Adverse systemic reaction to benznidazole

Coronel, María Verónica Pacheco; Frutos, Laura Oriente; Muñoz, Eva; Valle, Diana Kury; Hernández, Dolores

doi:10.1590/0037-8682-0071-2016

Cited by 10 publications

(3 citation statements)

References 8 publications

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“…These findings presumably demonstrate that the elevation in liver enzymes does not mean that there is structural damage in the hepatocytes per se. The AST and ALT enzymes are located inside hepatocytes, close to the cell membrane, and depending on the increase in the amount of these enzymes, they may be released from cells, which causes hepatocyte necrosis [ 21 , 22 ]. When a plasma increase in these enzymes reaches 10 or more times the reference values, it can be understood as reflecting hepatitis caused by drugs.…”

Section: Discussionmentioning

confidence: 99%

Hepatic changes by benznidazole in a specific treatment for Chagas disease

et al. 2018

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Chagas disease (Cd) is the third most common parasitic disease that causes damage to human health. Even a century after its description by Carlos Chagas and advances in its control, it remains a neglected disease. To eradicate the parasite or reduce the parasitic load, specific treatment for Trypanosoma cruzi (T. cruzi) is advisable; benznidazole (BNZ) is the drug that is currently prescribed. The purpose of this study is to report the adverse events (AE) due to the use of BNZ as a specific treatment for Cd, with a particular focus on hepatic changes. This was an observational, cross-sectional cohort study that included patients who were treated with BNZ. The medical records of patients who joined the Grupo de Estudo em doença de Chagas [Chagas Disease Study Group]/UNICAMP/Brazil and were treated with BNZ were reviewed for epidemiological, clinical, laboratory and AE parameters for the drug. The 204 patients who were assessed had an average age of 40.6 years ± 13.5 years, and 104 of them were women (50.98%). Fourteen (6.86%) individuals were in the acute phase of Cd, and 190 (93.13%) were in its chronic phase. AEs occurred in 85 patients (41.66%), 35 (41.17%) of whom had AEs related to the liver, characterized by an elevation of AST liver enzymes, ALT, alkaline phosphatase and gamma-glutamyltransferase (γGT). Other AEs that were observed included the following: 48 cases of cutaneous changes (56.47%), 8 cases of epigastric pain (9.41%), 7 cases of blood alteration (8.23%), and 3 cases of peripheral neuropathy (3.52%). Treatment was interrupted in 32 patients (37.64%) due to AD. Adverse events related to the liver secondary to the use of BNZ for Cd-specific treatment were frequent in this study and were characterized by an elevation of liver enzymes. Therefore, it is suggested that these enzymes be monitored during treatment with benznidazole.

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Section: Discussionmentioning

confidence: 99%

Hepatic changes by benznidazole in a specific treatment for Chagas disease

et al. 2018

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“…The implantation of a cardiac pacemaker may indicate having a weak heart or irregular beats 28 . Drug treatment was also pointed out as a reason for fear among this population, which is probably due to the possibility of severe adverse side effects caused by use of trypanocidal drugs (benznidazole and nifurtimox), such as cutaneous rash, gastrointestinal symptoms, and peripheral polyneuropathy [55][56][57] . In this scenario, communication is required between healthcare professionals and patients, especially regarding health education strategies.…”

Section: Discussionmentioning

confidence: 99%

Health-Related Quality of Life Reported by Patients With Chagas Disease: A Systematic Review of Qualitative Evidence With GRADE Recommendations

Silva

Oliveira

Xavier

et al. 2022

Rev. Soc. Bras. Med. Trop.

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Patients with Chagas disease have reduced health-related quality of life (HRQoL). Hence, we aimed to identify the factors that mostly affected their HRQoL. This was a systematic review of qualitative studies. The Latin American and Caribbean Health Sciences Literature, Medical Literature Analysis and Retrieval System Online, Excerpta Medica Database, Web of Science, and SciVerse Scopus databases were searched for relevant studies without language or date restrictions. The search and data analysis were performed by independent reviewers; all qualitative studies that reported the factors that had an impact on the HRQoL of patients with Chagas disease were included. The risk of bias was assessed using the Critical Appraisal Skills Program Qualitative Study Checklist; confidence in the evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative approach. Five studies were included in this review: four in Brazil and one in California, United States, with immigrants from Central and South America. The sample consisted of 207 patients with chronic Chagas disease. Stigma, physical limitations, work absenteeism, emotional or mental aspects, fear of treatment, and fear of the future had the strongest impact on the HRQoL. All items showed moderate confidence except for fear of treatment (low confidence). The physical, emotional, mental, and cultural aspects affected the HRQoL of patients with chronic Chagas disease. Identification of these factors is important in the development of strategies aimed at improving the HRQoL of this population.

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“…The limitations of the drugs used in the clinical treatment, Bz and nifurtimox, call attention to the elements possibly involved with the therapeutic failure, including (i) Serious adverse effects, leading to discontinuation of treatment [8]; (ii) the genetic variability of T. cruzi and the presence of naturally resistant strains [9,10]; (iii) the state of dormancy of T. cruzi and its resistance to treatment [11] and the low efficacy of Bz in chronic phase [12]. In this scenario, the search for new therapeutic regimens of reference drugs, aiming to preserve efficacy and minimize the side effects, as well as the identification of new targets, potent and safe drugs are urgently needed for the treatment of CD.…”

Section: Introductionmentioning

confidence: 99%

Optimization of 1,4-Naphthoquinone Hit Compound: A Computational, Phenotypic, and In Vivo Screening against Trypanosoma cruzi

et al. 2021

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Chagas disease (CD) still represents a serious public health problem in Latin America, even after more than 100 years of its discovery. Clinical treatments (nifurtimox and benznidazole) are considered inadequate, especially because of undesirable side effects and low efficacy in the chronic stages of the disease, highlighting the urgency for discovering new effective and safe drugs. A small library of compounds (1a–i and 2a–j) was designed based on the structural optimization of a Hit compound derived from 1,4-naphthoquinones (C2) previously identified. The biological activity, structure-activity relationship (SAR), and the in silico physicochemical profiles of the naphthoquinone derivatives were analyzed. Most modifications resulted in increased trypanocidal activity but some substitutions also increased toxicity. The data reinforce the importance of the chlorine atom in the thiophenol benzene ring for trypanocidal activity, highlighting 1g, which exhibit a drug-likeness profile, as a promising compound against Trypanosoma cruzi. SAR analysis also revealed 1g as cliff generator in the structure-activity similarity map (SAS maps). However, compounds C2 and 1g were unable to reduce parasite load, and did not prevent mouse mortality in T. cruzi acute infection. Phenotypic screening and computational analysis have provided relevant information to advance the optimization and design of new 1,4-naphthoquinone derivatives with a better pharmacological profile.

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Adverse systemic reaction to benznidazole

Cited by 10 publications

References 8 publications

Hepatic changes by benznidazole in a specific treatment for Chagas disease

Hepatic changes by benznidazole in a specific treatment for Chagas disease

Health-Related Quality of Life Reported by Patients With Chagas Disease: A Systematic Review of Qualitative Evidence With GRADE Recommendations

Optimization of 1,4-Naphthoquinone Hit Compound: A Computational, Phenotypic, and In Vivo Screening against Trypanosoma cruzi

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