11 pp; n = 17), and Day 70 (13 ± 14 pp, n = 14). Twelve cats were hypertensive at baseline, 4 of which developed encephalopathy during the study. An additional 6 cats became hypertensive during the study.

Conclusions and clinical importance: Results of this study suggest that SB-001 therapy represents a suitable single injection treatment that can address nonregenerative anemia in cats with CKD. It was generally well tolerated; however, hypertension and encephalopathy developed in some cats as previously described in association with erythropoiesis-stimulating agent therapy.

Keywords: AAV; cats; red blood cells; renal disease.

MeSH terms

  • Anemia* / therapy
  • Anemia* / veterinary
  • Animals
  • Brain Diseases* / veterinary
  • Cat Diseases* / therapy
  • Cats
  • Dependovirus / genetics
  • Erythropoietin* / genetics
  • Erythropoietin* / therapeutic use
  • Genetic Therapy / veterinary
  • Hypertension* / veterinary
  • Prospective Studies
  • Renal Insufficiency, Chronic* / complications
  • Renal Insufficiency, Chronic* / therapy
  • Renal Insufficiency, Chronic* / veterinary

Substances

  • Erythropoietin