New, improved treatments for Chagas disease: from the R&D pipeline to the patients

by Ribeiro I, Sevcsik AM, Alves F, Diap G, Don R, Harhay MO, Chang S, Pecoul BPLoS Negl Trop Dis, July 2009, 3(7):e484.

Summary: This policy paper outlines the urgent need for new treatments for Chagas, examines barriers to development and evaluation of new drugs, and reports on progress in bringing new treatments to patients. Part of a Chagas disease series published by PLoS NTD, this paper focuses on the efforts of DNDi and others to develop and make available better-adapted diagnostic and treatment tools. Published upon the occasion of the 100th anniversary of Chagas disease, this article also mentions a newly launched campaign, www.treatchagas.org, to increase awareness about Chagas disease, and is joined in the series by an editorial covering the unfinished public health agenda and a research article on MSF’s 10-year experience of treating Chagas disease in Latin America.

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Although the occurrence of acute cases of Chagas disease has declined, there still remain serious challenges, including the maintenance of sustainable public policies for Chagas disease control and the urgent need for better drugs to treat chagasic patients. Since the introduction of benznidazole and nifurtimox approximately 40 years ago, many natural and synthetic compounds have been assayed against Trypanosoma cruzi, yet only a few compounds have advanced to clinical trials. The development of more effective drugs requires (i) the identification and validation of parasite targets, (ii) compounds to be screened against the targets or the whole parasite and (iii) a panel of minimum standardised procedures to advance leading compounds to clinical trials. This third aim was the topic of a workshop held in Rio de Janeiro, Brazil, in November 2008: the minimum steps, requirements and decision gates for the determination of the efficacy of novel drugs for T. cruzi control were evaluated by interdisciplinary experts and an in vitro and in vivo flowchart was designed to serve as a general and standardised protocol for screening potential drugs for the treatment of Chagas disease.

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