Convalescent plasma treatment for COVID-19 sees renewed promise in study

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Medical researchers say there is a renewed promise to reduce hospitalizations and deaths from COVID-19 by increasing the use of convalescent plasma treatments at the onset of a coronavirus infection.

And some medical experts are pushing the federal government to allow more patients to receive the treatment, because lab-based monoclonal treatments such as Regeneron have seen their effectiveness diminished against the omicron variant.

Johns Hopkins University researchers on Tuesday released the results of a 16-month national study on the use of convalescent plasma in patients with COVID-19 and found there was a reduction in relative risk of 54% of hospitalizations related to COVID-19.

Dr Arturo Casadevall, one of the study’s co-authors and chairman of the Department of Molecular Microbiology and Immunology at the Johns Hopkins Bloomberg School of Public Health, told ABC News the results are promising, especially if the plasma is used from the start of the infection period.

“The results show 54% effectiveness in reducing hospitalization if you give it until the ninth day. It’s clear and highly significant,” he said. “If you look at less than five days, the effectiveness is much, much higher.”

Researchers observed 1,181 adults who contracted COVID-19, half of whom received high titer polyclonal convalescent plasma containing a concentrated mixture of SARS-CoV-2 antibodies. The other half received placebo control plasma without COVID-19 antibodies,

None of the patients who received the convalescent plasma died and only 17 were hospitalized within 28 days of infection, according to the study, while three patients who received the placebo died and 37 were hospitalized within 28 days. days after their infection, researchers say. .

After the Food and Drug Administration granted emergency use authorization for monoclonal treatments made by Regeneron and Eli Lilly, the use of plasma treatments for hospital patients with coronavirus declined.

Unlike plasma treatments, monoclonal treatments are not derived from the blood of COVID-19 survivors, but rather are a cocktail of antibodies created in the laboratory. These monoclonal treatments have been shown to be very effective in preventing worsening of symptoms and death in infected patients.

However, Casadevall, warned that plasma treatment options should be more strongly considered because the omicron variant has made monoclonal antibody treatments less effective.

George Yancopoulos, president and chief scientific officer of Regeneron, told ABC News his company has a collection of effective antibodies against the omicron variant, but it will be at least a few months before it is cleared and shipped. .

“People at high risk who contract COVID and who are given plasma instead of monoclonal drugs are hopefully staying out of the hospital,” Casadevall said. “And so the plasma holds up until Regeneron comes out with a new set of monoclones.”

The John Hopkins study comes two weeks after the World Health Organization advised against the use of treatments using plasma from COVID-19 survivors. The WHO said it used data from 16 trials involving more than 16,000 patients worldwide and determined that the treatment did not “improve survival or reduce the need for mechanical ventilation.”

Casadevall told ABC News the WHO did not use John Hopkins research data in its decision.

“We hope that they will reverse their recommendation against convalescent plasma in light of the results of the Hopkins study, as this therapy is inexpensive and available in resource-poor countries where plasma can be a major tool for reducing injury. hospitalizations and mortality, ”he told ABC News.

Andrea B. Troxel, professor of population health and director of the division of biostatistics at the NYU School of Medicine who has also written studies on convalescent plasma treatments for COVID-19 patients, told ABC News that studies Reports on the effectiveness of plasma therapy have been mixed, but she found the results of the John Hopkins University study very encouraging.

Troxel said the problem with plasma treatments is figuring out the right time to use them during the period of infection, and data from the new study gives doctors a better idea of ​​how effective it is.

“This is the ideal point for the plasma, early enough in the infection, the plasma can do what it needs to do. For other studies, it may have been a bit late,” he said. she told ABC News.

Casadevall said the Food and Drug Administration should extend its emergency use authorization for plasma treatments to the outpatient space to ensure treatment is delivered at the right time.

Troxel echoed the call and said plasma treatments should be used more widely for infected patients.

“There is a strong benefit for these patients to receive plasma,” she said. “It is safe and there is no reason not to trust this evidence.”

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