Monthly injections versus daily oral penicillin to stop early rheumatic heart disease from getting worse
Official title: Intramuscular vs. Enteral Penicillin Prophylaxis to Prevent Progression of Latent Rheumatic Heart Disease: A non-inferiority randomized trial. (GOALIE)
Funded at Cincinnati Childrens Hosp Med Ctr · NIH-11467137 · Data updated 2026-11-12
This trial compares daily oral penicillin to monthly injections to see if the easier oral option can prevent early rheumatic heart disease from worsening in children.
Quick facts
| Grant type | NIH-funded research |
|---|---|
| Study type | NIH-funded research |
| Funding institution | Cincinnati Childrens Hosp Med Ctr NIH-funded |
| Lab location | 1 site (Cincinnati, United States) |
| Project start | February 1, 2023 |
| Project end | January 31, 2028 |
| Funding year | 2026 |
| Award (this year) | $680,919 |
| NIH project number | 3R33HL166441-04S1 |
| Project ID | NIH-11467137 on NIH RePORTER |
Who could benefit from this research
✓Could help
Children diagnosed with latent (early) rheumatic heart disease by echocardiographic screening—typically school-age children in areas where RHD is common—are the intended participants.
✕Less likely to help
Children with advanced symptomatic rheumatic heart disease, a known allergy to penicillin, or those unable to take or adhere to the assigned medication are unlikely to benefit from this trial.
What this research studies
If my child has early (latent) rheumatic heart disease found on a screening ultrasound, they could be randomly assigned to receive either monthly intramuscular penicillin injections or daily oral penicillin. Study staff will track heart ultrasounds, symptoms, side effects, and missed school or work over time to watch for disease progression. The trial is set up to determine whether the oral option is not meaningfully worse than injections (a non-inferiority design). Participation will involve regular clinic visits, medication monitoring, and routine follow-up scans.
Why it matters
Potential benefit: If oral penicillin works as well as injections, it could make long-term prevention much easier, less painful, and more accessible for children and families.
How similar studies have gone: Prior work (the GOAL trial) showed monthly intramuscular penicillin reduced progression of latent RHD, while oral penicillin has not yet been proven equivalent for this purpose.
Where this research is happening
-
Cincinnati Childrens Hosp Med Ctr
Cincinnati, United States Active
Researchers
- Principal investigator: Beaton, Andrea Zawacki — Cincinnati Childrens Hosp Med Ctr
- Study coordinator: Beaton, Andrea Zawacki
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About this research
- This is an active NIH-funded research project — typically early-stage science, not a clinical trial accepting patient enrollment.
- Some NIH-funded labs run parallel clinical studies or seek volunteers for related work. To check, contact the principal investigator or institution listed above.
- For full project details, budget, and progress reports, visit the official NIH RePORTER page.