Update (June 8, 2026): Capromorelin (Elura) Approved for CKD Weight Loss in Cats — RCT Data

TL;DR

Capromorelin (Elura) is now FDA-approved for management of weight loss in cats with CKD; a 2025 multicenter RCT in 176 cats confirms a mean 5.18% body weight increase versus a 1.65% decrease in placebo at Day 55 (treatment effect +6.81%, P < 0.0001).

What just dropped

• Wofford JA, Milliken MacKinnon A, Heinen E. (2025, J Feline Med Surg) — multicenter, randomized, masked, placebo-controlled clinical trial in 176 cats with CKD and at least 5% unintended weight loss (PMID 41204815, https://pubmed.ncbi.nlm.nih.gov/41204815/)
• Capromorelin group (n = 118): mean body weight change +5.18% at Day 55; placebo group (n = 58): -1.65%; treatment effect +6.81% (95% CI 4.21-9.42), corresponding to +0.25 kg (95% CI 0.15-0.35), P < 0.0001
• Body weight increased progressively over the 55-day treatment period in the capromorelin group and decreased in the placebo group
• Hypersalivation was observed exclusively in the capromorelin group (P < 0.0001); overall adverse event rates were otherwise similar (81.4% capromorelin vs. 70.7% placebo, P = 0.37)
• DailyMed label for Elura (NADA 141-536) notes a precaution for use in cats with cardiac disease due to transient heart rate and blood pressure decreases lasting up to 4 hours after dosing (https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=be4beb9c-f39b-4b23-9c35-f72a049a3250)

Context

Capromorelin acts as a selective ghrelin receptor (GHS-R1a) agonist, mimicking the endogenous orexigenic hormone ghrelin. The canine formulation (Entyce, NADA 141-445) was approved first; the feline formulation Elura (NADA 141-536, 20 mg/mL oral solution) extends the indication to CKD-associated weight loss in cats — one of the most common clinical challenges in feline internal medicine. Weight loss in CKD cats is multifactorial, driven by reduced appetite, nausea, uremia, and cachexia; an appetite-stimulating agent with a demonstrated weight-maintenance effect addresses a meaningful gap.

The +6.81% treatment effect at Day 55 (roughly 2 months) is clinically significant given that patients enrolled had already lost at least 5% of body weight. Hypersalivation is the most drug-specific adverse effect to counsel owners about.

What this changes in capromorelin-canine-appetite-stimulant (https://www.thevoyage.ai/forvets/knowledge/capromorelin-canine-appetite-stimulant)

The canine page covers Entyce and the ghrelin receptor mechanism. Elura represents the same active molecule in a species-appropriate formulation with a distinct feline label and the Wofford 2025 pivotal trial for CKD cats. The key clinical difference in the feline context is the cardiac precaution absent from the canine label (transient bradycardia and hypotension) — a distinction relevant when managing cats with concurrent hypertrophic cardiomyopathy or other structural cardiac disease. This update establishes the feline CKD indication and pivotal trial as a reference anchor for feline clinical questions about capromorelin.

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References

1. Wofford JA, Milliken MacKinnon A, Heinen E. Capromorelin promotes weight gain in cats with unintended weight loss: a randomized, masked, placebo-controlled clinical trial. J Feline Med Surg. 2025;27(11). https://pubmed.ncbi.nlm.nih.gov/41204815/
2. Elura (capromorelin oral solution) drug label. DailyMed. Elanco US Inc. NADA 141-536. Updated November 2025. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=be4beb9c-f39b-4b23-9c35-f72a049a3250

Related reads

• Capromorelin (Entyce) for Appetite Stimulation in Dogs: Evidence and Clinical Use
• Telmisartan (Semintra) for Proteinuria and Hypertension in Cats with CKD