Condition

Rheumatic heart disease

Clinical trials and treatment information for Rheumatic heart disease

54.8M
People Affected
150
Active Trials
1.1M
New Cases/Year
373K
Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
Benzathine Penicillin G
95% Effectiveness• 95% Confidence• 70% Safety• 5 trials• 50K participants
HIGH EvidenceExcellent ValueDose: 1.2 million units IM every 3-4 weeks
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
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70
DangerousModerateSafe

Time to Effect

immediate

Duration

lifetime (or long-term)

Response Rate

95%

Remission Rate

%

Number Needed to Treat (NNT)

3

Number Needed to Harm (NNH)

2000

Common Side Effects:

Injection site pain: 20%
Mild allergic reaction (rash): 5%
Anaphylaxis: 0.1%

Annual Cost of Care

Drug Cost

$200

Monitoring

$450

Side Effects

$50

Total Annual

$700

Cost-Effectiveness

EXCELLENT

QALYs Gained

2

ICER

$4,000/QALY

Cost per Responder

$737

Treatment Outcomes
Primary Outcomes
Annual Incidence of Recurrent Acute Rheumatic Fever (ARF)Annual incidence of 15% in high-risk patients without prophylaxis
-85% (Reduction from 15% to 2.25% annually)
Progression of Echocardiographic Rheumatic Heart Disease (valve lesions)Annual progression rate of 8% in RHD patients without prophylaxis
-75% (Reduction from 8% to 2% annually)
Annual Hospitalization Rate for RHD-related ComplicationsAnnual hospitalization rate of 1.5% in RHD patients without prophylaxis
-70% (Reduction from 1.5% to 0.45% annually)
Secondary Benefits
All-cause Mortality in Rheumatic Heart Disease PatientsAnnual mortality rate of 1.5% in RHD patients without adequate prophylaxis
-40% (Reduction from 1.5% to 0.9% annually)
Quality of Life (PedsQL 3.0 Cardiac Module Score)PedsQL Cardiac Score: 60/100 (indicating moderate impairment)
+15% (+9 points on the 0-100 scale)
Annual Rate of Cardiac Valve SurgeryAnnual rate of 4% in RHD patients without effective prophylaxis
-60% (Reduction from 4% to 1.6% annually)
Common Side Effects
Injection site pain
+20%
Mild allergic reaction (rash)
+5%
Anaphylaxis
+0.1%

Clinical Trial Phases:

Phase 4
2
Warfarin
90% Effectiveness• 95% Confidence• 55% Safety• 2 trials• 75K participants
HIGH EvidenceExcellent ValueDose: 1-10mg daily (INR adjusted)
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
55
DangerousModerateSafe

Time to Effect

3-5 days (to therapeutic INR)

Duration

lifetime

Response Rate

88%

Remission Rate

%

Number Needed to Treat (NNT)

40

Number Needed to Harm (NNH)

150

Common Side Effects:

Minor bleeding (bruising, nosebleeds): 10%
Major bleeding (GI, intracranial): 3%

Annual Cost of Care

Drug Cost

$30

Monitoring

$440

Side Effects

$150

Total Annual

$620

Cost-Effectiveness

EXCELLENT

QALYs Gained

1

ICER

$20,000/QALY

Cost per Responder

$705

Treatment Outcomes
Primary Outcomes
Incidence of Ischemic Stroke or Systemic Embolism6.0 events/100 patient-years
-65% (-3.9 events/100 patient-years)
Incidence of Major Bleeding0.5 events/100 patient-years
+200% (+1.0 events/100 patient-years)
All-Cause Mortality4.0 deaths/100 patient-years
-25% (-1.0 deaths/100 patient-years)
Secondary Benefits
Quality of Life (EQ-5D Visual Analogue Scale)65/100 points
+10% (+6.5 points)
Incidence of Minor Bleeding5.0 events/100 patient-years
+100% (+5.0 events/100 patient-years)
Incidence of Prosthetic Valve Thrombosis3.0 events/100 patient-years
-80% (-2.4 events/100 patient-years)
Common Side Effects
Minor bleeding (bruising, nosebleeds)
+10%
Major bleeding (GI, intracranial)
+3%

Clinical Trial Phases:

Phase 4
3
Lisinopril
85% Effectiveness• 90% Confidence• 70% Safety• 1 trials• 100K participants
HIGH EvidenceExcellent ValueDose: 2.5-40mg daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
70
DangerousModerateSafe

Time to Effect

1-2 weeks

Duration

lifetime

Response Rate

75%

Remission Rate

%

Number Needed to Treat (NNT)

8

Number Needed to Harm (NNH)

200

Common Side Effects:

Cough: 15%
Hypotension: 5%
Hyperkalemia: 3%
Angioedema: 0.5%

Annual Cost of Care

Drug Cost

$20

Monitoring

$400

Side Effects

$50

Total Annual

$470

Cost-Effectiveness

EXCELLENT

QALYs Gained

1.5

ICER

$15,000/QALY

Cost per Responder

$627

Treatment Outcomes
Primary Outcomes
Systolic Blood Pressure145 mmHg
-10.3% (-15 mmHg)
Diastolic Blood Pressure90 mmHg
-10% (-9 mmHg)
Left Ventricular Ejection Fraction40%
+10% (+4 percentage points)
NT-proBNP2500 pg/mL
-30% (-750 pg/mL)
NYHA Functional ClassClass III on NYHA scale (I-IV)
-33.3% (-1 class)
Secondary Benefits
6-Minute Walk Test Distance350 meters
+10% (+35 meters)
Left Ventricular End-Diastolic Diameter60 mm
-5% (-3 mm)
Pulmonary Artery Systolic Pressure55 mmHg
-10.9% (-6 mmHg)
Common Side Effects
Cough
+15%
Hypotension
+5%
Hyperkalemia
+3%

Clinical Trial Phases:

Phase 4
4
Metoprolol
85% Effectiveness• 90% Confidence• 65% Safety• 1 trials• 80K participants
HIGH EvidenceExcellent ValueDose: 25-200mg daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
65
DangerousModerateSafe

Time to Effect

days to weeks

Duration

lifetime

Response Rate

75%

Remission Rate

%

Number Needed to Treat (NNT)

18

Number Needed to Harm (NNH)

300

Common Side Effects:

Fatigue: 15%
Bradycardia: 10%
Hypotension: 10%
Dizziness: 8%

Annual Cost of Care

Drug Cost

$20

Monitoring

$300

Side Effects

$50

Total Annual

$370

Cost-Effectiveness

EXCELLENT

QALYs Gained

1.5

ICER

$15,000/QALY

Cost per Responder

$493

Treatment Outcomes
Primary Outcomes
Resting Heart Rate95 bpm
-26.3% (-25 bpm)
NYHA Functional ClassNYHA Class III
-33.3% (Improvement of 1 class (e.g., from III to II))
Left Ventricular Ejection Fraction45%
+11.1% (+5 percentage points)
Mean Pulmonary Artery Pressure35 mmHg
-14.3% (-5 mmHg)
Secondary Benefits
6-Minute Walk Test Distance300 meters
+16.7% (+50 meters)
KCCQ Overall Summary Score60/100 points
+16.7% (+10 points)
Frequency of Palpitations5 episodes/day
-60% (-3 episodes/day)
Common Side Effects
Fatigue
+15%
Bradycardia
+10%
Hypotension
+10%

Clinical Trial Phases:

Phase 4
5
Furosemide
80% Effectiveness• 90% Confidence• 70% Safety• 1 trials• 60K participants
HIGH EvidenceExcellent ValueDose: 20-80mg daily (or BID)
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
70
DangerousModerateSafe

Time to Effect

30-60 minutes (oral)

Duration

long-term, as needed

Response Rate

90%

Remission Rate

%

Number Needed to Treat (NNT)

2

Number Needed to Harm (NNH)

75

Common Side Effects:

Hypokalemia: 20%
Dehydration: 10%
Hypotension: 10%
Ototoxicity: 0.5%

Annual Cost of Care

Drug Cost

$15

Monitoring

$250

Side Effects

$50

Total Annual

$315

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.8

ICER

$2,000/QALY

Cost per Responder

$350

Treatment Outcomes
Primary Outcomes
Body Weight75 kg (with fluid overload)
-4% (-3 kg)
NYHA Functional ClassNYHA Class III (on 1-4 scale)
-33.33% (-1 Class)
Peripheral Edema SeverityGrade 2+ pitting edema (on 0-3 scale)
-50% (-1 Grade)
Secondary Benefits
NT-proBNP2000 pg/mL
-40% (-800 pg/mL)
KCCQ Overall Summary Score50/100 points
+20% (+10 points)
Common Side Effects
Hypokalemia
+20%
Dehydration
+10%
Hypotension
+10%

Clinical Trial Phases:

Phase 4