Chagas Disease Clinical Trial
Official title:
Cardiovascular Health Investigation and Collaboration From Countries of America to Assess the Markers and Outcomes of Chagas Disease (CHICAMOCHA-3) - EQUITY (Equivalence of Usual Interventions for Trypanosomiasis)
This randomized, blind, parallel-group trial will evaluate the efficacy and safety of
Nifurtimox (NFX) and Benznidazole (BZN), the two usual interventions to treat the parasite
Trypanosoma cruzi.
The investigators will test whether NFX is an effective trypanocidal agent (by comparison
with placebo) and equivalent to BZN (as active comparator) in terms of both parasite-related
and safety outcomes.
Individuals found seropositive and without clinical signs of dilated cardiomyopathy will
receive either of the active treatments or matching placebo. Participants allocated to NFX or
BZN will receive either a 60-day (full-dose) or a 120-day (half-dose) active treatment,
whereas the control group will receive placebo for 120 days. There will be thus four arms of
active treatment (NFX60, NFX120, BZN60 and BZN120), and a fifth control arm receiving placebo
(1:1:1:1:1 allocation ratio) where every participant in the trial will take 120 days of study
drug (the groups receiving full-dose will complete a 120-day masked treatment with placebo).
The study plans to enroll 500 participants from Colombia (in two different geographical
areas) and Argentina, in order to explore regional differences in the treatment effects.
The specific aims of this multi-center randomized trial include:
1. To evaluate the feasibility of conducting a multinational trial in terms of
1. the ability to identify and recruit T. cruzi-infected individuals without clinical
disease in a relatively short period
2. the standardization of procedures to test the parasitic load using polymerase chain
reaction (PCR)
2. To evaluate, in the study population, the efficacy of a treatment with NFX using
conventional (full) dose (8/mg/Kg/day) or half-dose for a variable duration (full-dose
for 60 days versus half-dose for 120 days) in terms of the presence of positive PCR
tests one year after treatment, as compared with placebo.
3. To evaluate the equivalence (in terms of non-inferiority of its impact over the PCR
testing) of two treatment schedules with NFX: a full-dose treatment for 60 days and a
half-dose treatment for 120 days.
4. To evaluate the equivalence of two treatment schedules with BZN: A conventional (full)
dose of 5 mg/Kg/day) for 60 days, as compared with half-dose treatment for 120 days.
5. To evaluate the equivalence of the treatment schedules with NFX as compared with those
with BZN 5
6. To evaluate the safety (in terms of reporting of mild symptoms, limitation of daily
activities or hospitalizations, biochemical or blood abnormalities commonly reported by
individuals taking these treatments) and adherence to the allocated treatments among
individuals receiving NFX or BZN for varying duration and dose, as compared with placebo
7. To explore differences in the impact of active treatments on the PCR among four
subgroups of interest (geographical origin, T. cruzi discrete type unit found, parasitic
load at baseline and age of participants).
8. To explore, among individuals treated with placebo, the level of agreement in the tests
of parasitic load at baseline and during the follow up.
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