The decision by the AIIMS-ICMR Covid-19 National Task Force and the Health Ministry indicates that convalescent plasma offers no therapeutic benefits in patients admitted to hospital with the disease.
India on Monday dropped convalescent plasma therapy (CPT) from its national clinical management protocol for Covid-19.
The therapy uses blood plasma from people who have recovered from Covid-19 to help others recover.
The decision by the AIIMS-ICMR Covid-19 National Task Force and the Health Ministry indicates that convalescent plasma offers no therapeutic benefits in patients admitted to hospital with the disease.
It comes three days after findings of the RECOVERY trial, the largest randomised trial to report results of the effect of convalescent plasma in patients hospitalised with Covid-19, were published in The Lancet medical journal.
The study findings showed that compared with usual care alone, high-titre convalescent plasma did not reduce 28-day mortality. “In patients hospitalised with Covid-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes,” the researchers said.
Similar studies in China and the Netherlands have previously documented no significant benefit of CPT in improving clinical outcomes in hospitalised Covid-19 patients.
Plasma is the clear liquid portion of the blood that remains after red and white blood cells, platelets, and other cellular components have been taken from it. Convalescent plasma extracted from the blood of patients recovering from an infection is a source of antibodies against the infection.
India’s clinical management protocol had so far recommended off-label use of convalescent plasma when two specific criteria were met: early moderate disease, preferably within seven days of symptoms once, and no use after seven days; and availability of high titre donor plasma.
India’s largest trial PLACID had earlier found that convalescent plasma was ineffective in arresting Covid-19. An ICMR study published in October last year reported that convalescent plasma was not associated with reduction in progression to severe Covid-19 or all-cause mortality.
After the publication of the PLACID trial data, ICMR issued an evidence-based advisory to address the inappropriate use of convalescent plasma in Covid-19 patients. It emphasised that convalescent plasma with a low concentration of specific antibodies against SARS-CoV-2 may be less beneficial in the treatment of Covid-19 patients compared to plasma with high concentration of such antibodies.
The RECOVERY trial results published on May 14 revealed that compared to usual care alone, high-titre convalescent plasma did not reduce the probability of discharge within 28 days, or the probability of progressing to the composite outcome of invasive mechanical ventilation or death in patients who were not receiving invasive mechanical ventilation at randomisation.
“We saw no evidence of any material benefit or hazard of convalescent plasma in any patient subgroup… For patients admitted to hospital with COVID-19, convalescent plasma offers no material therapeutic benefits,” the study said.
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