Effectiveness of Nifurtimox in the Treatment of Chagas Disease: a Long-Term Retrospective Cohort Study in Children and Adults

Abstract

Chagas disease (ChD), caused by Trypanosoma cruzi , has a global prevalence due to patient migration. However, despite its worldwide distribution, long-term follow-up efficacy studies with nifurtimox (NF) are scarce and have been conducted with only small numbers of patients. A retrospective study of a large cohort of ChD treated children and adults with NF.

Efficacy and Safety of Nifurtimox in Pediatric Patients with Chagas Disease: Results at 4-Year Follow-Up in a Prospective, Historically Controlled Study (CHICO SECURE)

“…However, all of these tests were initially developed as diagnostic tools and have not been validated for posttreatment follow-up ( 17 ). Long-term posttreatment follow-up studies in patients with Chagas disease are uncommon ( 27 ); those that have evaluated nifurtimox in children are rare and have typically been conducted in small groups of patients or individual cases ( 16 ).…”

“…In chronic Chagas disease, it may take approximately 10 to 20 years of posttreatment follow-up to achieve seronegative conversion ( 12 – 15 ). A decrease in anti- T. cruzi serological reactivity, combined with persistently negative parasitological tests, may indicate a response to treatment ( 13 , 16 , 17 ).…”

Evaluation of the Anti-Histoplasma capsulatum Activity of Indole and Nitrofuran Derivatives and Their Pharmacological Safety in Three-Dimensional Cell Cultures

“…Although nitrofuran derivatives are known to cause mutagenic and genotoxic effects [ 16 , 19 ], beneficial effects of a drug of this family have already been proven in the treatment of Chagas disease [ 18 ]. Additionally, only mild adverse effects were observed in humans [ 17 , 18 ]. Therefore, regulatory agencies such as the Food and Drug Administration (FDA) have approved the commercial use of Nifurtimox in the treatment of Chagas disease [ 18 , 85 ].…”

“…Nitrofurans are described as antibiotics with a broad spectrum of action. They have been widely used in veterinary medicine for decades, and there are new drugs in this class approved for the treatment of Chagas disease [ 15 , 16 , 17 , 18 ]. However, due to problems related to toxicity, such as the appearance of mutations and cancers, as well as cases of pulmonary, cardiac, and reproductive system toxicity, hepatotoxicity, and nephrotoxicity, especially in long-term treatments, they have been banned in several countries [ 16 , 19 , 20 ].…”

Genetic Characterization of Trypanosoma cruzi I Populations from an Oral Chagas Disease Outbreak in Venezuela: Natural Resistance to Nitroheterocyclic Drugs

“…Nifurtimox (NFX) and Benznidazole (BZN) are the only available drugs with trypanocide activity to treat Chagas disease (CD). Their efficacy is optimal in patients at the acute stages of infection, including congenitally infected infants. − However, in the chronic stage of the disease, their efficacy is variable and appears to depend on the target populations . In fact, treatment response is heterogeneous in different geographic areas, where different Trypanosoma cruzi genotypes circulate. − It has been speculated that treatment failure can be attributed to the genetic characteristics of the T. cruzi populations circulating in a given area.…”