"Irrational And Unscientific": Centre Drops Off Plasma Therapy As Treatment For COVID-19

The Convalescent plasma therapy which was excessively used in hospitals to treat moderate COVID-19 patients has been dropped off by the government from the national treatment protocol for Coronavirus as an advised experimental treatment option for the patients.

The National task force took the decision in light of the recent discovery in recovery trials in the US that the experimental procedure was ineffective for the treatment.

Some clinicians and scientists wrote to Principal Scientific Advisor K Vijay Raghavan, warning against the "irrational and non-scientific use" of convalescent plasma for COVID-19 in the world, prompting the decision to exclude it from the guidelines.

The public health professionals stated in the letter, which was also addressed to ICMR president Balram Bhargava and AIIMS Director Randeep Guleria, that current plasma therapy recommendations are built on existing evidence and cited some preliminary evidence that suggests a potential connection between the appearance of variants with "lower susceptibility to neutralizing antibodies in immunosuppressed" to people given plasma therapy.

According to the letter signed by vaccinologist Gagandeep Kang, surgeon Pramesh C S, and others, this increases the risk of more virulent strains emerging mostly as a result of irrational plasma therapy use, which could provocate the pandemic.

"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.

Previously, a trial conducted by the ICMR in September of last year found that the drug is ineffective in lowering mortality or slowing disease development.

"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 reported The New Indian Express.

The ICMR and AIIMS, Delhi joint oversight committee, which is part of the union ministry of health and family welfare, released the guidelines.

Emerging reports showcase that it has little advantage for Covid patients in terms of minimizing mortality or disease outcome, the off-label use of convalescent plasma has been included in India's coronavirus care guideline as an investigational therapy.

It has often prompted relatives of critical Covid patients to search for plasma, often paying exorbitant prices for it amid the fact that it cannot be sold or imported under current regulations, in the expectation of saving the ill in the absence of a conclusive cure for the disease. The use of plasma therapy on hospitalized Covid patients did not increase survival rate or any other pre-specified clinical effects, according to findings from the randomized study of Covid-19 therapy (recovery) study, which were released in The Lancet on Friday.

PLACID was a clinical trial that took place in 39 hospitals in 14 states and union territories. Facing warnings from researchers and scientists that its widespread use could be contributing to undesirable mutations in SARS-CoV2, a point officially accepted by the ICMR director several months ago, the government has not removed this inquiry therapy from the Covid19 treatment regimen.

"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."

While many scientists believe the use of plasma therapy without prior tests for neutralizing antibodies would do more damage than good, many prescribing doctors in various parts of the world regularly request that it be arranged for hospitalized Covid patients.

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