Current Treatment of Chagas Disease

Autor: Claudia Ferreira, Mario-Andrés González-Chávez, Luis Alberto Martinez-Juarez, Alberto-Manuel González-Chávez, Rosalino Vázquez-López, Rodolfo García-Rodríguez-Arana, Diego Abelardo Álvarez-Hernández, Zaira-Leticia Castro-Rico
Rok vydání: 2020
Předmět:
Zdroj: Current Treatment Options in Infectious Diseases. 12:438-457
ISSN: 1534-6250
DOI: 10.1007/s40506-020-00238-1
Popis: Chagas disease (CD) is recognized as a neglected tropical disease. It is endemic of Latin America, but globalization has led to its spread worldwide. Even though its presence has been tracked at least 9000 years ago, treatment options remain scarce. The purpose of this review is to analyze the evidence for current and future options to combat the disease. CD patients benefit from dietary and exercise recommendations. Benznidazole and nifurtimox continue to be the available treatment options. Besides them, several drugs have been developed, repurposed, and tested in clinical trials, mostly inhibitors of the ergosterol synthesis like albaconazole, itraconazole, posaconazole, ravuconazole/fosravuconazole, voriconazole, and TAK-187; antiarrhythmics like amiodarone/dronedarone; inhibitors of the purine synthesis like allopurinol; nitroimidazoles like fexinidazole; and minerals like selenium. Even though they have shown in vitro and in vivo activity against Trypanosoma cruzi, their effectiveness is inferior to the one from benznidazole. Chronic CD patients who develop the cardio-digestive forms of the disease may eventually need assistive devices and/or surgical procedures to improve their outcome. Benznidazole and nifurtimox are the only trypanosomal drugs available to combat T. cruzi infection, and their effectiveness relies upon the stage of the disease at where the patients are. Their side effects frequently lead to patient’s non-compliance to treatment. Therefore, more effective drugs with a better safety profile are required. Up to date, controversial and promising results have been observed. Further compromise and research must be encouraged to tackle the challenges of developing new effective and safer drugs for CD patients.
Databáze: OpenAIRE
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