ACT4RHD
Improving treatment for acute rheumatic fever and rheumatic heart disease
The ACT4RHD Trial
ACT4RHD is a platform trial designed to evaluate different interventions for people affected by acute rheumatic fever and rheumatic heart disease, helping researchers identify which approaches lead to better outcomes.
Primary outcome:
Building better evidence for the treatment of acute rheumatic fever and rheumatic heart disease.
Primary outcome:
The trial brings research into an area where the burden of disease remains deeply inequitable, particularly for Māori and Pacific peoples in Aotearoa New Zealand and Aboriginal and Torres Strait Islander peoples in Australia.
Rheumatic fever can develop following infection with Group A Streptococcus when an abnormal immune response causes inflammation that can damage the heart valves. Repeated episodes can lead to rheumatic heart disease and lifelong health consequences.
Background
In Aotearoa New Zealand, the burden is highly inequitable. In 2024 there were 149 confirmed or probable first episodes of rheumatic fever, with 124 occurring among children and young people aged 5–24. Rates were 24.1 per 100,000 for Pacific peoples and 6.9 per 100,000 for Māori, compared with 0.1 per 100,000 for European and other ethnicities.
Ministry of Health NZ
Australia experiences similar inequities. In 2024, 506 acute rheumatic fever diagnoses were recorded across reporting jurisdictions, with Aboriginal and Torres Strait Islander people accounting for 93% of diagnoses. The highest rate was among First Nations children aged 5–14, at 110.8 diagnoses per 100,000. AIHW
These disparities are associated with longstanding inequities in housing, socioeconomic conditions and access to timely healthcare, rather than ethnic predisposition.
Trial design
ACT4RHD uses a platform trial design, allowing different interventions to be evaluated within a common trial infrastructure.
Participants will be screened for eligibility, consented and randomised to the intervention domains relevant to them.
Clinical information will be collected across baseline, discharge and follow-up assessments, including laboratory and echocardiographic data.
Echocardiograms are an important component of the study, providing researchers with information about the heart and its valves as participants move through the trial.
The platform has been designed to support the study as it evolves, allowing additional research questions and functionality to be incorporated over time.
Trial partners
University of Auckland
Starship Child Health
Key connections
“I find my day-to-day work with Spiral so purposeful and interesting - I feel really engaged with what we’re trying to achieve.””
Spiral’s contribution
Our Spiral Project Lead for the ACT4RHD Trial is Mel Booth
From managing sprints to building wireframes, working with developers, to liaising with the client, Mel is able to draw heavily upon her project management experience to get her projects out the door. She enjoys being immersed in the medical industry and the technical challenges that come with it.