Anti-Trypanosomal Drugs and Ongoing and Upcoming Trials
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In this presentation, Dr. Maria Jesus Pinazo discusses the global disease burden, clinical manifestations, risk factors, and the use of anti-Trypanosomal agents in the therapeutic management of Chagas disease. Dr. Pinazo also reviews clinical trials relevant to the treatment of Chagas disease.
This session of the United States Chagas Disease Providers’ Network Virtual Presentations took place on Friday, November 1 2024, at 3:00 p.m.
Activity Information
How to Claim Credit
You may claim credit after watching this activity.
You will be redirected to the BCM DCPD credit management site when claiming credit and may be asked to register or log in.
Needs Statement
Clinicians in the United States, public health workers, and healthcare students and trainees do not receive systematic training about Chagas disease, even though a large portion of the U.S. population is at risk, including immigrants from continental Latin America and people living in the Southern United States where the Triatomine vector is endemic. At-risk children, women of reproductive age, and immunocompromised individuals particularly should be screened for the disease, and those confirmed to be positive should be treated to reduce their risk of developing severe sequelae of Chagas disease. This case conference aims to advance learner knowledge about the evidence-based recommendations for Chagas disease diagnosis, management, monitoring of treatment side effects, and implementation of strategies for screening and prevention. The overall goals are to enhance the quality of care for patients with Chagas disease in the United States and to improve patient outcomes by reducing disease-related morbidity and mortality.
Educational Objectives
At the conclusion of the sessions, the participants should be able to:
- Discuss the epidemiology and transmission of Chagas disease, its known risk factors, and its classical clinical manifestations.
- Apply guideline-based strategies to screen for and diagnose Chagas disease.
- Use public health tools to identify U.S. populations most at risk for Chagas disease and its sequelae.
- Implement effective treatment regimens and recognize their common side effects.
Target Audience
Professional Categories
- Physicians
- Medical Students
- Fellows
- Residents
- Nurses
- Other Health Professionals
Specialties
- Infectious Disease
- Internal Medicine
Interest Groups
- Global Health
Activity Evaluation
Evaluation by questionnaire will address program content, presentation, and possible bias.
Educational Methods
- Lectures
Accreditation/Credit Designation
Baylor College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Baylor College of Medicine designates this enduring material activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Activity Directors
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Jeffrey D. Whitman, M.D., M.S.
Assistant Professor of Laboratory Medicine
University of California, San Francisco, Zuckerberg San Francisco General Hospital
Term of Approval
November 1, 2024 through November 30, 2026. Original release date: November 1, 2024.
Disclosure Policy
Baylor College of Medicine (BCM) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education (CME) for physicians. BCM is committed to sponsoring CE activities that are scientifically based, accurate, current, and objectively presented.
In accordance with the ACCME Standards for Commercial Support, BCM has implemented a mechanism requiring everyone in a position to control the content of an educational activity (i.e., directors, planning committee members, faculty) to disclose any relevant financial relationships with commercial interests (drug/device companies) and manage/resolve any conflicts of interest prior to the activity. Individuals must disclose to participants the existence or non-existence of financial relationships at the time of the activity or within 24 months prior.
In addition, BCM has requested activity faculty/presenters to disclose to participants any unlabeled use or investigational use of pharmaceutical/device products; to use scientific or generic names (not trade names) in referring to products; and, if necessary to use a trade name, to use the names of similar products or those within a class. Faculty/presenters have also been requested to adhere to the ACCME's validation of clinical content statements.
BCM does not view the existence of financial relationships with commercial interests as implying bias or decreasing the value of a presentation. It is up to participants to determine whether the relationships influence the activity faculty with regard to exposition or conclusions. If at any time during this activity you feel that there has been commercial/promotional bias, notify the Activity Director or Activity Coordinator. Please answer the questions about balance and objectivity in the activity evaluation candidly.
All of the relevant financial relationships listed for these individuals have been mitigated.
Echeverría LE, Marcus R, Novick G, et al. WHF IASC Roadmap on Chagas Disease. Glob Heart. 2020;15(1):26. Published 2020 Mar 30. doi:10.5334/gh.484.
Lee BY, Bacon KM, Bottazzi ME, Hotez PJ. Global economic burden of Chagas disease: a computational simulation model. Lancet Infect Dis. 2013;13(4):342-348. doi:10.1016/S1473-3099(13)70002-1.
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Molina I, Gómez i Prat J, Salvador F, et al. Randomized trial of posaconazole and benznidazole for chronic Chagas' disease. N Engl J Med. 2014;370(20):1899-1908. doi:10.1056/NEJMoa1313122.
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Torrico F, Gascón J, Barreira F, et al. New regimens of benznidazole monotherapy and in combination with fosravuconazole for treatment of Chagas disease (BENDITA): a phase 2, double-blind, randomised trial [published correction appears in Lancet Infect Dis. 2021 Aug;21(8):e208. doi: 10.1016/S1473-3099(21)00419-9]. Lancet Infect Dis. 2021;21(8):1129-1140. doi:10.1016/S1473-3099(20)30844-6.
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Cortes-Serra N, Losada-Galvan I, Pinazo MJ, Fernandez-Becerra C, Gascon J, Alonso-Padilla J. State-of-the-art in host-derived biomarkers of Chagas disease prognosis and early evaluation of anti-Trypanosoma cruzi treatment response. Biochim Biophys Acta Mol Basis Dis. 2020;1866(7):165758. doi:10.1016/j.bbadis.2020.165758.
García-Álvarez A. Myocardial Delayed Enhancement in Chagas Heart Disease: Ready for the Clinical Arena?. J Am Coll Cardiol. 2018;72(21):2588-2590. doi:10.1016/j.jacc.2018.09.034.
Garcia-Alvarez A, Sitges M, Pinazo MJ, et al. Chagas cardiomyopathy: the potential of diastolic dysfunction and brain natriuretic peptide in the early identification of cardiac damage. PLoS Negl Trop Dis. 2010;4(9):e826. Published 2010 Sep 21. doi:10.1371/journal.pntd.0000826.
García-Álvarez A, Sitges M, Regueiro A, et al. Myocardial deformation analysis in Chagas heart disease with the use of speckle tracking echocardiography. J Card Fail. 2011;17(12):1028-1034. doi:10.1016/j.cardfail.2011.08.007.
Forsyth C. From Lemongrass to Ivermectin: Ethnomedical Management of Chagas Disease in Tropical Bolivia. Med Anthropol. 2018;37(3):236-252. doi:10.1080/01459740.2017.1360878.
Forsyth C, Meymandi S, Moss I, Cone J, Cohen R, Batista C. Proposed multidimensional framework for understanding Chagas disease healthcare barriers in the United States. PLoS Negl Trop Dis. 2019;13(9):e0007447. Published 2019 Sep 26. doi:10.1371/journal.pntd.0007447.
Pinazo MJ, Lacima G, Elizalde JI, et al. Characterization of digestive involvement in patients with chronic T. cruzi infection in Barcelona, Spain. PLoS Negl Trop Dis. 2014;8(8):e3105. Published 2014 Aug 21. doi:10.1371/journal.pntd.0003105.
Torrico F, Gascón J, Ortiz L, et al. A Phase 2, Randomized, Multicenter, Placebo-Controlled, Proof-of-Concept Trial of Oral Fexinidazole in Adults With Chronic Indeterminate Chagas Disease. Clin Infect Dis. 2023;76(3):e1186-e1194. doi:10.1093/cid/ciac579.
Disclosures
The following individual(s) has/have reported financial or other relationship(s) with commercial entities whose products/services may relate to the educational content of this activity:
Presenter
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Maria Jesus Pinazo, M.D., Ph.D.
Head of Chagas Disease Program
Drugs for Neglected Diseases Initiative
Disclosure:
Nothing to disclose.
Activity Directors
-
Eva Clark, M.D., Ph.D., CTropMed
Instructor
Baylor College of Medicine
Disclosure:
Nothing to disclose.
-
Jeffrey D. Whitman, M.D., M.S.
Assistant Professor of Laboratory Medicine
University of California, San Francisco, Zuckerberg San Francisco General Hospital
Disclosure:
- Consultancy: MelioLabs, Inc.
Planning Committee Members
-
Caryn Bern, M.D., M.P.H.
Professor of Epidemiology & Biostatistics
University of California, San Francisco School of Medicine
Disclosure:
- Intellectual Property: UpToDate (Wolters Kluwer Health)
-
Eva Clark, M.D., Ph.D., CTropMed
Instructor
Baylor College of Medicine
Disclosure:
Nothing to disclose.
-
Jill Weatherhead, M.D., M.Sc., DTM&H
Assistant Professor
Baylor College of Medicine
Disclosure:
Nothing to disclose.
-
Jeffrey D. Whitman, M.D., M.S.
Assistant Professor of Laboratory Medicine
University of California, San Francisco, Zuckerberg San Francisco General Hospital
Disclosure:
- Consultancy: MelioLabs, Inc.