Chagas disease, also known as American trypanosomiasis, is a potentially life-threatening illness caused by the protozoan parasite Trypanosoma cruzi1.
The disease affects approximately 6 million people1, mainly in Latin America. Less than 1% of affected individuals receive proper treatment2, and current available drugs have high rates of adverse effects and do not meet the need for the entire spectrum of the disease. Chagas disease usually begins with a bite by the triatomine bug, also known as the “kissing bug” because it usually bites people’s faces when they sleep. Often people are infected without even noticing it.
The disease sits at the crossroads between two worlds: it starts as a tropical parasitic disease but can end as a chronic disease. This is why preventing, treating and managing Chagas disease requires an integrated, end-to-end approach that covers both the acute and chronic phases.
Improving health outcomes for Chagas patients also requires being active on three fronts: novel drug discovery, clinical development, and healthcare system strengthening.
The Novartis Institute for Tropical Diseases (NITD) and its academic partners have been conducting research into novel proteasome inhibitors for the treatment of Chagas disease and other kinetoplastid diseases. These efforts have identified a unique drug target for trypanosomatid parasitic protozoa and a new chemical tool for investigating the function of cell division. The parasites that cause Chagas disease, leishmaniasis and African sleeping sickness share a common cell cycle protein, which may be a promising new target for treatment. The study was published in Nature Microbiology in October 2020. In 2020, NITD was awarded a three-year grant from the Wellcome Trust for drug discovery science in cryptosporidiosis and Chagas disease to pursue potential first-in-class anti-parasitic treatments.
During the chronic phase, when the disease evolves, it can affect key organs as the heart, leading to cardiac disorders in up to 30% of patients and up to 10% may develop neurological and/or gastrointestinal disorders. Chagas cardiomyopathy accounts for the majority of death and disability among individuals affected by the disease. Against this background, in 2019, in collaboration with the Brazilian Clinical Research Institute, Novartis launched the first clinical study in people with heart failure due to chronic Chagas cardiomyopathy to assess an innovative therapy in this underserved patient population. This Phase IV trial also includes sub-studies that may help better understand the underlying pathophysiology of Chagas cardiomyopathy (biomarkers, arrhythmia burden, and use of magnetic resonance imaging to evaluate cardiac structure, function and fibrosis).
Further, we are working with health authorities and stakeholders in Latin America on healthcare system strengthening initiatives to improve health outcomes and access to innovation. For example, Novartis signed a collaboration agreement with IS Global to improve the well-being of Chagas patients in Bolivia. In 2021, we involved more than 100 stakeholders to identify and prioritize unmeet needs along the patient journey, and co-create solutions. Aiming for long-term sustainability, local empowerment and impact, the interventions will be implemented in phases hand-in-hand with Bolivian and regional stakeholders – starting with a capability-building program in 2022. In 2021, we also supported MedShr, a medical professionals network, with the inclusion of clinical cases and content on Chagas disease, reaching nearly 70 000 doctors globally and contributing to increase disease awareness. We are also collaborating with the Global Chagas Disease Coalition to develop an online medical platform for Chagas disease, which aims to build capability among healthcare professionals to adopt an integrated disease management approach.
We supported the World Heart Federation and the Inter-American Society of Cardiology in developing an end-to-end roadmap for Chagas disease, published in 2020. It explores the patient journey from diagnosis to treatment, and provides actionable recommendations for policymakers and healthcare professionals.
In 2019, Novartis joined the Global Chagas Disease Coalition, an alliance to increase disease awareness and foster synergies in controlling the disease and promoting access to diagnosis and treatment.