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.

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💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

immediate

Duration

lifetime (or long-term)

Response Rate

95%

Remission Rate

Number Needed to Treat (NNT)

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

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

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💧

DangerousModerateSafe

Time to Effect

3-5 days (to therapeutic INR)

Duration

lifetime

Response Rate

88%

Remission Rate

Number Needed to Treat (NNT)

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

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

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💧

DangerousModerateSafe

Time to Effect

1-2 weeks

Duration

lifetime

Response Rate

75%

Remission Rate

Number Needed to Treat (NNT)

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

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💧

DangerousModerateSafe

Time to Effect

days to weeks

Duration

lifetime

Response Rate

75%

Remission Rate

Number Needed to Treat (NNT)

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

Furosemide

80% Effectiveness• 90% Confidence• 70% Safety• 1 trials• 60K participants

HIGH EvidenceExcellent ValueDose: 20-80mg daily (or BID)

Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

30-60 minutes (oral)

Duration

long-term, as needed

Response Rate

90%

Remission Rate

Number Needed to Treat (NNT)

Number Needed to Harm (NNH)

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