Painful monthly penicillin injections to treat and prevent Rheumatic Heart Disease (RHD) could be replaced with a longer-acting implant, a recent The Kids Research Institute Australia-led study has found.
RHD results from untreated Strep A bacteria found in the throat and skin, which can cause an abnormal immune response known as Acute Rheumatic Fever (ARF) that can lead to cardiac valve damage.
The condition disproportionately affects Australian Aboriginal and Torres Strait Islander children and can cause heart failure and premature death.
Projections estimate 8,997 children could develop ARF or RHD by 2031, potentially causing 663 deaths.
The Kids Research Institute Australia partnered with the Monash Institute of Pharmaceutical Sciences, to evaluate a slow-release implant in sheep that could potentially replace injections with results published in the European Journal of Pharmaceutics and Biopharmaceutics.
Results of The Kids Research Institute Australia-funded study showed implants were structurally intact after nine weeks but further work to reduce implant size was needed to support clinical suitability.
Lead researcher Dr Renae Barr, from the Wesfarmers Centre of Vaccines and Infectious Diseases and END RHD Program at The Kids Research Institute Australia, said alternative treatment was an urgent priority as painful and frequent injections were significant barriers for continued RHD treatment.
"Painful intramuscular penicillin injections given monthly for at least five to 10 years is the best protection against acute rheumatic fever and rheumatic heart disease, but pain and injection-frequency are major deterrents for continued treatment," Dr Barr said.
Only 35 per cent of Indigenous Australians living with RHD received the recommended 80 per cent or more of required injections in 2020, so it is an urgent priority that alternative treatments like an implant be developed and evaluated.
“Our study showed a longer-acting penicillin implant could offer better protection for RHD patients, with reduced pain and treatment frequency.”
While the study is promising for future development of a longer-acting and less-painful treatment for RHD, further research will focus on reducing implant size for clinical use.
The journal article Development of a sustained release implant of benzathine penicillin G for secondary prophylaxis of rheumatic heart disease is available here.
Further information about RHD is available here