Monthly penicillin injections versus daily oral penicillin to prevent 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-11467140 · Data updated 2026-11-12
This trial compares daily oral penicillin to monthly penicillin shots for children with early, hidden rheumatic heart disease.
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) | $135,660 |
| NIH project number | 3R33HL166441-04S3 |
| Project ID | NIH-11467140 on NIH RePORTER |
Who could benefit from this research
✓Could help
Children identified by screening echocardiography as having latent (early) rheumatic heart disease are the ideal candidates for this trial.
✕Less likely to help
Children with advanced rheumatic heart disease or those with a penicillin allergy would not be expected to benefit from this prevention comparison.
What this research studies
If an echocardiogram shows a child has latent (early) rheumatic heart disease, this randomized trial will assign children to receive either monthly intramuscular penicillin injections or daily oral penicillin. Participants will be followed over time to see whether the heart condition progresses, and researchers will track side effects, missed school or work, and how well families stick to the medication plan. The study uses a non-inferiority design, meaning oral penicillin must be shown not to be meaningfully worse than injections for preventing progression. If oral treatment is similar, it could offer a less painful, easier option for long-term prevention in low-resource settings.
Why it matters
Potential benefit: If oral penicillin is not meaningfully worse than injections, patients could have a simpler, less painful option that makes long-term prevention easier and more accessible.
How similar studies have gone: Previous work (including the GOAL trial) showed intramuscular penicillin reduced progression compared with no treatment, but direct head-to-head comparisons with daily oral penicillin are limited, so this question remains relatively new.
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.