PMID- 34287382
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210724
IS  - 2414-6366 (Electronic)
IS  - 2414-6366 (Linking)
VI  - 6
IP  - 3
DP  - 2021 Jul 12
TI  - A Rapid Review on the Efficacy and Safety of Pharmacological Treatments for 
      Chagas Disease.
LID - 10.3390/tropicalmed6030128 [doi]
LID - 128
AB  - Chagas disease remains a neglected tropical disease, causing significant burden 
      in the Americas and countries that receive immigrants from endemic nations. 
      Current pharmaceutical treatments are suboptimal, not only varying drastically in 
      efficacy, depending on the stage of disease, but also presenting significant risk 
      of adverse events. The objective of this review is to provide a timely update on 
      the efficacy and safety of current trypanocidals. Eligible studies published from 
      January 2015 to December 2020 were retrieved by one reviewer from six electronic 
      databases. Ana-lysis was done with review management software and risk of bias 
      was assessed using tools appropriate for the type of study (i.e., experimental or 
      observational). Thirteen studies (10 observational and three RCTs) were included 
      in the analysis. All 13 studies tested Benznidazole (BNZ) or Nifurtimox (NFX), 
      and two studies also tested Posaconazole (POS) or E1224 (Ravucanazole). BNZ was 
      found to be the most efficacious trypanocidal drug compared to Nifurtimox, POS, 
      and E1224; it also resulted in the highest percentage of adverse effects (AEs) 
      and treatment discontinuation due to its toxicity. Adults experienced higher 
      frequency of neurological AEs while taking BNZ or NFX compared to children. 
      Children had a higher frequency of general AEs compared to adults while taking 
      BNZ. Overall, BNZ is still the most efficacious, but development of new, less 
      toxic drugs is paramount for the quality of life of patients. Studies testing 
      combination therapies and shorter regimens are needed, as is the devising of 
      better clinical parameters and laboratory biomarkers to evaluate treatment 
      efficacy. Considering the variability in methodology and reporting of the studies 
      included in the present analysis, we offer some recommendations for the 
      improvement and replicability of clinical studies investigating pharmacological 
      treatment of Chagas disease. These include full disclosure of methodology, 
      standardization of outcome measures, and always collecting and reporting data on 
      both the efficacy of trypanocidals and on safety outcomes.
FAU - Malone, Cody J
AU  - Malone CJ
AUID- ORCID: 0000-0001-8692-5394
AD  - Department of Health Sciences, Faculty of Applied Health Sciences, Brock 
      University, St. Catharines, ON L2S 3A1, Canada.
FAU - Nevis, Immaculate
AU  - Nevis I
AUID- ORCID: 0000-0001-5666-201X
AD  - Department of Health Sciences, Faculty of Applied Health Sciences, Brock 
      University, St. Catharines, ON L2S 3A1, Canada.
FAU - Fernandez, Eduardo
AU  - Fernandez E
AUID- ORCID: 0000-0002-4645-947X
AD  - Department of Health Sciences, Faculty of Applied Health Sciences, Brock 
      University, St. Catharines, ON L2S 3A1, Canada.
FAU - Sanchez, Ana
AU  - Sanchez A
AUID- ORCID: 0000-0002-6683-2518
AD  - Department of Health Sciences, Faculty of Applied Health Sciences, Brock 
      University, St. Catharines, ON L2S 3A1, Canada.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20210712
PL  - Switzerland
TA  - Trop Med Infect Dis
JT  - Tropical medicine and infectious disease
JID - 101709042
PMC - PMC8293415
OTO - NOTNLM
OT  - American Trypanosomiasis
OT  - Chagas disease
OT  - rapid review
OT  - trypanocidals
COIS- The authors declare no conflict of interest.
EDAT- 2021/07/22 06:00
MHDA- 2021/07/22 06:01
PMCR- 2021/07/12
CRDT- 2021/07/21 12:51
PHST- 2021/06/06 00:00 [received]
PHST- 2021/07/02 00:00 [revised]
PHST- 2021/07/08 00:00 [accepted]
PHST- 2021/07/21 12:51 [entrez]
PHST- 2021/07/22 06:00 [pubmed]
PHST- 2021/07/22 06:01 [medline]
PHST- 2021/07/12 00:00 [pmc-release]
AID - tropicalmed6030128 [pii]
AID - tropicalmed-06-00128 [pii]
AID - 10.3390/tropicalmed6030128 [doi]
PST - epublish
SO  - Trop Med Infect Dis. 2021 Jul 12;6(3):128. doi: 10.3390/tropicalmed6030128.