Advancing the Treatment for Chagas' Disease

Albajar-Viñas, Pedro; Dias, João Carlos Pinto

doi:10.1056/nejme1403689

Cited by 7 publications

(13 citation statements)

References 8 publications

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“…The prevalence of HCD is expected to decrease progressively in the next three decades, along with the incidence and morbidity, particular if medical care and specific treatment can be universalized. Millions of individuals are waiting for this (9) (10) . We are now at a crossroads regarding Chagas disease research, and tension is mounting due to opposing views among researchers, health authorities, and policy makers.…”

Section: Human Chagas Disease In 2015mentioning

confidence: 99%

“…Millions of infected people will require specific and symptomatic treatments in Latin America and the rest of the world over the next 30 years, but the proportion of detected and treated cases has been extremely low. Better drugs for specific treatment are highly desirable, but new products usually take years to be available and the benefits of the treatment generally diminish with the duration of infection (5) (8) (9) (10) . Benznidazole and nifurtimox must continue to be the mainstay of treatment, but their production today is not a priority of the existing manufacturers (10) .…”

Section: Managing the Diseasementioning

confidence: 99%

“…Better drugs for specific treatment are highly desirable, but new products usually take years to be available and the benefits of the treatment generally diminish with the duration of infection (5) (8) (9) (10) . Benznidazole and nifurtimox must continue to be the mainstay of treatment, but their production today is not a priority of the existing manufacturers (10) . Symptomatic treatment has advanced greatly in terms of heart and digestive tract symptom management, but its provision is also extremely low in terms of the real need (5) (8) .…”

Section: Managing the Diseasementioning

confidence: 99%

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Chagas disease: still a challenge around the World

Dias

2015

Rev. Soc. Bras. Med. Trop.

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Section: Human Chagas Disease In 2015mentioning

confidence: 99%

Section: Managing the Diseasementioning

confidence: 99%

Section: Managing the Diseasementioning

confidence: 99%

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Chagas disease: still a challenge around the World

Dias

2015

Rev. Soc. Bras. Med. Trop.

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“…CD is currently emerging in non-endemic areas, such as North America, Europe and Oceania, mostly associated with the migration of infected carriers (Albajar-Viñas and Dias, 2014). CD presents in two stages: an acute and a later chronic phase, which after years or decades about 30-40% of patients progress to symptomatic forms, causing heart disease and/or digestive and neurological disorders (Teixeira et al 2006;Marin-Neto et al 2008;Coura and Dias, 2015).…”

Section: Introductionmentioning

confidence: 99%

Anti-parasitic effect of novel amidines against Trypanosoma cruzi: phenotypic and in silico absorption, distribution, metabolism, excretion and toxicity analysis

et al. 2017

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S U M M A R YNew more selective and potent drugs are urgently need to treat Chagas disease (CD). Among the many synthetic compounds evaluated against Trypanosoma cruzi, aromatic amidines (AAs) and especially arylimidamides (AIAs) have potent activity against this parasite. Presently, the effect of four mono-amidines (DB2228, DB2229, DB2292 and DB2294), four diamidines (DB2232, DB2235, DB2251 and DB2253) and one AIA (DB2255) was screened in vitro against different forms (bloodstream trypomastigotes -BT and intracellular forms) and strains from discrete typing unit (DTU) I and VI of T. cruzi and their cytotoxic profile on mammalian host cells. Except for DB2253, all molecules were as active as benznidazole (Bz), resulting in 50% of reduction in the number of alive BT, with EC 50 ranging from 2·7 to 10·1 µM after 24 h of incubation. DB2255 was also the most potent against amastigotes (Tulahuen strain) showing similar activity to that of Bz (3 µM). In silico absorption, distribution, metabolism, excretion and toxicity analysis demonstrated probability of human intestinal adsorption, while mutagenicity and inhibition of hERG1 were not predicted, besides giving acceptable predicted volumes of distribution. Our findings contribute for better knowledge regarding the biological effect of this class of aromatic molecules against T. cruzi aiming to identify novel promising agent for CD therapy.

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“…1,2 Despite this substantial burden, recent estimates suggest that less than 1% of infected patients receive treatment with benznidazole or nifurtimox, the two antitrypanosomal medicines currently available to treat Chagas disease. [3][4][5] The burden of Chagas disease has historically been concentrated among the poor in Latin America, in particular, because of substandard housing and living conditions that create suitable vector habitats for repeated domestic transmission. In addition to vector-borne transmission, the T. cruzi parasite can be transmitted congenitally from infected mother to child and through blood and organ donation.…”

Section: Introductionmentioning

confidence: 99%

Access to Care for Chagas Disease in the United States: A Health Systems Analysis

Manne‐Goehler¹,

Reich²,

Wirtz³

2015

The American Society of Tropical Medicine and Hygiene

104

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Abstract. There are 300,000 estimated cases of Chagas disease in the United States but limited data on access to care. This study analyzed trends in access to care for Chagas disease in the United States and assessed the national and state barriers to access. Data on cases in blood donors and drug releases were obtained from the AABB (formerly American Association of Blood Banks) and U.S. Centers for Disease Control and Prevention (CDC), respectively. Semi-structured in-depth interviews were conducted with 30 key informants at the national level and in five states where treatment had been released. Interview responses were analyzed according to the health systems dimensions of regulation, financing, payment, organization, and persuasion. Data indicate that 1,908 cases were identified in the blood donation system from 2007 to 2013 and that CDC released 422 courses of benznidazole or nifurtimox during this period. The barriers to access at the national level include limited diagnostic and institutionalized referral and care processes, lack of financing for patient-care activities, and limited awareness and training among providers. This study demonstrates that access to treatment of Chagas disease in the United States is limited. The lack of licensing is only one of several barriers to access, highlighting the need for a health systems perspective when scaling up access to these essential medicines.BACKGROUND

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Advancing the Treatment for Chagas' Disease

Cited by 7 publications

References 8 publications

Chagas disease: still a challenge around the World

Chagas disease: still a challenge around the World

Anti-parasitic effect of novel amidines against Trypanosoma cruzi: phenotypic and in silico absorption, distribution, metabolism, excretion and toxicity analysis

Access to Care for Chagas Disease in the United States: A Health Systems Analysis

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