TY - JOUR
T1 - Risk factors for treatment interruption and severe adverse effects to benznidazole in adult patients with Chagas disease
AU - Olivera, Mario J.
AU - Cucunubá, Zulma M.
AU - Valencia-Hernández, Carlos A.
AU - Herazo, Rafael
AU - Agreda-Rudenko, Diana
AU - Flórez, Carolina
AU - Duque, Sofía
AU - Nicholls, Rubén S.
N1 - Publisher Copyright:
© 2017 Olivera et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2017/9
Y1 - 2017/9
N2 - Background: Etiological treatment of Chagas disease in chronic asymptomatic patients is still in debate and the adverse effects of traditional drugs are one of the main concerns in clinical practice. This study evaluated retrospectively the safety profile of benznidazole (BZN) and identified predictive factors for definite treatment interruption and development of severe reactions in adult patients treated with BZN in Colombia. Methods: Retrospective follow-up study conducted by review of medical records of adults with chronic Chagas disease treated with BZN in Colombia. A parametric survival analysis based on a generalized gamma distribution was used for assessing risk factors for treatment interruption. A multinomial logistic regression model was used to estimate the probability of severe adverse drug reactions (ADRs). Statistical associations were expressed as time ratios (TR) and adjusted odds ratios (aOR) respectively. Results: In total 224 adults patients treated with BZN were included; 172 (76.8%) completed the standard therapy (60 days of treatment), 205 (91.5%) presented ADRs and 52 cases (23.2%) required treatment interruption. The predominant symptoms were: rash (37.9%), itching (33.7%), epigastric pain (26.4%), abdominal bloating (24.2%) and nausea (22.1%). ADRs were mild (57.4%), moderate (35.5%) and severe (7.3%). Time to treatment interruption was significantly shorter when using doses of BZN ≥ 6 mg/kg/day (TR 0.55; 95% CI 0.39–0.76), presenting severe ADRs (TR 0.12; 95% CI: 0.07–0.19) and eosinophilia (TR 0.68; 95% CI: 0.49–0.94). Female sex (aOR 3.98; 95% CI 1.56–10.16), dose of BZN ≥ 6 mg/kg/ day (aOR 1.41; 95% CI 1.17–1.70) and presence of > 3 ADRs (aOR 6.47; 95% CI 1.24–34.34) were considered as risk factors for developing severe ADRs. Conclusions: Dose, severity of ADRs, eosinophilia and female sex were the main predictors for treatment interruption or severe ADRs. The potential implications of these findings are discussed.
AB - Background: Etiological treatment of Chagas disease in chronic asymptomatic patients is still in debate and the adverse effects of traditional drugs are one of the main concerns in clinical practice. This study evaluated retrospectively the safety profile of benznidazole (BZN) and identified predictive factors for definite treatment interruption and development of severe reactions in adult patients treated with BZN in Colombia. Methods: Retrospective follow-up study conducted by review of medical records of adults with chronic Chagas disease treated with BZN in Colombia. A parametric survival analysis based on a generalized gamma distribution was used for assessing risk factors for treatment interruption. A multinomial logistic regression model was used to estimate the probability of severe adverse drug reactions (ADRs). Statistical associations were expressed as time ratios (TR) and adjusted odds ratios (aOR) respectively. Results: In total 224 adults patients treated with BZN were included; 172 (76.8%) completed the standard therapy (60 days of treatment), 205 (91.5%) presented ADRs and 52 cases (23.2%) required treatment interruption. The predominant symptoms were: rash (37.9%), itching (33.7%), epigastric pain (26.4%), abdominal bloating (24.2%) and nausea (22.1%). ADRs were mild (57.4%), moderate (35.5%) and severe (7.3%). Time to treatment interruption was significantly shorter when using doses of BZN ≥ 6 mg/kg/day (TR 0.55; 95% CI 0.39–0.76), presenting severe ADRs (TR 0.12; 95% CI: 0.07–0.19) and eosinophilia (TR 0.68; 95% CI: 0.49–0.94). Female sex (aOR 3.98; 95% CI 1.56–10.16), dose of BZN ≥ 6 mg/kg/ day (aOR 1.41; 95% CI 1.17–1.70) and presence of > 3 ADRs (aOR 6.47; 95% CI 1.24–34.34) were considered as risk factors for developing severe ADRs. Conclusions: Dose, severity of ADRs, eosinophilia and female sex were the main predictors for treatment interruption or severe ADRs. The potential implications of these findings are discussed.
UR - http://www.scopus.com/inward/record.url?scp=85029949514&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0185033
DO - 10.1371/journal.pone.0185033
M3 - Article
C2 - 28949997
AN - SCOPUS:85029949514
SN - 1932-6203
VL - 12
JO - PLoS ONE
JF - PLoS ONE
IS - 9
M1 - e0185033
ER -
