BENGALURU: Karnataka’s health experts have stated that they will continue with convalescent plasma therapy (CPT) as it has been found effective in the state despite the Indian Council of Medical Research (ICMR) study suggesting to the contrary. The ICMR randomised trial, called PLACID, to assess CPT for Covid, has shown that it does not benefit either in reducing mortality or arresting the progression of the disease.
Dr U S Vishal Rao, who started the plasma trials and the State plasma bank, said, “About 60% of the patients have recovered with CPT in the state. We have administered plasma to about 400 people. The remaining 40% hadn’t recovered as they were critically ill. However, with the success of the plasma therapy here, we will continue CP therapy in the state.” He said the study has several weaknesses and that they will be writing to ICMR seeking clarification and guidance.
“In the PLACID trial, less than 54% of patients had negative PCR by day 7. This means that patients have been infused with plasma on a median of 14 days, which is conceptually late. Hence, it necessitates the clarification for the median day of infusion of CP since the onset of symptoms.” He said, “In the ICMR study, 67.9% of the CPT group are PCR negative by day 7 when compared to 54.6% of non-CPT group. This perhaps can be considered as a beneficial effect of CPT which helps in decreasing community transmission.” He added, “Further details of NAb (neutralising antibody) titres and IgG (immunoglobulin) in the infused CP need to be clarified.
The optimum titres play a pivotal role for the success of CPT; in the study they have only mentioned that the titres were detectable but the percentage of high, moderate and low titres has not been mentioned. Hence, the need of the hour is to conduct further randomised controlled trials with larger sample sizes and homogeneity of data and standardised diagnostic tools are required to evaluate the real efficacy of CPT in greater detail.” Dr Anoop Amarnath, Head Scientific Board and Chairman- Geriatric Medicine, Manipal Hospital and Member of State Critical Care Support Team, said, “The study still needs a peer review to be done. In terms of overall care of CP , it is more on a case-to-case basis than a standard treatment.
Another interpretation is that usually we need larger trials to be done to come to a conclusion.” Dr Giridhar R Babu, Head of Lifecourse Epidemiology at the Public Health Foundation of India and member of the Karnataka expert committee of Ccovid task force, however, said that there is no conclusive evidence if the CP helps. “ICMR study covers multiple aspects and it is good. Till now there are no studies from Karnataka which can question the evidence.”