A Cochrane review [Abstract] 1 included 13 studies with a total of 4229 subjects. Ten studies tested nitroderivative drugs nifurtimox or benznidazole (three exposed participants to allopurinol, one to itraconazole). TT was associated with substantial, but heterogeneous reductions on parasite-related outcomes such as positive serology (9 studies, OR 0.21, 95% CI 0.10 to 0.44), positive PCR (2 studies, OR 0.50, 95% CI 0.27 to 0.92), positive xenodiagnosis after treatment (6 studies, OR 0.35, 95% CI 0.14 to 0.86), or reduction on antibody titres (3 studies, SMD -0.56, 95% CI -0.89 to -0.23). Efficacy data on patient-related outcomes was largely from non-RCTs. TT with nitroderivatives was associated with potentially important, but imprecise and inconsistent reductions in progression of CCC (4 studies, 106 events, OR 0.74, 95% CI 0.32 to 1.73) and mortality after TT (6 studies, 99 events, OR 0.55, 95% CI 0.26 to 1.14). The overall median incidence of any severe side effects among 1475 individuals from five studies exposed to TT was 2.7%, and the overall discontinuation of this two-month therapy in RC. The low quality and inconsistency of the data for patient-important outcomes must be treated with caution.
A Cochrane review [Abstract] 1 included one study on the effects of trypanocidal drugs for treating late stage chronic Chagas disease and chronic Chagasic cardiopathy (CCC), with with a total of 77 subjects. Benznidazole and nifurtimox, both with 5mg/kg/day every 12 hours during 30 days, were compared to placebo. Parasitologic cure was achieved in patients who received either benznidazole or nifurtimox, 98% and 90% respectively, but also 66% in the placebo group (p > 0.05). Serological reactions did not change over the follow-up and there were no clinical ECG or X-ray changes one year after treatment in any of the groups. The five non-randomised studies related to the treatment of chronic Chagasic cardiopathy were inconclusive.
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