Pediatric Clinical Pharmacology Studies in Chagas Disease

Abstract

Chagas disease is a neglected parasitic disease endemic in the Americas. It mainly affects impoverished populations and the acute phase of the infection mostly affects children. Many cases have also been detected in nonendemic countries as a result of recent migratory trends. The chronic phase is relatively asymptomatic, but 30% of patients with chronic infection eventually develop cardiac and digestive complications that commonly lead to death or disability. Only two drugs are available for the treatment of Chagas disease, benznidazole and nifurtimox. These drugs have been shown to be effective in the treatment of both acute and early chronic phases in children, but the pharmacokinetics of these drugs have never been studied in this population. We have set out to conduct a pharmacokinetics study of benznidazole in a pediatric population with Chagas disease. The results of this study are expected to allow better estimation of the optimal doses and schedule of pharmacotherapy for Chagas disease in children.

Therapy, diagnosis and prognosis of chronic Chagas disease: insight gained in Argentina

“…During the past decade, numerous pharmacological studies have demonstrated the existence of significant pharmacokinetic and pharmacodynamic differences between adults and children (Reed 1999, Standing & Tuleu 2005 and studies describing the kinetics of benznidazole are being carrying out (Garcia-Bournissen et al 2009). Every year, the National Chagas Programs detect thousands of children infected in the chronic or earlier stages who require treatment.…”

Population Pharmacokinetic Study of Benznidazole in Pediatric Chagas Disease Suggests Efficacy despite Lower Plasma Concentrations than in Adults

“…Even though both drugs were developed over 4 decades ago, there is little information available on their clinical pharmacology, particularly for special populations such as children [8], [9]…”

A Simple and Efficient HPLC Method for Benznidazole Dosage in Human Breast Milk

“…2 Initial infections with T. cruzi take place mostly in children, by vector or congenital transmission. 3 As vector control improves, congenital transmission is rapidly becoming the main route of infection, highlighting the importance of the diagnosis of maternal infection. However, in view of the particular cultural and social context of endemic Chagas disease regions, this diagnosis is frequently associated with pregnancy screening or birth attendance.…”