Efficacy in kidney disease

The efficacy of Fortekor (benazepril hydrochloride) in kidney disease has been proven in the BENRIC (Benazepril in Renal Insufficiency in Cats) study¹. This large, prospective, randomised, double-blinded trial studied 192 cats with chronic kidney disease (CKD) receiving a renal diet, and compared effects of Fortekor versus placebo. Another prospective, randomised, double-blinded trial of 61 cats with CKD also showed the benefits of Fortekor over placebo (Mizutani trial)². These studies showed that the greatest benefits are seen in the most proteinuric cats. However positive effects on renal haemodynamics are likely to be beneficial even before proteinuria is detected.

The studies showed that in cats with CKD:

• Fortekor significantly reduces proteinuria
• Fortekor improves appetite and weight gain
• Fortekor helps to slow disease progression and improve survival
• Fortekor helps improve quality of life

Fortekor significantly reduces proteinuria (UP/C) 

Proteinuria is a risk factor for reduced survival. Any treatment that reduces proteinuria is, therefore, likely to slow disease progression and improve survival. ACE inhibitors are very effective in reducing proteinuria, and ACE inhibitors are routinely prescribed in man to slow disease progression. Fortekor prevents glomerular hypertension and thus reduces proteinuria.

• BENRIC: Fortekor produced a significant reduction in proteinuria (UP/C), which occurred very quickly (by day 7)¹ 
• Mizutani: UP/C was significantly lower in the Fortekor group after 3 and 6 months²

Fortekor has better overall efficacy than placebo

Vets assessed the overall efficacy of Fortekor as significantly better than a placebo, with more cats having ‘good’ efficacy and fewer cats having ‘insufficient’ efficacy.

Fortekor improves appetite and weight gain

Poor appetite is common in cats with CKD. Fortekor has been shown to improve appetite and weight gain in normal cats (cats treated for 1 year at 2mg/kg).³ In the BENRIC trial, Fortekor increased the appetite, particularly in cats with more advanced disease¹.

Fortekor helps to slow disease progression and improve survival

In the Mizutani trial, whatever their IRIS stage at inclusion, Fortekor reduced the worsening rate, i.e. fewer cats progressed to IRIS stage 4, death or withdrawal due to worsening CKD, during the study. At the end of the study (after 6 months), the survival rate was higher for Fortekor (88%) than for placebo (70%). Fewer cats in the Fortekor group progressed from IRIS stage 2/3 to IRIS stage 4 (93% vs. 73%).

In the BENRIC study, there was a trend to better survival in the Fortekor-treated cats, although this did not quite reach statistical significance.

Fortekor improves quality of life

In the Mizutani trial, more cats were rated as having improved at the end of the study (34% vs. 21%). In the BENRIC study the quality of life scores in the cats with severe disease (UP/C>1) were higher (average 2.8 vs. 2.0).

References: 1. J.N. King et al. (2006). J Vet Intern Med, 20, 1054-1064. 2. H. Mizutani et al. (2006). J Vet Intern Med, 20, 1074-1079. 3. S. Witte et al. (2003). Proceedings 21^st Annual ACVIM Forum.