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Less Painful Treatment for Rheumatic Heart Disease

An Otago-led study has successfully trialled a less painful way of delivering treatment to prevent rheumatic heart disease progression. The existing treatment, which has been in use for almost 70 years, involves monthly intramuscular injections of benzathine penicillin for patients with acute rheumatic fever. However, these injections are often painful and disruptive to patients' lives, making it challenging to maintain regular treatment.

The Problem

Acute rheumatic fever and rheumatic heart disease remain significant health issues in Aotearoa New Zealand, particularly for Māori and Pacific peoples. Despite their disappearance from high-income countries, these conditions continue to cause preventable suffering and death.

The Innovative Solution

Researchers conducted a study to improve the delivery of long-acting penicillin. They trialled a new method that involves administering penicillin using a small needle inserted into patients' stomachs. Patients reported that this method was less painful than the usual intramuscular injection. Additionally, the new method allowed for a larger dose of penicillin, reducing the frequency of injections to once every three months.

Promising Results

Over 50 patients in the North Island participated in the trial, with more than 95% expressing a preference for the new method over the monthly injection. This alternative mode of penicillin delivery shows enormous promise in improving patient experience and adherence, potentially preventing disease progression and death.

Next Steps

The Phase II clinical trial is awaiting Medsafe approvals and treatment guidelines before the new treatment method can be widely adopted.

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