Today is World Chagas Disease Day. This celebration, the second in history, takes place against the backdrop of the COVID-19 pandemic which continues to disproportionately affect vulnerable populations around the world, including people affected by Chagas disease. Patients who have heart conditions caused by Chagas disease could be at higher risk of severe complications from COVID-19.
Considered by the World Health Organization as one of the 20 neglected tropical diseases, Chagas disease affects approximately 6 million people, mainly in Latin America – yet it has spread in recent years to the United States, Spain, Australia and Japan.
The disease starts as a tropical parasitic disease but can end as a chronic disease. At Novartis, we take a holistic approach, combining drug discovery efforts for new therapies at the Novartis Institute for Tropical Diseases and development work on chronic Chagas cardiomyopathy (CCC). This cardiovascular complication is what drives mortality due to Chagas disease.
Taking an integrated approach to Chagas disease
Preventing, treating, and managing Chagas disease requires an integrated approach that covers both the acute and chronic phases. Yet, clinical care tends to be provided in silos, either focusing on prevention or on the acute phase of the disease, but not holistically.
It is mainly during the chronic phase that organ damage complications drive morbidity and mortality. Therefore, it is important that efforts address patients’ needs across the spectrum of the disease, as even 20 to 30 years after being infected, up to one third of people may develop chronic Chagas cardiomyopathy. In contrast to heart failure patients due to other causes, Chagas patients are usually younger, with less comorbidities but their prognoses are worse.
Early detection of organ damage through early identification of patients who have cardiovascular complications is thus critical to improve health outcomes.
In 2019, Novartis started a Phase IV clinical trial (PARACHUTE-HF) in Argentina, Brazil, Colombia and Mexico, in partnership with the Brazilian Clinical Research Institute, to assess the efficacy and safety of sacubitril/valsartan in people with heart failure due to CCC. The trial includes sub-studies that will contribute to increase the scientific knowledge around the disease.
Until now, the treatment for Chagas cardiomyopathy has been extrapolated from limited data from subgroups of patients randomized in big trials. PARACHUTE-HF is the first fully dedicated study to evaluate the effect of sacubitril-valsartan vs. the standard of care in patients with Chagas cardiomyopathy. This study addresses a long-time request from the regional scientific community and findings should help better understand and manage the disease in the future
Claudio Gimpelewicz, Senior Global Program Clinical Head at Novartis
Working with partners to improve the patient journey
Across Latin America, Novartis is working with health authorities and other stakeholders on healthcare system strengthening initiatives to promote early Chagas cardiomyopathy diagnosis and better care across the region.
For example, we have signed a collaboration agreement with the Barcelona Institute for Global Health (IS Global) to enhance awareness of Chagas disease and improve patient well-being along the care pathway in Bolivia. The objective is to enhance disease awareness, working directly with communities, build capabilities toward an integrated care approach, and improve patients’ outcomes by strengthening the healthcare system.
We believe our collaboration with Novartis will help improve the capacity to diagnose Chagas heart disease and management of the disease overall. We also aim to strengthen the health system by using digital tools that can support better prioritization of health interventions. More importantly, we will work hand-in-hand with local and regional stakeholders to ensure the long-term sustainability of our activities
María Jesús Pinazo Delgado, Assistant Research Professor, Chagas Initiative Director ISGlobal
Novartis Corporate Affairs & Global Health
Novartis Corporate Affairs & Global Health aims to transform health in lower income populations through applying expertise, people and full organizational capability to address major, unresolved global health challenges. Chagas disease is part of the Novartis Corporate Affairs & Global Health Unit as a Flagship program. In 2020, as part of the company’s ambition to expand access to medicines, Novartis committed to increasing patient reach of our four Flagship programs by at least 50% by 2025.