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Bengaluru: Doctors in the city do not share the recent conclusion of the Indian Council of Medical Research (ICMR) that convalescent plasma therapy has not helped in reducing Covid-19 deaths. They say they have been using the therapy in clinical trials for moderate to severe patients and it has helped save many lives. An ICMR study has cast doubts on the benefits of the therapy, setting off a debate among experts.
A team of researchers from HCG cancer hospital in Bengaluru had received the Drug Controller General of India’s nod to study the potential use of plasma therapy in moderate Covid-19 cases through clinical trials. The team collaborated with the Bangalore Medical College and Research Institute. HCG has since tied up with 55 hospitals in Karnataka and administered convalescent plasma to 430 patients.
“We have seen improvement in nearly 60 per cent of the patients. We are writing to the ICMR in this regard,” said Dr US Vishal Rao, principal investigator of the research. “All our plasma transfusions were strictly monitored for antibodies and then administered. In the ICMR study, researchers have not checked the plasma for antibodies.”
Since July, when the drug controller general allowed off-label use of convalescent plasma, multiple private hospitals have been using the therapy on their own.
According to Dr C Shivaram, head of transfusion medicine at Manipal Hospitals, the ICMR study has not been able to demonstrate the benefits of plasma therapy unlike Mayo Clinic in the US, which showed a 37 per cent reduction in mortality. “One possible reason is poor patient selection. While the study was intended for moderate patients, undue pressure could have led to its use among severe patients,” said Dr Shivaram, adding that quantitation of antibodies through titres was not available when the ICMR study began. “Lack of standardisation of plasma is another point. When the ICMR trial began, there were no methods or kits to quantitate the antibody to SARS-CoV2 [virus that causes Covid-19] and hence, titration was made optional. This led to poor quality of plasma, with low titre of antibodies, being given to patients.”
Another doctor said it was too early to say plasma was not useful: “What would have been the condition of patients had they not received plasma?”
According to Dr Rao, the ICMR’s findings don’t match with other studies because neutralising antibody titres were not used. “A study conducted by the ICGEB-Emory Vaccine Centre said 50 per cent of the patients didn’t have neutralising antibodies. The study included many Delhi patients. If plasma without required antibodies is used, it may not be effective. It’s like giving paracetamol of 0.5mg to a patient with high fever,” Dr Rao said.
A team of researchers from HCG cancer hospital in Bengaluru had received the Drug Controller General of India’s nod to study the potential use of plasma therapy in moderate Covid-19 cases through clinical trials. The team collaborated with the Bangalore Medical College and Research Institute. HCG has since tied up with 55 hospitals in Karnataka and administered convalescent plasma to 430 patients.
“We have seen improvement in nearly 60 per cent of the patients. We are writing to the ICMR in this regard,” said Dr US Vishal Rao, principal investigator of the research. “All our plasma transfusions were strictly monitored for antibodies and then administered. In the ICMR study, researchers have not checked the plasma for antibodies.”
Since July, when the drug controller general allowed off-label use of convalescent plasma, multiple private hospitals have been using the therapy on their own.
According to Dr C Shivaram, head of transfusion medicine at Manipal Hospitals, the ICMR study has not been able to demonstrate the benefits of plasma therapy unlike Mayo Clinic in the US, which showed a 37 per cent reduction in mortality. “One possible reason is poor patient selection. While the study was intended for moderate patients, undue pressure could have led to its use among severe patients,” said Dr Shivaram, adding that quantitation of antibodies through titres was not available when the ICMR study began. “Lack of standardisation of plasma is another point. When the ICMR trial began, there were no methods or kits to quantitate the antibody to SARS-CoV2 [virus that causes Covid-19] and hence, titration was made optional. This led to poor quality of plasma, with low titre of antibodies, being given to patients.”
Another doctor said it was too early to say plasma was not useful: “What would have been the condition of patients had they not received plasma?”
According to Dr Rao, the ICMR’s findings don’t match with other studies because neutralising antibody titres were not used. “A study conducted by the ICGEB-Emory Vaccine Centre said 50 per cent of the patients didn’t have neutralising antibodies. The study included many Delhi patients. If plasma without required antibodies is used, it may not be effective. It’s like giving paracetamol of 0.5mg to a patient with high fever,” Dr Rao said.
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