Randomized Trial of Posaconazole and Benznidazole for Chronic Chagas' Disease

Abstract

Posaconazole showed antitrypanosomal activity in patients with chronic Chagas' disease. However, significantly more patients in the posaconazole groups than in the benznidazole group had treatment failure during follow-up. (Funded by the Ministry of Health, Spain; CHAGASAZOL ClinicalTrials.gov number, NCT01162967.).

2 nd Brazilian Consensus on Chagas Disease, 2015

“…In addition, there is apparent suppression of the parasitemia with the current antiparasitic treatment (289) (290) . In turn, the rates of cure and their confirmation depend on several factors, such as the phase and the duration of disease, the age of the patient, the tests used to evaluate therapeutic efficacy, the duration of follow-up after treatment, associated conditions, and the susceptibility of the specific T. cruzi strain to antiparasitic drugs.…”

“…It should be noted that demonstrating cure depends on various factors, including follow-up of treated cases, which should continue for more than two decades for patients treated in the late phase. Increased seroconversion of cases showing no acute illness and without cardiac failure was also assessed (290) .…”

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

“…8 However, we also contemplated a more optimistic rate of 50%, which substantially improved the ICER, based on new data for PCR follow-up testing suggesting that the efficacy of benznidazole (or at least the antiparasitic efficacy) in chronic Chagas disease could be higher than previously believed. 41 In the base case analysis, the model considered that 80% of the target population would be finally screened and treated. This high coverage level is optimistic because it is unlikely that the 80% of target population can be reached at primary health centres without additional effort and additionally optimistic that this 80% would accept the screening and remain adherent to treatment.…”

Match-making for posaconazole through systems thinking

“…However, the results in Phase II clinical trials were disappointing. While the parasitemia dropped below detection limit after treatment, 10 months later, most patients again tested positive for T. cruzi [9]. Either candidate was less efficacious than benznidazole.…”