Beneficial effects of benznidazole in Chagas disease: NIH SaMi-Trop cohort study

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art_CARDOSO_Beneficial_effects_of_benznidazole_in_Chagas_disease_NIH_2018.PDF (1.3 MB)
Citações na Scopus
60
Tipo de produção
article
Data de publicação
2018
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
PUBLIC LIBRARY SCIENCE
Autores
CARDOSO, Clareci Silva
RIBEIRO, Antonio Luiz P.
OLIVEIRA, Claudia Di Lorenzo
FERREIRA, Ariela Mota
BIERRENBACH, Ana Luiza
LUIZ, Jose
SILVA, Padilha
COLOSIMO, Enrico Antonio
FERREIRA, Joao Eduardo
Citação
PLOS NEGLECTED TROPICAL DISEASES, v.12, n.11, article ID e0006814, 12p, 2018
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background The 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. Methods The 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. Results Mortality 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]. Conclusion Patients 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.
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URI
https://observatorio.fm.usp.br/handle/OPI/29945
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MIP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - IMT
Artigos e Materiais de Revistas Científicas - LIM/03
Artigos e Materiais de Revistas Científicas - LIM/46