Monthly penicillin injections versus daily oral penicillin to prevent early rheumatic heart disease
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-11467138 · Data updated 2026-11-12
This compares monthly penicillin shots with daily oral penicillin for children who have early (latent) rheumatic heart disease to prevent the condition from getting worse.
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) | $62,634 |
| NIH project number | 3R33HL166441-04S2 |
| Project ID | NIH-11467138 on NIH RePORTER |
Who could benefit from this research
✓Could help
Children identified by echocardiographic screening as having latent rheumatic heart disease, particularly in regions where RHD is common, are the intended participants.
✕Less likely to help
Children with established clinical (advanced) rheumatic heart disease, or those allergic to penicillin, would not be expected to benefit from this preventive comparison.
What this research studies
If a child is found to have early or 'latent' rheumatic heart disease on a screening heart ultrasound, the study randomly assigns them to receive either standard monthly intramuscular penicillin injections or a daily oral penicillin pill. Care teams will follow children over time with repeat echocardiograms and clinical visits to monitor whether heart valve changes progress. The trial is set up as a non-inferiority comparison so that oral penicillin would be considered an acceptable, less-burdensome alternative if it is not meaningfully worse than injections. The work builds on prior results showing injections can prevent progression and aims to test whether a simpler oral regimen can offer similar protection while reducing pain, missed school, and health-system burden.
Why it matters
Potential benefit: If oral penicillin works as well as injections, children could avoid painful shots and have a simpler, more accessible long-term preventive option.
How similar studies have gone: A prior GOAL trial in Uganda showed monthly intramuscular penicillin reduced progression of latent RHD, while oral penicillin has not yet been proven equivalent and is the focus of this trial.
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.