NEW DELHI: Convalescent plasma therapy has been dropped from the national treatment protocol for coronavirus as a suggested experimental treatment option for patients, days after the evidence from the recovery trial in the US showed that it offers no benefit.
The decision to remove it from the guidelines comes in the backdrop of some clinicians and scientists writing to Principal Scientific Advisor K VijayRaghavan cautioning against the "irrational and non-scientific use" of convalescent plasma for COVID-19 in the country.
In the letter, which was also marked to ICMR chief Balram Bhargava and AIIMS Director Randeep Guleria, public health professionals alleged that the current guidelines on plasma therapy are not based on existing evidence and pointed out some very early evidence that indicates a possible association between emergence of variants with "lower susceptibility to neutralising antibodies in immunosuppressed" people given plasma therapy.
This raises the possibility of more virulent strains developing due to irrational use of plasma therapy which can fuel the pandemic, according to the letter signed by vaccinologist Gagandeep Kang, surgeon Pramesh C S and others.
"We are writing to you as concerned clinicians, public health professionals and scientists from India about the irrational and non- scientific use of convalescent plasma for COVID-19 in the country."
"This has stemmed from guidelines issued by government agencies, and we request your urgent intervention to address the issue which can prevent harassment of COVID-19 patients, their families, their clinicians and COVID-19 survivors," said the letter.
"The current research evidence unanimously indicates that there is no benefit offered by convalescent plasma for treatment of COVID-19. However, it continues to be prescribed rampantly in hospitals across India," the letter said.
The guidelines have been issued by the ICMR and AIIMS, Delhi joint monitoring group under the union ministry of health and family welfare.
The off label use of convalescent plasma, despite evidence earlier that it offered no benefit to Covid patients in reducing mortality or disease outcome, has been part of India’s coronavirus treatment guideline as an investigational therapy.
It has often led kin of serious Covid patients to scramble for plasma, sometimes even by paying exorbitantly, despite under the existing norms it cannot be sold and purchased, in the hope of saving the sick in the absence of any definitive treatment for the disease.
Results from the randomised evaluation of Covid-19 therapy (recovery) trial, whose results were published in The Lancet on Friday said that the use of plasma therapy on hospitalised Covid patients does not improve survival rate or any other pre-specified clinical outcomes.
Earlier, a trial by the ICMR too, in September last year, had shown that the therapy does not benefit either in reducing mortality or arresting progression of the disease.
The trial, called PLACID, was carried out in 39 hospitals across 14 states and Union Territories.
The government however, had not dropped this investigation therapy from the Covid19 treatment protocol, despite suggestions by researchers and scientists that its rampant use may be leading to unwanted mutation in SARS-CoV2, a fact publicly acknowledged by the ICMR chief several months ago.
“We have to maintain judicious use of therapies which are going to benefit, if their benefit is not established, we should not use those therapies otherwise they would put tremendous immune pressure on the virus, and the virus will tend to mutate more,” ICMR director general Balram Bhargava had said in December.
“Therapies that are well established should be used, and those that are not well-established, their judicious use has to happen.”
Many experts have been saying that rampant use of plasma therapy without prior testing for neutralizing antibodies will do more harm than good but a lot of treating doctors in several parts of the country routinely ask attendants to arrange it for hospitalised Covid patients.
(With PTI Inputs)