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October 7, 2005Cochrane libraryOpen Access

Trypanocidal drugs for late stage, symptomatic Chagas disease (Trypanosoma cruzi infection)

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Why the study?

Do trypanocidal drugs (benznidazole and nifurtimox) improve clinical outcomes or parasite clearance in patients with late-stage, symptomatic Chagas disease and chronic chagasic cardiomyopathy?

Population

2 RCTs pooling 2,931 participants with late-stage, symptomatic Chagas disease and chronic chagasic…

Comparison

Trypanocidal drugs. vs Placebo or no treatment.

Design

Systematic_review

Follow-up

Up to 5 years

Authors

MVMaité VallejoInstituto Nacional de CardiologiaPRPedro PA ReyesInstituto Nacional de Cardiología

Discussion

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Implication

Discourages benznidazole in late-stage Chagas cardiomyopathy; strengthens evidence against routine use due to absent clinical benefit and net harm.

Structured PICO

Do trypanocidal drugs (benznidazole and nifurtimox) improve clinical outcomes or parasite clearance in patients with late-stage, symptomatic Chagas disease and chronic chagasic cardiomyopathy?

P
Population
2 RCTs pooling 2,931 participants with late-stage, symptomatic Chagas disease and chronic chagasic cardiomyopathy (CCC).
I
Intervention
Trypanocidal drugs (benznidazole 5 mg/kg/day for 30 days or 300 mg/day for 40 to 80 days; nifurtimox 5 mg/kg/day for 30 days).
C
Comparator
Placebo or no treatment.
O
Outcome
Blood parasite reduction or clearance, mortality, adverse effects, and quality of life.

There is insufficient evidence to support the efficacy of benznidazole and nifurtimox for improving clinical outcomes in late-stage, symptomatic Chagas disease and chronic chagasic cardiomyopathy, while benznidazole significantly increases adverse events.

Limitations

  • Insufficient evidence
  • Low quality of evidence
  • Very limited evidence for nifurtimox

Cite This Study

Vallejo et al. (2005) studied this question.

synapsesocial.com/papers/6a909d90fdb099d0d8dd925dhttps://doi.org/10.1002/14651858.cd004102.pub2
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Feasibility, Drug Safety, and Effectiveness of Etiological Treatment Programs for Chagas Disease in Honduras, Guatemala, and Bolivia: 10-Year Experience of Médecins Sans Frontières2009 · 189 citations
  2. 2Ergosterol biosynthesis and drug development for Chagas disease2009 · 234 citations
  3. 3Structural equation model testing and the quality of natural killer cell activity measurements2005 · 258 citations
  4. 4Long-Term Cardiac Outcomes of Treating Chronic Chagas Disease with Benznidazole versus No Treatment2006 · 604 citations