Anti-parasite drug may improve long-term prognosis of Chagas patients

Benznidazole associated with lower mortality rates and better clinical outcomes when administered in early stages of disease

Researchers have found that the anti-parasite drug benznidazole may improve the long-term prognoses of patients with chronic Chagas disease, according to a study published in PLOS Neglected Tropical Diseases, by Clareci Silva Cardoso at the Federal University of São João del-Rei, Divinópolis, Brazil, and colleagues from the SaMi-Trop study, a project funded by NIAID/NIH.

Unilateral painless periorbital swelling: “Romaña’s Sign,” associated with acute stage of Chagas disease. Credit: Schmunis, CDC, 2007 (Public Domain)

Caused by exposure to the protozoa Trypanosoma cruzi, Chagas disease is a leading cause of cardiopathy and death in Latin America. An estimated 5.7 million people in Latin America are infected with Chagas, yet few treatments exists, and among known treatment options, specific therapeutic benefits are not well understood. Researchers in Brazil observed 1,813 patients who had tested positive for T. cruzi infection for two years, comparing clinical outcomes of those who had previously received benznidazole treatments with those who had not taken benznidazole.

The authors found that Chagas patients treated with benznidazole while still in the early stages of disease, had improved clinical and parasitological outcomes after a two-year follow-up period. Compared to the untreated group, researchers observed lowered mortality rates, lower parasite counts, and a lower risk of Chagas-related heart disease.

This is one of the most comprehensive studies of this kind demonstrating a marked clinical benefit from benznidazole. According to the authors, further research is necessary to learn more about the appropriate dose and duration of treatment. However, despite the study’s limitations, the researchers recommend using benznidazole to treat early-stage Chagas disease. “Because there are millions of untreated ChD patients in the world and no new treatments are available for the foreseeable future, it is reasonable to consider treating all Chagas disease patients without advanced cardiopathy with benznidazole, especially those who are less than 50 years of age.”