Randomized Trial of Posaconazole and Benznidazole for Chronic Chagas' Disease

• Published in: The New England journal of medicine Vol. 370; no. 20; pp. 1899 - 1908
• Main Authors: Molina, Israel, Gómez i Prat, Jordi, Salvador, Fernando, Treviño, Begoña, Sulleiro, Elena, Serre, Núria, Pou, Diana, Roure, Sílvia, Cabezos, Juan, Valerio, Lluís, Blanco-Grau, Albert, Sánchez-Montalvá, Adrián, Vidal, Xavier, Pahissa, Albert
• Format: Journal Article
• Language: English
• Published: Waltham, MA Massachusetts Medical Society 15.05.2014
• Subjects: Adult; Animal models; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antifungal agents; Benznidazole; Biological and medical sciences; Chagas disease; Chagas Disease - drug therapy; Chronic Disease; Chronic illnesses; Chronic infection; DNA, Protozoan - analysis; Drug dosages; Drug therapy; Evidence-based medicine; Female; General aspects; Human protozoal diseases; Humans; Infections; Infectious diseases; Intention to Treat Analysis; Male; Medical sciences; Middle Aged; Motivation; Nifurtimox; Nitroimidazoles - administration & dosage; Nitroimidazoles - adverse effects; Parasitic diseases; Patients; Pharmacology. Drug treatments; Polymerase chain reaction; Posaconazole; Prospective Studies; Protozoal diseases; Toxicity; Transaminases - blood; Treatment Outcome; Triazoles - administration & dosage; Triazoles - adverse effects; Trypanocidal Agents - adverse effects; Trypanocidal Agents - therapeutic use; Trypanosoma cruzi - genetics; Trypanosoma cruzi - isolation & purification; Trypanosomiasis; Spain; Nitro compound; Imidazole derivatives; Protozoal disease; Benznidazole; Chronic disease; Azole derivatives; Chagas disease; Parasitosis; Infection; Medicine; Antiprotozoal agent; Antifungal agent; Triazole derivatives; Parasiticide; Posaconazole; Trypanosomiasis
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa1313122

There are limited treatment options for Trypanosoma cruzei infection, or Chagas' disease. Preclinical data had suggested that posaconazole might be an effective therapy. In this randomized trial, posaconazole monotherapy was found not to be effective. Chagas' disease, a chronic parasitic infection caused by the protozoan Trypanosoma cruzi, is considered to be one of the neglected tropical diseases. 1 Although Chagas' disease was identified more than 100 years ago, current therapeutic options for this condition are limited mainly to benznidazole and nifurtimox. The phase of the disease is one of the factors that determine the success of treatment. Cure rates of 65 to 80% have been documented when treatment is administered in the acute phase of the disease, with rates reaching almost 100% in cases of congenitally acquired infection that is treated during the first years of . . .