by Torrico F, Gascón J, Ortiz L, Pinto J, Rojas G, Palacios A, Barreira F, Blum B, Gabriel Schijman AG, Vaillant M, Strub-Wourgaft N, Pinazo MJ, Bilbe G, Ribeiro I, on behalf of the FEXI-CHAGAS study group. Clinical Infectious Diseases 2022, 76(3):e1186–e1194. doi: 10.1093/cid/ciac579
Summary: Pre-clinical data for the sleeping sickness treatment fexinidazole has shown efficacy against the causative agent of Chagas disease, T. cruzi, and a lack of genotoxicity. The authors describe a double-blind, randomised, placebo-controlled study of this potential treatment for Chagas disease, conducted in Bolivia. Six regimens were tested: 1200 or 1800 mg fexinidazole per day for 2, 4, or 8 weeks. Enrolment was interrupted after 4/47 patients presented with transient asymptomatic grade-3 and 4 neutropenia, while rapid, sustained clearance of parasitemia was observed in all treated patients with available data, varying between 66.7% (1200 mg, 2 weeks) and 100.0% (1800 mg, 2 weeks). Further exploratory exposure-response analysis suggested that low dosages of fexinidazole may be safe and effective.