Beneficial effects of benznidazole in Chagas disease: NIH SaMi-Trop cohort study.
BackgroundThe effectiveness of anti-parasite treatment with benznidazole in the chronic Chagas disease (ChD) remains uncertain. We evaluated, using data from the NIH-sponsored SaMi-Trop prospective cohort study, if previous treatment with benznidazole is associated with lower mortality, less advance...
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ftcdlib:oai:escholarship.org/ark:/13030/qt212036f6 2023-05-15T18:11:50+02:00 Beneficial effects of benznidazole in Chagas disease: NIH SaMi-Trop cohort study. Cardoso, Clareci Silva Ribeiro, Antonio Luiz P Oliveira, Claudia Di Lorenzo Oliveira, Lea Campos Ferreira, Ariela Mota Bierrenbach, Ana Luiza Silva, José Luiz Padilha Colosimo, Enrico Antonio Ferreira, João Eduardo Lee, Tzong-Hae Busch, Michael P Reingold, Arthur Lawrence Sabino, Ester Cerdeira e0006814 2018-11-01 application/pdf https://escholarship.org/uc/item/212036f6 unknown eScholarship, University of California qt212036f6 https://escholarship.org/uc/item/212036f6 public PLoS neglected tropical diseases, vol 12, iss 11 Humans Trypanosoma cruzi Parasitemia Chagas Disease Chronic Disease Nitroimidazoles Trypanocidal Agents Aftercare Follow-Up Studies Prospective Studies National Institutes of Health (U.S.) United States Brazil National Institutes of Health Tropical Medicine Biological Sciences Medical and Health Sciences article 2018 ftcdlib 2021-01-24T17:37:25Z BackgroundThe effectiveness of anti-parasite treatment with benznidazole in the chronic Chagas disease (ChD) remains uncertain. We evaluated, using data from the NIH-sponsored SaMi-Trop prospective cohort study, if previous treatment with benznidazole is associated with lower mortality, less advanced cardiac disease and lower parasitemia in patients with chronic ChD.MethodsThe study enrolled 1,959 ChD patients and abnormal electrocardiogram (ECG) from in 21 remote towns in Brazil. A total of 1,813 patients were evaluated at baseline and after two years of follow-up. Those who received at least one course of benznidazole were classified as treated group (TrG = 493) and those who were never treated as control group (CG = 1,320). The primary outcome was death after two-year follow-up; the secondary outcomes were presence at the baseline of major ChD-associated ECG abnormalities, NT-ProBNP levels suggestive of heart failure, and PCR positivity.ResultsMortality after two years was 6.3%; it was lower in the TrG (2.8%) than the CG (7.6%); adjusted OR: 0.37 (95%CI: 0.21;0.63). The ECG abnormalities typical for ChD and high age-adjusted NT-ProBNP levels suggestive of heart failure were lower in the TrG than the CG, OR: 0.35 [CI: 0.23;0.53]. The TrG had significantly lower rates of PCR positivity, OR: 0.35 [CI: 0.27;0.45].ConclusionPatients previously treated with benznidazole had significantly reduced parasitemia, a lower prevalence of markers of severe cardiomyopathy, and lower mortality after two years of follow-up. If used in the early phases, benznidazole treatment may improve clinical and parasitological outcomes in patients with chronic ChD.Trial registrationClinicalTrials.gov, Trial registration: NCT02646943. Article in Journal/Newspaper sami University of California: eScholarship |
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University of California: eScholarship |
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topic |
Humans Trypanosoma cruzi Parasitemia Chagas Disease Chronic Disease Nitroimidazoles Trypanocidal Agents Aftercare Follow-Up Studies Prospective Studies National Institutes of Health (U.S.) United States Brazil National Institutes of Health Tropical Medicine Biological Sciences Medical and Health Sciences |
spellingShingle |
Humans Trypanosoma cruzi Parasitemia Chagas Disease Chronic Disease Nitroimidazoles Trypanocidal Agents Aftercare Follow-Up Studies Prospective Studies National Institutes of Health (U.S.) United States Brazil National Institutes of Health Tropical Medicine Biological Sciences Medical and Health Sciences Cardoso, Clareci Silva Ribeiro, Antonio Luiz P Oliveira, Claudia Di Lorenzo Oliveira, Lea Campos Ferreira, Ariela Mota Bierrenbach, Ana Luiza Silva, José Luiz Padilha Colosimo, Enrico Antonio Ferreira, João Eduardo Lee, Tzong-Hae Busch, Michael P Reingold, Arthur Lawrence Sabino, Ester Cerdeira Beneficial effects of benznidazole in Chagas disease: NIH SaMi-Trop cohort study. |
topic_facet |
Humans Trypanosoma cruzi Parasitemia Chagas Disease Chronic Disease Nitroimidazoles Trypanocidal Agents Aftercare Follow-Up Studies Prospective Studies National Institutes of Health (U.S.) United States Brazil National Institutes of Health Tropical Medicine Biological Sciences Medical and Health Sciences |
description |
BackgroundThe effectiveness of anti-parasite treatment with benznidazole in the chronic Chagas disease (ChD) remains uncertain. We evaluated, using data from the NIH-sponsored SaMi-Trop prospective cohort study, if previous treatment with benznidazole is associated with lower mortality, less advanced cardiac disease and lower parasitemia in patients with chronic ChD.MethodsThe study enrolled 1,959 ChD patients and abnormal electrocardiogram (ECG) from in 21 remote towns in Brazil. A total of 1,813 patients were evaluated at baseline and after two years of follow-up. Those who received at least one course of benznidazole were classified as treated group (TrG = 493) and those who were never treated as control group (CG = 1,320). The primary outcome was death after two-year follow-up; the secondary outcomes were presence at the baseline of major ChD-associated ECG abnormalities, NT-ProBNP levels suggestive of heart failure, and PCR positivity.ResultsMortality after two years was 6.3%; it was lower in the TrG (2.8%) than the CG (7.6%); adjusted OR: 0.37 (95%CI: 0.21;0.63). The ECG abnormalities typical for ChD and high age-adjusted NT-ProBNP levels suggestive of heart failure were lower in the TrG than the CG, OR: 0.35 [CI: 0.23;0.53]. The TrG had significantly lower rates of PCR positivity, OR: 0.35 [CI: 0.27;0.45].ConclusionPatients previously treated with benznidazole had significantly reduced parasitemia, a lower prevalence of markers of severe cardiomyopathy, and lower mortality after two years of follow-up. If used in the early phases, benznidazole treatment may improve clinical and parasitological outcomes in patients with chronic ChD.Trial registrationClinicalTrials.gov, Trial registration: NCT02646943. |
format |
Article in Journal/Newspaper |
author |
Cardoso, Clareci Silva Ribeiro, Antonio Luiz P Oliveira, Claudia Di Lorenzo Oliveira, Lea Campos Ferreira, Ariela Mota Bierrenbach, Ana Luiza Silva, José Luiz Padilha Colosimo, Enrico Antonio Ferreira, João Eduardo Lee, Tzong-Hae Busch, Michael P Reingold, Arthur Lawrence Sabino, Ester Cerdeira |
author_facet |
Cardoso, Clareci Silva Ribeiro, Antonio Luiz P Oliveira, Claudia Di Lorenzo Oliveira, Lea Campos Ferreira, Ariela Mota Bierrenbach, Ana Luiza Silva, José Luiz Padilha Colosimo, Enrico Antonio Ferreira, João Eduardo Lee, Tzong-Hae Busch, Michael P Reingold, Arthur Lawrence Sabino, Ester Cerdeira |
author_sort |
Cardoso, Clareci Silva |
title |
Beneficial effects of benznidazole in Chagas disease: NIH SaMi-Trop cohort study. |
title_short |
Beneficial effects of benznidazole in Chagas disease: NIH SaMi-Trop cohort study. |
title_full |
Beneficial effects of benznidazole in Chagas disease: NIH SaMi-Trop cohort study. |
title_fullStr |
Beneficial effects of benznidazole in Chagas disease: NIH SaMi-Trop cohort study. |
title_full_unstemmed |
Beneficial effects of benznidazole in Chagas disease: NIH SaMi-Trop cohort study. |
title_sort |
beneficial effects of benznidazole in chagas disease: nih sami-trop cohort study. |
publisher |
eScholarship, University of California |
publishDate |
2018 |
url |
https://escholarship.org/uc/item/212036f6 |
op_coverage |
e0006814 |
genre |
sami |
genre_facet |
sami |
op_source |
PLoS neglected tropical diseases, vol 12, iss 11 |
op_relation |
qt212036f6 https://escholarship.org/uc/item/212036f6 |
op_rights |
public |
_version_ |
1766184458109583360 |