An evaluation of nifurtimox for Chagas disease in children

Abstract

Introduction: Chagas disease (CD) is a zoonosis disease caused by Trypanosoma cruzi (T. cruzi) and currently affects 6 million people worldwide. Described 100 years ago, two drugs are available for treatment, nifurtimox (NFX) and benznidazole (BZN), developed over 50 years ago. Though BZN has been more commonly used for CD, new development efforts on NFX has been undertaken with its recently released pediatric formulation and an ongoing study continuation with long-term follow-up. Areas covered: In this narrative review, we searched electronic databases (e.g. PubMed, Cochrane) and critically analyzed clinical and preclinical studies about NFX for CD treatment from a pediatric perspective, focusing on pharmacodynamics, pharmacokinetics, metabolism, safety, tolerance, and clinical efficacy of this drug. Expert opinion: In order to achieve CD elimination goals, early diagnosis and opportune treatment are fundamental. In this context, the approval by FDA of NFX for children 0–18 years of age has made this drug the only one available in 0 to 2 years and over 12 age groups in USA. This approval might also change preconceptions about NFX safety and tolerance. Considering CD has only two pharmacological options, this is a significant step toward a new era for the treatment of this disease in the pediatric population.