Benznidazole and Chagas disease: can an old drug be the answer to an old problem?

Expert Opin Investig Drugs. 2008 Oct;17(10):1427-33. doi: 10.1517/13543784.17.10.1427.

Abstract

Background: Chagas disease is a significant public health problem in the Americas, despite efforts to decrease the number of new cases since 1990. Etiologic treatment of the disease's chronic phase is still controversial.

Objective: We reviewed the strongest studies to evaluate the drugs used in the acute and chronic disease phases, with emphasis on benznidazole.

Methods: A Medline search using the keywords 'Chagas disease' and 'treatment,' with no date limitations, was performed.

Results: Study methods in completed trials varied greatly, with none being a randomized, double-blind, placebo-controlled study. The only trial using these methods is still ongoing. The treatment in acute phase is the major indication, but during chronic phase doubts still remain.

Conclusion: Only patients in the acute phase of Chagas disease (whatever their age; including children and adolescents) who are treated have good outcomes, although the criteria defining 'cure' remain controversial.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Chagas Disease / drug therapy*
  • Child
  • Humans
  • Middle Aged
  • Nifurtimox / therapeutic use
  • Nitroimidazoles / therapeutic use*
  • Trypanocidal Agents / therapeutic use*

Substances

  • Nitroimidazoles
  • Trypanocidal Agents
  • Nifurtimox
  • benzonidazole