Browsing by Autor "Ariel Bardach"

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Direct evidence gap on fixed versus adjusted‐dose benznidazole for adults with chronic Chagas disease without cardiomyopathy: Systematic review and individual patient data meta‐analysis
(Wiley, 2022) Agustín Ciapponi; Fabiana Barreira; Lucas Perelli; Ariel Bardach; Joaquím Gascón; Israel Molina; Carlos A. Morillo; Nilda Graciela Prado; Adelina Riarte; Faustino Torrico
The study protocol was registered in PROSPERO (CRD42019120905).
[Financial impact of smoking on health systems in Latin America: A study of seven countries and extrapolation to the regional level].
(National Institutes of Health, 2016) Andrés Pichón-Rivière; Ariel Bardach; Federico Augustovski; Andrea Alcaraz; Luz Myriam Reynales-Shigematsu; Márcia Teixeira Pinto; Marianela Castillo‐Riquelme; Esperanza Peña Torres; Diana Isabel Osorio; Leandro Huayanay
Smoking is responsible for a significant proportion of health spending in Latin America, and tax revenues from cigarette sales are far from covering it. The region's countries should seriously consider stronger measures, such as an increase in tobacco taxes.
Fixed vs adjusted-dose benznidazole for adults with chronic Chagas disease without cardiomyopathy: A systematic review and meta-analysis
(Public Library of Science, 2020) Agustín Ciapponi; Fabiana Barreira; Lucas Perelli; Ariel Bardach; Joaquím Gascón; Israel Molina; Carlos A. Morillo; Nilda Graciela Prado; Adelina Riarte; Faustino Torrico
Chagas disease is a neglected disease that remains a public health threat, particularly in Latin America. The most important treatment options are nitroimidazole derivatives, such as nifurtimox and benznidazole (BZN). Some studies suggest that for adults seropositive to T. cruzi but without clinically evident chronic Chagas cardiomyopathy (CCC), a simple fixed-dose scheme of BZN could be equivalent to a weight-adjusted dose. We compared the efficacy and safety of a fixed dose of BZN with an adjusted dose for T. cruzi seropositive adults without CCC. We used the Cochrane methods, and reported according to the PRISMA statement. We included randomized controlled trials (RCTs) allocating participants to fixed and/or adjusted doses of BZN for T. cruzi seropositive adults without CCC. We searched (December 2019) Cochrane, MEDLINE, EMBASE, LILACS, Clinicaltrials.gov, and International Clinical Trials Registry Platform (ICTRP), and contacted Chagas experts. Selection, data extraction, and risk of bias assessment, using the Cochrane tool, were performed independently by pairs of reviewers. Discrepancies were solved by consensus within the team. Primary outcomes were parasite-related outcomes and efficacy or patient-related safety outcomes. We conducted a meta-analysis using RevMan 5.3 software and used GRADE summary of finding tables to present the certainty of evidence by outcome. We identified 655 records through our search strategy and 10 studies (four of them ongoing) met our inclusion criteria. We did not find any study directly comparing fixed vs adjusted doses of BZN, however, some outcomes allowed subgroup comparisons between fixed and adjusted doses of BZN against placebo. Moderate-certainty evidence suggests no important subgroup differences for positive PCR at one year and for three safety outcomes (drug discontinuation, peripheral neuropathy, and mild rash). The same effect was observed for any serious adverse events (low-certainty evidence). All subgroups showed similar effects (I2 0% for all these subgroup comparisons but 32% for peripheral neuropathy), supporting the equivalence of BZN schemes. We conclude that there is no direct evidence comparing fixed and adjusted doses of BZN. Based on low to very low certainty of evidence for critical clinical outcomes and moderate certainty of evidence for important outcomes, fixed and adjusted doses may be equivalent in terms of safety and efficacy. An individual patient data network meta-analysis could better address this issue.
Health and Economic Burden of Tobacco Use in Seven Latin American Countries: Results from a Microsimulation Health Economic Model (HEM)
(Elsevier BV, 2013) Andrés Pichón-Rivière; Ariel Bardach; Joaquín Caporale; Federico Augustovski; Andrea Alcaraz; M.D.P. Navia; Márcia Pinto; Carlos Vallejos; E. Peña Torres; L.M. Reynales