BENznidazole Evaluation For Interrupting Trypanosomiasis pilot trial

ISRCTN ISRCTN13967269
DOI https://doi.org/10.1186/ISRCTN13967269
Secondary identifying numbers MCT-79704
Submission date
01/06/2007
Registration date
01/06/2007
Last edited
03/09/2015
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Infections and Infestations
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Not provided at time of registration

Contact information

Dr Carlos A Morillo
Scientific

McMaster University
Population Health Research Institute
HGH-McMaster Clinic 5th Floor, Room 501
237 Barton Street East
Hamilton
Ontario
L8L 2X2
Canada

Study information

Study designMulticentre multinational two-arm randomised parallel controlled placebo trial with study participant, study investigator, caregiver, outcome assessor, and data analyst blinding
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Scientific titleBENznidazole Evaluation For Interrupting Trypanosomiasis pilot trial
Study acronymBENEFIT Pilot
Study objectivesBenznidazole is effective in producing parasitic cure in patients with Chronic Chagas Cardiomyopathy. 60 days of therapy with Benznidazole will:
1. Increase negativization of Trypanosomiasis cruzi as detected by Polymerase Chain Reaction (PCR) by at least 30%, and
2. Reduce t. cruzi parasite load by at least 50%
Ethics approval(s)1. Research Ethics Board of Hamilton Health Sciences Corporation & McMaster University (Canada), 21/09/2006, ref: NREC # 05-348
2. Comité de Ethica em Pesquisa de l'Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo (Brazil), 04/02/2004, ref: NREC# 213/2004
3. Ministerio de Salud y Ambiente (Argentina), 11/03/2005, ref: NREC 1-0047-0000-00733-05-1
4. Comite Investigaciones de Fundacion ABBOD SHAIO (Columbia), 19/04/2004
Health condition(s) or problem(s) studiedChagas disease; American trypanosomiasis
Intervention1. Benznidazole: 60 days of treatment at 5 mg/kg/day given twice a day (at maximum dose of 400 mg/day)
2. Matching placebo: 60 days of treatment at 5 mg/kg/day given twice a day (at maximum dose of 400 mg/day)
Intervention typeDrug
Pharmaceutical study type(s)
PhaseNot Applicable
Drug / device / biological / vaccine name(s)Benznidazole
Primary outcome measureThere are two related co-primary outcomes:
1. Negativisation and reduction of t. cruzi detected by PCR at the end of treatment which lasted 60 days, and at a two-year follow-up
2. Reduction in the mean burden of t. cruzi (parasite load) as detected by the concentration of t. cruzi/ml of blood by PCR in the treated group, at the end of treatment which lasted 60 days, and at a two-year follow-up
Secondary outcome measures1. Safety and tolerability of benznidazole in chronic Chagas cardiomyopathy, 11 ± 2 days after initial randomisation, three weeks ± 3 days after randomisation, end of therapy (60 days) and two years later
2. Long-term feasibility of conducting a Randomised Controlled Trial (RCT) in patients with Chagas disease measured by patient enrolment and completion of follow-up, recruitment rate measured at baseline, completion measured at the end of therapy (60 days later), and two years later
3. Cardiovascular events:
3.1. Composite of major cardiovascular outcomes defined as the first occurrence of: death, cardiac arrest, sustained ventricular tachycardia, symptomatic heart failure, pacemaker or implantable cardiac defibrillator insertion, ischemic stroke or other systemic thromboembolic event, 11 days, 21 days, 60 days, 6 months, 1 year and 2 year after randomisation
3.2. New development of any of the following echo changes: segmental wall motion abnormalities, ventricular aneurysm, reduction in LV ejection fraction greater than 5%, increase in Left Ventricular end-Diastolic Dimension [LVDD] greater than 5.0 mm compared with baseline, 11 days, 21 days, 60 days, 6 months, 1 year and 2 year after randomisation
3.3. New 12 lead ECG alterations (complete bundle branch block, fascicular block, advanced atrio-ventricular block, atrial fibrillation, etc); 1st Degree AV Block PR greater than 280 ms, 11 days, 21 days, 60 days, 6 months, 1 year and 2 year after randomisation
3.4. Progression of NYHA functional class by at least one category, 11 days, 21 days, 60 days, 6 months, 1 year and 2 year after randomisation
Overall study start date01/03/2006
Completion date30/04/2009

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants600
Key inclusion criteria1. Either sex, aged greater than or equal to 18 and less than or equal to 70 years
2. At least two positive serological tests for Chagas disease (indirect immunofluorescence, indirect hemagglutination, OR Enzyme-Linked Immunosorbent Assay [ELISA]) and at least ONE of the following markers of cardiac involvement (which identify individuals at high risk of progression):
2.1. Abnormal 12 lead Electrocardiogram (ECG): One-major criteria (second or third degree AV block) OR at least two minor criteria:
2.1.1. Any bundle branch block
2.1.2. Any fascicular block
2.1.3. Ventricular premature beats (greater than one)
2.1.4. First degree AV block greater than 220 ms, in the absence of drugs that slow AV node conduction
2.1.5. Mobitz type I AV block, in the absence of drugs that slow AV
2.1.6. Sinus bradycardia less than 50 bpm or sinus pauses greater than 3.0s, in the absence of sinus node blocking drugs
2.1.7. Low voltage of QRS in the frontal plane
2.1.8. Atrial fibrillation
2.2. Increased cardiothoracic ratio greater than 0.50 at baseline on upright chest X ray
2.3. Evidence of regional wall motion abnormality (hypokinesis, akinesis or dyskinesis) or reduced global Left Ventricular Systolic Function (LVEF) less than 50% (2D-Echo Radionuclide Angiography [RNA] LV ventriculography) or increased left ventricular diastolic diameter (greater than 55 mm) on 2D-Echo
2.4. Complex ventricular arrhythmias (multiform greater than 10/hour, couplets or non-sustained Ventricular Tachycardia [NSVT]) on 24 hour ambulatory ECG monitoring
Key exclusion criteria1. New York Heart Association (NYHA) heart failure class IV or decompensated heart failure
2. Evidence of concomitant Coronary Artery Disease (CAD) or other etiology of dilated cardiomyopathy
3. Previous treatment with antitrypanosomal agents or an accepted indication for antiparasitic therapy (e.g. reactivation of Chagas infection due to immunosuppression by several diseases or treatment with steroids)
4. Patients living in inadequate housing conditions that may predispose to t. cruzi re-infection will not be excluded; instead this condition will be appropriately documented
5. Inability to comply with follow-up
6. History of severe alcohol abuse within two years
7. Known chronic renal insufficiency (serum creatinine greater than 2.5 mg/dl or 200 umol) or hepatic insufficiency (Aspartate Aminotransferase [AST]/Alanine Aminotransferase [ALT] greater than 3 x normal)
8. Pregnancy or breast feeding
9. Megaesophagus with swallowing impairment
10. Other severe disease significantly curtailing life expectancy
Date of first enrolment01/03/2006
Date of final enrolment30/04/2009

Locations

Countries of recruitment

  • Argentina
  • Brazil
  • Canada
  • Colombia

Study participating centre

McMaster University
Ontario
L8L 2X2
Canada

Sponsor information

Hamilton Health Science Corporation (HHSC) (Canada)
Government

c/o Beena Cracknell
Population Health Research Institute
CEBA McMaster University
1200 Main Street West
Hamilton
Ontario
L8N 3Z5
Canada

Phone +1 (0)905 527 4322 ext. 44555
Email beena@cardio.on.ca
Website http://www.hamiltonhealthsciences.ca/
ROR logo "ROR" https://ror.org/02dqdxm48

Funders

Funder type

Research organisation

The Canadian Institutes of Health Research (CIHR) (Canada) - http://www.cihr-irsc.gc.ca (ref: MCT-79704)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol article protocol 01/07/2008 Yes No
Results article results 01/10/2015 Yes No