A serological method’s ability to distinguish treatment regimens by assessing early antibody decline in Chagas patients: insights from E1224 data

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ID: 325602
2026
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Abstract
BACKGROUND: No reliable markers exist for parasitological cure in adult patients with chronic Chagas disease. We assessed whether a serological multiplex immunoassay for Trypanosoma cruzi, MultiCruzi, could differentiate the outcomes of treatment regimens. METHODS: This analysis included adults with indeterminate Chagas disease from a randomized trial of E1224. Serum samples at baseline, 6, and 12 months post-treatment with Benznidazole, E1224 regimens, or placebo were tested at three dilutions using MultiCruzi. We calculated the dilution factor at which 50% of reactivity remained (DF50) and used mixed-effects models to assess antibody decline. Log2DF50 slopes compared Benznidazole and E1224 regimens, and pooled data from the BENDITA trials helped define a cut-off for treatment response. FINDINGS: Within six months after treatment, participants exhibited a significantly greater rate of decline in antibody levels compared to the placebo group, contrasting with results from T. cruzi conventional ELISA tests. Our analysis showed a difference in response to benznidazole and to E1224 regimens after twelve months' follow-up, confirming results for benznidazole from BENDITA. Combining data from both trials allowed discrimination of benznidazole and E1224 treatment regimens after six months' follow-up. CONCLUSION: MultiCruzi enables the early assessment of treatment-associated biological responses in adults with Chagas disease, with antibody decline serving as an exploratory pharmacodynamic marker.
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Authors Ursula Saade, Juan Carlos Ramirez, Jasper de Boer, Noelia Anahi Bazan, Franco Mauricio Mangone, Thomas Ramadier, Ivan Scandale, Hans Pottel, Jaime Altcheh, Eric Chatelain, Maan Zrein
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Journal The Journal of infectious diseases
Year 2026
DOI
10.1093/infdis/jiag427
URL
https://doi.org/10.1093/infdis/jiag427
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