Randomized Trial of Benznidazole for Chronic Chagas’ Cardiomyopathy

Morillo, Carlos A.; Marin-Neto, José Antônio; Avezum, Álvaro; Sosa-Estáni, Sergio; Rassi, Anis; Rosas, Fernando; Villena, Erick; Quiroz, Roberto; Bonilla, Rina; Britto, Constança; Guhl, Felipe; Velázquez, Elsa; Bonilla, Laura; Meeks, Brandi; Rao‐Melacini, Purnima; Pogue, Janice; Mattos, AC; Lazdins, Janis; Connolly, Stuart J.; Yusuf, Salim

doi:10.1056/nejmoa1507574

Cited by 840 publications

(837 citation statements)

References 31 publications

Supporting

Mentioning

759

Contrasting

Unclassified

Order By: Relevance

“…In the chronic phase, T. cruzi can only be detected from a limited number of patients by parasitological methods, such as xenodiagnosis or blood culture 4,[20][21][22][23] . Therefore, the development of additional molecular methods is necessary for parasite detection in patients with unclear serology and for better evaluation of the roles of specific trypanocidal treatments in patients with established Chagas' cardiomyopathy [24][25][26] . In addition, these tools are important for studies involving biological and genetic characterization of the parasite.…”

Section: Introductionmentioning

confidence: 99%

Combined parasitological and molecular-based diagnostic tools improve the detection of Trypanosoma cruzi in single peripheral blood samples from patients with Chagas disease

Volpato

Sousa

D’Ávila

et al. 2017

Rev. Soc. Bras. Med. Trop.

View full text Add to dashboard Cite

Introduction:In order to detect Trypanosoma cruzi and determine the genetic profiles of the parasite during the chronic phase of Chagas disease (ChD), parasitological and molecular diagnostic methods were used to assess the blood of 91 patients without specific prior treatment. Methods: Blood samples were collected from 68 patients with cardiac ChD and 23 patients with an indeterminate form of ChD, followed by evaluation using blood culture and polymerase chain reaction. T. cruzi isolates were genotyped using three different genetic markers. Results: Blood culture was positive in 54.9% of all patients, among which 60.3% had the cardiac form of ChD, and 39.1% the indeterminate form of ChD. There were no significant differences in blood culture positivity among patients with cardiac and indeterminate forms. Additionally, patient age and clinical forms did not influence blood culture results. Polymerase chain reaction (PCR) was positive in 98.9% of patients, although comparisons between blood culture and PCR results showed that the two techniques did not agree. Forty-two T. cruzi stocks were isolated, and TcII was detected in 95.2% of isolates. Additionally, one isolate corresponded to TcIII or TcIV, and another corresponded to TcV or TcVI. Conclusions: Blood culture and PCR were both effective for identifying T. cruzi using a single blood sample, and their association did not improve parasite detection. However, we were not able to establish an association between the clinical form of ChD and the genetic profile of the parasite.

show abstract

Section: Introductionmentioning

confidence: 99%

Combined parasitological and molecular-based diagnostic tools improve the detection of Trypanosoma cruzi in single peripheral blood samples from patients with Chagas disease

Volpato

Sousa

D’Ávila

et al. 2017

Rev. Soc. Bras. Med. Trop.

View full text Add to dashboard Cite

show abstract

“…Recent results of the BENEFIT trial support this premise showing that benznidazole treatment for chronic Chagas cardiomyopathy did not reduce cardiac clinical deterioration through 5 years of follow-up. 42 Transition from the gastrointestinal to the cardiac form was also not allowed, and it was therefore assumed that no patients simultaneously developed cardiac and digestive complications. Additionally, we contemplated the same treatment for severe cardiomyopathy for all patients.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of Chagas disease screening in Latin American migrants at primary health-care centres in Europe: a Markov model analysis

Requena‐Méndez

Bussion

Aldasoro

et al. 2017

The Lancet Global Health

View full text Add to dashboard Cite

SummaryBackground Chagas disease is currently prevalent in European countries hosting large communities from Latin America. Whether asymptomatic individuals at risk of Chagas disease living in Europe should be screened and treated accordingly is unclear. We performed an economic evaluation of systematic Chagas disease screening of the Latin American population attending primary care centres in Europe.

show abstract

“…One of the main barriers for the widespread use of BZN is the high reported incidence of adverse drug reactions (ADRs), documented in up to 50% of treated patients (11) . Whereas only a minor number of ADRs are severe (1%) (12) , about a third of patients interrupt BZN treatment due to ADRs or other reasons (11) (12) (13) .…”

Section: Discussionmentioning

confidence: 99%

High seroconversion rates in Trypanosoma cruzi chronic infection treated with benznidazole in people under 16 years in Guatemala

Brum-Soares¹,

Cubides²,

Burgos³

et al. 2016

Rev. Soc. Bras. Med. Trop.

View full text Add to dashboard Cite

Introduction: Geographical, epidemiological, and environmental differences associated with therapeutic response to Chagas etiological treatment have been previously discussed. This study describes high seroconversion rates 72 months after benznidazole treatment in patients under 16 years from a project implemented by Doctors without Borders in Guatemala. Methods: An enzyme-linked immunosorbent assay was used to detect Trypanosoma cruzi IgG antibodies in capillary blood samples from patients 72 months after treatment. Fisher's exact test was used to establish association between characteristics, such as sex, age, and origin of patients, and fi nal seroconversion. Kappa index determined concordance between laboratory tests. The level of signifi cance was set to 5%. Results: Ninety-eight patients, aged 6 months to 16 years, were available for follow-up. Sex and origin were not associated with seroconversion. Individuals older than 13 were more prone to maintain a positive result 72 months after treatment, although results were not highly signifi cant. Laboratory tests presented elevated Kappa concordance (95% CI) = 0.8290 (0.4955-1), as well as high (97%) seroconversion rates. Conclusions: The high seroconversion rate found in this study emphasizes the importance of access to diagnosis, treatment, and follow-up of individuals affected by Chagas disease. Moreover, it contradicts the idea that it is not possible to achieve a cure with the currently available drugs. This study strongly supports expanding programs for patients infected with T. cruzi in endemic and non-endemic countries.

show abstract

Randomized Trial of Benznidazole for Chronic Chagas’ Cardiomyopathy

Cited by 840 publications

References 31 publications

Combined parasitological and molecular-based diagnostic tools improve the detection of Trypanosoma cruzi in single peripheral blood samples from patients with Chagas disease

Combined parasitological and molecular-based diagnostic tools improve the detection of Trypanosoma cruzi in single peripheral blood samples from patients with Chagas disease

Cost-effectiveness of Chagas disease screening in Latin American migrants at primary health-care centres in Europe: a Markov model analysis

High seroconversion rates in Trypanosoma cruzi chronic infection treated with benznidazole in people under 16 years in Guatemala

Contact Info

Product

Resources

About