Keywords
Etiological treatment
Benznidazole
Nifurtimox
New drugs
Therapeutic innovation
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Abstract
Objective: To critically analyze current evidence on the etiological treatment of Chagas disease, addressing efficacy, safety, access to medications, and future prospects. Literature review: The currently available drugs, benznidazole and nifurtimox, have proven efficacy in the acute phase and in children with recent infection, but face limitations such as high toxicity, low therapeutic adherence, and reduced efficacy in adults in the chronic phase. A small number of clinical trials are investigating abbreviated regimens, combinations with triazole antifungals, and new molecules such as fexinidazole, as well as experimental strategies such as therapeutic vaccines and immunomodulation. However, structural barriers persist, such as diagnostic difficulties, discontinuity of care, and inequalities in access to medicines. Final considerations: The current scenario reinforces the urgency of therapeutic innovation but shows that isolated scientific advances are not enough. Sustainable public policies, equity in access to treatment, and strengthening translational research are essential to transform the care of Chagas disease and reduce its social impact.
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