New Drugs and Promising Drug Combinations in the Treatment of Chagas Disease in Brazil: A Systematic Review and Meta-Analysis

IF 4.7 3区医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL

Archives of Medical Research Pub Date : 2024-09-26 DOI:10.1016/j.arcmed.2024.103084

Elainne Silva Freire , Letícia Pinto da Silva , Aline do Carmo Silva , Pedro Alves Soares Vaz de Castro , Giovanna Rotondo de Araújo , Dayane Andriotti Otta , Danilo Cavalcante Braz , Juliana Maria Trindade Bezerra

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引用次数: 0

Abstract

Chagas disease (CD) is a parasitic infection caused by the protozoan Trypanosoma cruzi (Kinetoplastida, Trypanosomatidae). Benznidazole (Bz) has a limited ability to interfere with the pathogenicity of the parasite, which manages to overcome host defenses. This study aimed to conduct a systematic literature review and meta-analysis to understand and describe the drugs and their combinations, as well as new promising compounds used in the treatment of CD in Brazil. This study was registered in the Open Science Framework (OSF) and the International Prospective Register of Systematic Reviews, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches were performed in the electronic scientific databases PubMed, LILACS, SciELO, and BVS. Searches were conducted using descriptors cataloged in the Health Sciences Descriptors (DeCS) and Medical Subject Headings (MeSH), in Portuguese, English, and Spanish. Of the 26 articles included in this systematic review and meta-analysis, 16 were related to drug combinations, and nine described new inhibitors of parasitic molecules. Despite high heterogeneity (I² = 92%), studies that evaluated the combination of Bz with other treatments for CD had an overall grouped cure rate of 74% (95% CI 54–94%). Only one study presented drug repositioning by monotherapy. Thus, drug combinations offer quick and accessible solutions for CD treatment, acting against resistant strains of T. cruzi. Certainly, the introduction of these promising compounds into the pharmaceutical market is distant, and the adoption of prophylactic measures is recommended as a barrier to the increasing number of CD cases.

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治疗巴西南美锥虫病的新药和有前途的药物组合：系统回顾与元分析

南美锥虫病（CD）是由原生动物克鲁斯锥虫（Kinetoplastida，Trypanosomatidae）引起的寄生虫感染。苯并咪唑（Bz）干扰寄生虫致病性的能力有限，而寄生虫却能克服宿主的防御能力。本研究旨在进行系统的文献综述和荟萃分析，以了解和描述巴西用于治疗 CD 的药物及其组合，以及有前景的新化合物。本研究遵循系统综述和荟萃分析首选报告项目（PRISMA）指南，在开放科学框架（OSF）和国际系统综述前瞻性登记处进行了登记。在电子科学数据库 PubMed、LILACS、SciELO 和 BVS 中进行了检索。检索时使用了葡萄牙语、英语和西班牙语的健康科学描述符（DeCS）和医学主题词表（MeSH）中的描述符。在纳入本系统综述和荟萃分析的 26 篇文章中，16 篇与药物组合有关，9 篇描述了寄生虫分子的新抑制剂。尽管异质性很高（I² = 92%），但对 Bz 与其他 CD 治疗方法联合使用进行评估的研究显示，总体分组治愈率为 74%（95% CI 54-94%）。只有一项研究介绍了通过单一疗法重新定位药物的情况。因此，联合用药为 CD 的治疗提供了快速、便捷的解决方案，并能对抗耐药的 T. cruzi 菌株。当然，将这些前景广阔的化合物引入医药市场还很遥远，建议采取预防措施，以阻止 CD 病例的增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Medical Research 医学-医学：研究与实验

CiteScore

12.50

自引率

0.00%

发文量

审稿时长

28 days

期刊介绍： Archives of Medical Research serves as a platform for publishing original peer-reviewed medical research, aiming to bridge gaps created by medical specialization. The journal covers three main categories - biomedical, clinical, and epidemiological contributions, along with review articles and preliminary communications. With an international scope, it presents the study of diseases from diverse perspectives, offering the medical community original investigations ranging from molecular biology to clinical epidemiology in a single publication.