What Do Early Trial Results Say About Plasma Therapy for COVID-19?

An interim analysis of a trial on plasma therapy has found that it does not reduce death risk in COVID-19 patients.

Updated
An interim analysis of a trial on convalescent plasma therapy at AIIMS has found that it does not reduce death risk in COVID-19 patients.
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An interim analysis of a randomised controlled trial on convalescent plasma therapy done at AIIMS, Delhi, has found that the treatment does not reduce the risk of death in COVID-19 patients, The Times of India reported.

What Is Plasma Therapy: Convalescent plasma treatment is an investigational therapy for off-label use in coronavirus infected patients. In this, antibodies from the blood of patients who have recovered from coronavirus are used to treat severely infected COVID-19 patients.

The Trial: The study looked at two groups of 15 COVID-19 patients each in a randomised controlled trial. One group received convalescent plasma therapy with standard supportive treatment and the other only standard treatment.

Initial Findings: AIIMS Director Dr Randeep Guleria told PTI on Thursday no clear mortality benefit of convalescent plasma therapy was seen during a trial conducted among 30 COVID-19 patients. The number of fatalities recorded in both the groups was equal and there was not much clinical improvement in the condition of patients, he said.

“However, this is just an interim analysis and we need to do a more detailed evaluation to see if any sub-group may benefit from plasma therapy.”
Dr Randeep Guleria

Safety Not A Concern, Efficacy Is: Plasma therapy is considered safe as there is no evidence of any significant side-effects in COVID-19 patients so far. But there is also no conclusive evidence for its efficacy, which is why it remains investigational. The Indian Council of Medical Research is also conducting trials on the therapy. Read more about the available evidence on the treatment in our explainer here.

Dr Monish Soneja, additional professor in the Medicine department at AIIMS, said at a webinar on Wednesday, “Plasma is safe. As far as its efficacy is concerned, we do not have a green signal yet. So the clinical use has to be very judicious and within the ambit of national guidelines. Till the time we know the characteristics of the subset of patients, we have to use convalescent plasma very judiciously.”

Risks/Benefits: One of the benefits of this therapy is that it is a tried and tested method which has been used in other diseases. But COVID-19 is a new illness and there is still a lot that we don’t know about antibodies and immunity in this context.

Dr Neeraj Nischal, associate Professor in the department of medicine at AIIMS, said that the findings highlight that relatives of the patients should not insist on plasma therapy until and unless the treating doctor considers the patient fit for it and where they may think that the mode of treatment would be beneficial. The therapy is expected to work best in early disease, and the plasma must contain a sufficient amount of neutralizing antibody.

"This therapy also carries risks such as inadvertent transfer of blood-borne infections and reactions to serum constituents, including immunological reactions such as serum sickness, that may worsen the clinical condition," Dr Nischal said, according to the PTI report.

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