Benznidazole and Posaconazole in Eliminating Parasites in Asymptomatic T. Cruzi Carriers: The STOP-CHAGAS Trial

MORILLO, CARLOS A.; WASKIN, HETTY; SOSA-ESTANI, SERGIO; DEL CARMEN BANGHER, MARIA; CUNEO, CARLOS; MILESI, RODOLFO; MALLAGRAY, MARCELO; APT, WERNER; BELOSCAR, JUAN; GASCON, JOAQUIM; MOLINA, ISRAEL; ECHEVERRIA, LUIS E.; COLOMBO, HUGO; PEREZ-MOLINA, JOSE ANTONIO; WYSS, FERNANDO; MEEKS, BRANDI; BONILLA, LAURA R.; GAO, PEGGY; WEI, BO; MCCARTHY, MICHAEL; YUSUF, SALIM

JACC - J. AM. COLL. CARDIOL.

Elsevier USA

Año: 2017 vol. 69 p. 939 - 947

0735-1097

Background Benznidazole is recommended for treatment of Chagas infection. Effects of combination therapy with benznidazole and posaconazole have not been tested in Trypanosoma cruzi carriers. Objectives The purpose of this study was to determine whether posaconazole alone or combined with benznidazole were superior to benznidazole monotherapy in eliminating T. cruzi parasites measured by real time polymerase chain reaction (RT-PCR) in asymptomatic Chagas carriers. Methods A prospective, multicenter randomized placebo-controlled study was conducted in 120 subjects from Latin America and Spain who were randomized to 4 groups: posaconazole 400 mg twice a day (b.i.d.); benznidazole 200 mg + placebo b.i.d.; benznidazole 200 mg b.i.d. + posaconazole 400 mg b.i.d.; or placebo 10 mg b.i.d. T. cruzi deoxyribonucleic acid was detected by RT-PCR at 30, 60, 90, 120, 150, 180, and 360 days. The primary efficacy outcome is the proportion of subjects with persistent negative RT-PCR by day 180; the secondary outcome was negative RT-PCR at 360 days. Results Only 13.3% of those receiving posaconazole and 10% receiving placebo achieved the primary outcome, compared with 80% receiving benznidazole + posaconazole and 86.7% receiving benznidazole monotherapy (p