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New Scheme of Intermittent Benznidazole Administration in Patients Chronically Infected with Trypanosoma cruzi: a Pilot Short-Term Follow-Up Study with Adult Patients.

Authors :
Álvarez MG
Hernández Y
Bertocchi G
Fernández M
Lococo B
Ramírez JC
Cura C
Albizu CL
Schijman A
Abril M
Sosa-Estani S
Viotti R
Source :
Antimicrobial agents and chemotherapy [Antimicrob Agents Chemother] 2015 Nov 23; Vol. 60 (2), pp. 833-7. Date of Electronic Publication: 2015 Nov 23 (Print Publication: 2016).
Publication Year :
2015

Abstract

There is a clinical need to test new schemes of benznidazole administration that are expected to be at least as effective as the current therapeutic scheme but safer. This study assessed a new scheme of benznidazole administration in chronic Chagas disease patients. A pilot study with intermittent doses of benznidazole at 5 mg/kg/day in two daily doses every 5 days for a total of 60 days was designed. The main criterion of response was the comparison of quantitative PCR (qPCR) findings prior to and 1 week after the end of treatment. The safety profile was assessed by the rate of suspensions and severity of adverse effects. Twenty patients were analyzed for safety, while qPCR was tested for 17 of them. The average age was 43 ± 7.9 years; 55% were female. Sixty-five percent of treated subjects showed detectable qPCR results prior to treatment of 1.45 (0.63 to 2.81) and 2.1 (1.18 to 2.78) parasitic equivalents per milliliter of blood (par.eq/ml) for kinetoplastic DNA (kDNA) qPCR and nuclear repetitive sequence satellite DNA (SatDNA) qPCR, respectively. One patient showed detectable PCR at the end of treatment (1/17), corresponding to 6% treatment failure, compared with 11/17 (65%) patients pretreatment (P = 0.01). Adverse effects were present in 10/20 (50%) patients, but in only one case was treatment suspended. Eight patients showed mild adverse effects, whereas moderate reactions with increased liver enzymes were observed in two patients. The main accomplishment of this pilot study is the promising low rate of treatment suspension. Intermittent administration of benznidazole emerges a new potential therapeutic scheme, the efficacy of which should be confirmed by long-term assessment posttreatment.<br /> (Copyright © 2016, American Society for Microbiology. All Rights Reserved.)

Details

Language :
English
ISSN :
1098-6596
Volume :
60
Issue :
2
Database :
MEDLINE
Journal :
Antimicrobial agents and chemotherapy
Publication Type :
Academic Journal
Accession number :
26596935
Full Text :
https://doi.org/10.1128/AAC.00745-15