ABSTRACT

Introduction

Chagas disease affects 6–7 million people, mainly in the Americas, and benznidazole is one of the two therapeutic options available. Trypanocide treatment aims to eliminate the parasite from the body to prevent the establishment or progression of visceral damage, mainly cardiac and/or digestive. Remarkably, it helps interrupt vertical transmission when administered to women of childbearing age.

Areas covered

We discuss the basic and scarce data regarding chemical, pharmacokinetic, and pharmacodynamic structure. We also collect the most important data from previous phase II and III studies, as well as studies currently underway and upcoming. We reflect on the main indications for treatment and its challenges, such as the profile of adverse effects in adults, the pharmaceutical formulations, the search for reliable biomarkers, as well as regulatory aspects and access barriers. Alternative strategies such as shorter regimens, lower doses, and fixed doses are currently being evaluated to improve access and the safety profile of this treatment.

Expert opinion

Benznidazole is likely to continue to be the drug of choice for Chagas disease in the coming years. However, it would probably be with a different treatment scheme.

中文翻译：

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苄硝唑治疗南美锥虫病

摘要

介绍

恰加斯病影响了 6-700 万人，主要在美洲，而苯并咪唑是两种可用的治疗选择之一。杀锥虫剂治疗旨在消除体内寄生虫，以防止内脏损伤的建立或发展，主要是心脏和/或消化系统。值得注意的是，当对育龄妇女给药时，它有助于阻断​​垂直传播。

覆盖区域

我们讨论有关化学、药代动力学和药效学结构的基本和稀缺数据。我们还从之前的 II 期和 III 期研究以及目前正在进行和即将进行的研究中收集最重要的数据。我们反思了治疗的主要适应症及其挑战，例如成人不良反应的概况、药物配方、寻找可靠的生物标志物，以及监管方面和准入障碍。目前正在评估替代策略，例如更短的方案、更低的剂量和固定剂量，以改善这种治疗的可及性和安全性。

专家意见

未来几年，苯并咪唑可能会继续成为治疗恰加斯病的首选药物。然而，它可能会采用不同的治疗方案。