Benznidazole Tx Explored in Chagas' Cardiomyopathy
Reduces serum parasite detection but does not reduce cardiac clinical deterioration through 5 years
TUESDAY, Sept. 1, 2015 (HealthDay News) -- For patients with established Chagas' cardiomyopathy, benznidazole reduces serum parasite detection, according to a study published online Sept. 1 in the New England Journal of Medicine to coincide with the annual European Society of Cardiology Congress, held from Aug. 29 to Sept. 2 in London.
Carlos A. Morillo, M.D., from Hamilton Health Sciences and McMaster University in Canada, and colleagues conducted a prospective randomized trial involving 2,854 patients with Chagas' cardiomyopathy who received benznidazole or placebo for up to 80 days. Patients were followed for a mean of 5.4 years.
The researchers found that the primary outcome (first event of a composite of death, resuscitated cardiac arrest, sustained ventricular tachycardia, insertion of a pacemaker or implantable cardioverter-defibrillator, cardiac transplantation, new heart failure, stroke, or other thromboembolic event) occurred in 27.5 and 29.1 percent of the benznidazole and placebo groups, respectively (P = 0.31). In polymerase chain reaction (PCR), 60.5 percent of patients had positive results for Trypanosoma cruzi at baseline. At the end of treatment, the rates of conversion from negative PCR results were 66.2 and 33.5 percent in the benznidazole and placebo groups, respectively; at two years the rates were 55.4 and 35.3 percent, respectively, and at five or more years, 46.7 and 33.1 percent, respectively (P < 0.001 for all comparisons).
"Benznidazole treatment significantly reduced the detection of circulating parasites but did not reduce cardiac clinical progression," the authors write.
Two authors disclosed financial ties to the pharmaceutical industry.