Project Details

E.W. "Al" Thrasher

Status: Funded - Open

A Long-Term Follow-up Study for Patients Who Participated in the GOAL Trial (GOAL-Post)

Andrea Beaton, MD

Summary

BACKGROUND: The GOAL trial showed secondary antibiotic prophylaxis was protective against rheumatic heart disease (RHD) progression in children with latent RHD, or RHD detected through screening echocardiography. However, the trial also showed that 50% of children with latent RHD regress at two-years, with the majority (85% of those) returning to a normal echocardiographic study with or without prophylaxis. GAP: GOAL-Post is comprised of two studies that will help refine recommendations for the duration of secondary prophylaxis for children diagnosed with latent RHD, which is currently not known. HYPOTHESIS: We hypothesize that the risk of RHD development (borderline or definite RHD, by the 2012 WHF Criteria) in children and adolescents who have had normalization of their echocardiogram following latent RHD diagnosis is not higher than children and adolescents without prior documentation of latent RHD. METHODS: GOAL-Post includes two observational studies to investigate outcomes for participants who completed the GOAL Trial, divided by final GOAL diagnosis: 1. normal or 2. persistent latent RHD. RESULTS: Pending. IMPACT: GOAL-Post will provide critical data need to guide duration of prophylaxis and to understand if children who show resolution of latent RHD require continued prophylaxis to prevent later progression. These data will have important implications for determining the standard of care for children diagnosed with latent RHD through echocardiographic screening. Optional/Additional Comments: GOAL-Post is part of the RHD research portfolio of the Rheumatic Heart Disease Research Collaborative in Uganda (RRCU).