Safety of benznidazole use in the treatment of chronic Chagas' disease

Hasslocher‐Moreno, Alejandro Marcel; Brasil, Pedro Emmanuel Alvarenga Americano do; Sousa, Andréa Silvestre de; Xavier, Sérgio Salles; Chambela, Mayara C.; Silva, Gilberto M Sperandio da

doi:10.1093/jac/dks027

Cited by 77 publications

(81 citation statements)

References 20 publications

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“…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.

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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.

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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.

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“…Según los estudios, se ha evidenciado la aparición de efectos adversos hasta en el 50% de los pacientes que son manejados con benznidazol, siendo los más frecuentes la dermatitis asociada a hipersensibilidad (no relacionada con la dosis del medicamento ni con la erradicación del parásito), la intolerancia gastrointestinal y la polineuropatía (comprometiendo sistema nervioso central y periférico), los cuales se presentan comúnmente de forma simultánea (30)(31)(32) . Es imperativo tener en cuenta que la aparición de estos eventos adversos disminuye la adherencia al tratamiento, alcanzando tasas de deserción hasta del 18% (30) .…”

Section: Efectos Adversos Del Tratamientounclassified

“…Es imperativo tener en cuenta que la aparición de estos eventos adversos disminuye la adherencia al tratamiento, alcanzando tasas de deserción hasta del 18% (30) .…”

Section: Efectos Adversos Del Tratamientounclassified

Tripanosomiasis americana, una mirada desde el tratamiento

et al. 2016

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ResumenLa tripanosomiasis americana o enfermedad de Chagas es una infección parasitaria causada por el parásito flagelado Trypanosoma cruzi, cuyo principal vector es un insecto de la clase hemíptera conocido como triatomino. La quimioterapia, adicional a un control oportuno de vectores y rigurosidad en el control de las transfusiones, son los elementos más importantes para el manejo de esta parasitosis. En la actualidad, el mercado farmacéutico solo ofrece nifurtimox y benznidazol como opciones terapéuticas, y a pesar de que se han obtenido resultados satisfactorios con el uso de estos medicamentos en fases agudas de la enfermedad, tripanosomiasis congénita y accidentes de laboratorio, la efectividad en las fases crónicas es notoriamente menor. Además, ambos fármacos generan ciertos efectos adversos que deben ser tenidos en cuenta por el personal de la salud, antes de iniciar el debido manejo de esta enfermedad. El objetivo del presente artículo es revisar el estado actual del tratamiento farmacológico de la tripanosomiasis americana, buscando resumir los nuevos avances terapéuticos y dar a conocer las limitaciones de los mismos debido a sus efectos adversos. Palabras clave. Enfermedad de Chagas; Tripanosomiasis; Terapéutica. Abstract American trypanosomiasis or Chagas disease is a parasitic infection caused by the flagellate parasite Trypanosoma cruzi, whose main vector is an insect of the Hemiptera class, called triatomine. Chemotherapy, in addition to an appropriate vector control and a rigorous control of transfusions, are the most important strategies for the management of this parasitosis. Currently, the pharmaceutical market only offers nifurtimox and benznidazole as treatment options, and although satisfactory results have been obtained with the use of these drugs in either acute stages of the disease, congenital trypanosomiasis and laboratory accidents, its effectiveness in the chronic phases is significantly smaller. In addition, both drugs produce some side effects that must be taken into account by health workers, before starting the proper management of the disease. The aim of this article is to review the current state of the American trypanosomiasis treatment, in order to summarize the new advances in therapeutics and to introduce their limitations due to adverse effects. Keywords. Chagas Disease; Trypanosomiasis; Therapeutics. An INTRODUCCIÓNLa tripanosomiasis americana, también conocida como enfermedad de Chagas, es la infección parasitaria más importante en las Américas, en donde afecta de 8 a 10 millones de personas (1)(2)(3) . Es causada por el parásito flagelado Trypanosoma cruzi, cuyo principal vector es un insecto de la clase hemíptera conocido como triatomino. El parási-to también puede ser adquirido por el consumo de alimentos y bebidas contaminadas, trasplantes de órganos, transfusiones sanguíneas y por vía congénita, siendo estas vías menos frecuentes (1,4) .En el curso natural de la enfermedad es posible diferenciar tres fases clínicas: una fase aguda, usualmente asintomá-tica, que t...

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“…Although pharmacotherapy with benznidazole is associated with adverse reactions and limited effectiveness in the chronic phase of Chagas disease 1,3 , it has been used in the indeterminate phase of Chagas disease to reduce parasitemia, prevent visceral lesions and transmission. As well, observational studies have shown that benznidazole may even benefi t patients in the cardiac chronic stage of the disease 4 .…”

Section: Dear Editormentioning

confidence: 99%

“…As well, observational studies have shown that benznidazole may even benefi t patients in the cardiac chronic stage of the disease 4 . Moreover, despite the large number of adverse reactions caused by benznidazole administration, it is considered safe when administered by a qualifi ed professional, as monitoring of the treatment can prevent complications 3 .…”

Section: Dear Editormentioning

confidence: 99%

Authors' reply: Vitamins in the treatment of chronic Chagas disease: adjuvant antiparasitary or antioxidant therapy?

Andrade

Oliveira

Nagão-Dias

et al. 2014

Rev. Soc. Bras. Med. Trop.

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Safety of benznidazole use in the treatment of chronic Chagas' disease

Abstract: The Naranjo algorithm was a useful tool to reduce the underreporting of ADRs. Events were common, but were associated with low morbidity and were reversible upon discontinuation of drug treatment. Moreover, there were no fatal events; therefore, benznidazole treatment was considered safe.

Cited by 77 publications

References 20 publications

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

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

Tripanosomiasis americana, una mirada desde el tratamiento

Authors' reply: Vitamins in the treatment of chronic Chagas disease: adjuvant antiparasitary or antioxidant therapy?

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