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New treatment regimens for Chagas disease: light at the end of the tunnel?
The quest to find effective aetiological treatments for Chagas disease has been ongoing for more than five decades. Sadly, Chagas disease remains neglected, although there has been some renewed interest in the past decade and repurposing of some molecules such as azoles has sparked some hope. A parasitic infection caused by Trypanosoma cruzi, still mostly confined to endemic countries in Latin America, but also affecting high-income nations due to migration patterns, Chagas disease can affect up to 30% of those infected, leading to devastating rapidly progressive cardiomyopathy and death. 1 For the past 50 years, only two drugs to treat Chagas disease have been available (benznidazole and nifurtimox). Benznidazole was launched in 1971 and was not approved by the US Food and Drug Administration until 2017. Despite benznidazole being highly effective and capable of reportedly eradicating 100% of parasites when patients are treated early, substantial limitations, including toxicity (peripheral neuropathy, granulocytopenia, rash, and severe gastrointestinal symptoms) leading to treatment discontinuation within a few weeks, have been reported in up to 25% of patients. Therefore, research efforts have been recently tailored to improving tolerability without sacrificing efficacy.