Funders:
- Medical Research Future Fund, Clinical Trials Activity Grant MRF2031200
- Health Research Council of New Zealand HRC 23/180
- A Randomised Controlled Trial of Oral Dexamethasone to treat Sydenham's Chorea | Health Research Council of New Zealand (hrc.govt.nz)
Collaborations:
Objectives:
Primary:
To determine if oral dexamethasone is an effective treatment to reduce SC severity at one month
Secondary:
To determine if oral dexamethasone is a safe treatment for SC
To determine if oral dexamethasone is an effective treatment to reduce morbidity associated with SC
To determine if oral dexamethasone is a safe treatment for SC
To determine if oral dexamethasone is an effective treatment to reduce morbidity associated with SC
Summary:
Sydenham’s chorea (SC) is the neuropsychiatric presentation of acute rheumatic fever (ARF) and accounts for approximately 12% of ARF cases. ARF is a complex, multisystem autoimmune condition triggered by infection with Group A Streptococcus which remains endemic in Māori, Pasifika, Aboriginal Australian and Torres Strait Islander children. Sydenham’s chorea consists of random-appearing, continuous, involuntary movements which can affect the entire body and are associated with psychiatric symptoms which impact on learning and development. Early use of corticosteroids has the potential to rapidly improve symptoms and reduce the risk of chronic neuropsychiatric sequelae.
Our multi-centre, randomised, placebo-controlled clinical trial of a three day course of oral dexamethasone for SC will determine whether a simple intervention can substantially reduce SC morbidity in the first 12 months after diagnosis. Utilising our multi-site network, the trial will recruit more participants than have been randomised globally to treatment trials to date and inform treatment of this debilitating disease.
Implications for policy and practice:
This trial will randomise more patients with SC into a treatment trial than the previous sum total internationally. Findings from this study will be translated into practice for the use, or cessation of use, of corticosteroids to treat SC.
Chief Investigator:
Co-Investigators:
- Dr Hannah Jones
- Dr Cynthia Sharp
- Dr Kathryn Roberts (Menzies)
- Professor Jonathan Carapetis
- Associate Professor Joshua Francis (Menzies)
- Dr Bianca Middleton (Menzies)
- Dr Shekeeb Mohammad
- Professor Peter Morris*
- Dr Sean Taylor (Menzies)
- Aunty Vicki Wade (Menzies)
- Dr Rachel Webb
Associate Investigators:
- Professor Russell Dale
- Dr Neil Archer
- Dr Christopher Troedson
- Dr Melanie Thompson
- Dr James Dowler
- Dr Benjamin Reeves
- Dr Te Aro Moxon
- Dr Zhiqiang Wang (Menzies)
- Professor Asha Bowen
Project Manager:
- Olivia Walsh
For more information please email Olivia Walsh
Project dates:
March 2024 – February 2029