Role of ascorbic acid in the presentation of adverse reactions secondary to treatment in chagas disease

Abstract

Chagas disease (CD) is a parasitary disease caused by Trypanosoma cruzi. Treatment is indicated in children, reactivations in immunosuppressed patients and chronic Chagas without evident pathology. Poor tolerance and presentation of adverse reactions (AR) make it ineffective. ARs are due to oxidative stress. Animal studies found that ascorbic acid (aa) can attenuate these effects. The administration of aa with the antiparasitic treatment would contribute to attenuate ARs, facilitating compliance and efficacy. The objectives were: to identify AR secondary to the antiparasitic; compare the prevalence of AR in patients receiving associated aa versus standard treatment.

This is an open randomized controlled experimental study. Population: patients with CD without apparent pathology.GI antiparasitic treatment; GII: antiparasitic + aa. Study period: June 2019/June 2022.

Eighteen patients were included, 22% male, mean age: 34 years. Educational level: 5.5% were illiterate, 22% have completed primary school, 33% have not finished primary school. 28% have started but not finished secondary school whereas 11% completed it. Eight patients were assigned to GI and 10 to GII. They presented the following ARs: GI: asthenia 11% of them (50% moderate intensity (Mo) and 50% mild (Mi)) GII 5.5% Mi, GI distension 11% Mi, GI colic 16.5% (11% M 5, 5% Mi), epigastric pain GI 27.5% (22% M and 5.5% Mi) GII 5.5% Mi, nausea GI 28% (23% M and 5% Mi) GII 16.5% Mi, diarrhea GI 11% Mi GII 5.5% Mi, GI vomits 5.5% Mi, anorexia GI 16.5% M GII 5.5% M, GII paresthesias 5.5% Mi, dizziness GI 22% (16, 5%M 5.5%Mi), headache GI 27.5% (16.5%M and 11% Mi) GII 22% M, rash GI 22% ( 5.5% severe (S) 16.5% M), GII 22% (11% M 11% Mi), eosinophilia GI 11% Mi GII 11% M.

In conclusion, the middle-aged female sex with a low educational level predominated. The most frequent ARs were digestive followed by exanthema with greater intensity in GI. The study is still opened for the recruitment patients in order to determine if the differences found in this preliminary report are statistically significant.