Tolerance of Benznidazole in Treatment of Chagas' Disease in Adults

Pinazo, María Jesús; Muñóz, José; Posada, Elizabeth; López-Chejade, Paulo; Gállego, Montserrat; Ayala, Edgar; Cacho, Elena del; Soy, Dolors; Gascón, Joaquim

doi:10.1128/aac.00537-10

Cited by 161 publications

(140 citation statements)

References 17 publications

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“…2 Treatment with either benznidazole or nifurtomox can present a number of clinical and therapeutic challenges. 3,4 Vector-borne infection occurs when the T. cruzi parasite is transmitted from an infected Triatoma insect to a mammalian host during the blood meal defecation process. Transmission occurs in two cycles: sylvatic and domestic.…”

Section: Introductionmentioning

confidence: 99%

Evidence of Autochthonous Chagas Disease in Southeastern Texas

Garcia¹,

Aguilar²,

Gorchakov³

et al. 2015

The American Society of Tropical Medicine and Hygiene

107

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Abstract. Autochthonous transmission of Trypanosoma cruzi in the United States is rarely reported. Here, we describe five newly identified patients with autochthonously acquired infections from a small pilot study of positive blood donors in southeast Texas. Case-patients 1-4 were possibly infected near their residences, which were all in the same regioñ 100 miles west of Houston. Case-patient 5 was a young male with considerable exposure from routine outdoor and camping activities associated with a youth civic organization. Only one of the five autochthonous case-patients received anti-parasitic treatment. Our findings suggest an unrecognized risk of human vector-borne transmission in southeast Texas. Education of physicians and public health officials is crucial for identifying the true disease burden and source of infection in Texas.

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Section: Introductionmentioning

confidence: 99%

Evidence of Autochthonous Chagas Disease in Southeastern Texas

Garcia¹,

Aguilar²,

Gorchakov³

et al. 2015

The American Society of Tropical Medicine and Hygiene

107

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“…Although BZN effectiveness during the chronic phase of the disease remains uncertain (12)(13)(14), there is compelling evidence supporting the beneficial use of BZN even during the chronic phase of Chagas disease (13,15), and some international guidelines are now advocating the use of BZN even among adults with chronic disease (16)(17)(18). However, adverse drug reactions (ADRs) occur in 30% to 87% of the patients treated with BZN (19)(20)(21), and 12% to 29% of patients fail to complete their full course of treatment (19)(20)(21). Therefore, the development of tools to identify patients with high probabilities of developing ADRs to BZN is highly desirable, as this strategy would improve compliance to BZN treatment and minimize complications (21,22).…”

mentioning

confidence: 99%

A Clinical Adverse Drug Reaction Prediction Model for Patients with Chagas Disease Treated with Benznidazole

Silva

Mediano

Brasil

et al. 2014

Antimicrob Agents Chemother

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Benznidazole (BZN) is the main trypanocidal drug used to treat Chagas disease, and the evidence supporting the benefits of BZN use during the chronic phase of the disease will favor its use in millions of individuals. However, more than 30% of patients treated with BZN may suffer adverse drug reactions (ADRs), and the development of tools to identify those patients at risk is highly desirable. In the present study, we aimed to identify predictive factors for ADRs in Chagas disease patients treated with BZN. Among 195 patients included in the study, 48.7% experienced ADRs and 31.3% had ADRs that caused BZN treatment discontinuation. Overall ADRs and ADRs that caused BZN treatment discontinuation were more common among women and in those who graduated from elementary school. Overall ADRs were also less frequent among black individuals. Based on logistic regression analysis, female sex (odds ratio [OR], 2.9; 95% confidence interval [CI], 1.5 to 5.4), graduation from elementary school (OR, 2.0; 95% CI, 1.1 to 3.8), and white (OR, 5.0; 95% CI, 1.0 to 24.1) and mulatto (OR, 5.6; 95% CI, 1.1 to 28.7) races were considered to predict overall ADRs, and female sex (OR, 2.3; 95% CI, 1.2 to 4.3) was considered to predict ADRs that caused BZN treatment discontinuation. Graduation from elementary school also presented a tendency to predict ADRs that caused BZN treatment discontinuation (OR, 1.8; 95% CI, 0.9 to 3.6). The logistic regression (LR) models to predict ADRs to BZN described in this study may become important tools to minimize ADRs and improve patients' compliance and thus assist physicians treating patients with Chagas disease with BZN. E ven 100 years after it was first reported (1), Chagas disease remains a serious public health problem in Latin America, with a high social and economic burden (2, 3). Moreover, the prevalence of Chagas disease is increasing, mainly due to migration, in countries where it is not endemic, such as the United States and European countries (4-7).Benznidazole (BZN) is the main trypanocidal drug used to treat Chagas disease (8, 9), and the parasitological cure rate when patients are treated with BZN during the acute phase of the disease is almost 80% (10, 11). Although BZN effectiveness during the chronic phase of the disease remains uncertain (12)(13)(14), there is compelling evidence supporting the beneficial use of BZN even during the chronic phase of Chagas disease (13, 15), and some international guidelines are now advocating the use of BZN even among adults with chronic disease (16-18). However, adverse drug reactions (ADRs) occur in 30% to 87% of the patients treated with BZN (19-21), and 12% to 29% of patients fail to complete their full course of treatment (19-21). Therefore, the development of tools to identify patients with high probabilities of developing ADRs to BZN is highly desirable, as this strategy would improve compliance to BZN treatment and minimize complications (21,22).Logistic regression (LR) is a method often used to predict outcomes in health studies (23,24), and...

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“…The most common adverse reactions involve the skin and occur in up to 30% of patients; they include a variety of itchy lesions (maculopapular rash, urticaria, morbilliform exanthema, or eczema) that usually appear 10-15 days after starting benznidazole 5,6 . Administration of antihistamines ameliorates these symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Asymptomatic individuals, with low levels of the parasite in the blood and other tissues, can still be a source of transmission 4 , making the diagnosis and treatment of these patients an important public health challenge 5 .…”

Section: Introductionmentioning

confidence: 99%

Adverse systemic reaction to benznidazole

Coronel

Frutos

Muñoz

et al. 2017

Rev. Soc. Bras. Med. Trop.

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Benznidazole, drug of choice for Chagas disease (CD), has been associated with a high incidence of adverse reactions that can become serious, necessitating discontinuation of the drug. We describe the case of a Bolivian patient living in Spain for 9 years, who, following treatment with benznidazole for CD in indeterminate chronic phase, presented with fever, skin lesions, digestive symptoms, general malaise, and laboratory abnormalities. After the discontinuation of benznidazole and, the intake of antihistamines and systemic corticosteroids, the patient presented a complete resolution of the symptoms. Optimization of dose strategies and development of more effective, and better-tolerated drugs is advisable.

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Tolerance of Benznidazole in Treatment of Chagas' Disease in Adults

Cited by 161 publications

References 17 publications

Evidence of Autochthonous Chagas Disease in Southeastern Texas

Evidence of Autochthonous Chagas Disease in Southeastern Texas

A Clinical Adverse Drug Reaction Prediction Model for Patients with Chagas Disease Treated with Benznidazole

Adverse systemic reaction to benznidazole

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