Plasma Therapy: Avoid unproven Covid-19 treatments, experts caution doctors

Earlier, an ICMR study showed that plasma therapy may no longer be an option for Covid-19 treatment

Top medical experts on Friday cautioned practising doctors not to succumb to unproven and investigational treatments that are being permitted throughout the world as an emergency to tackle Covid-19, Indian Council of Medical Research (ICMR) published its study.

The Council issued this advisory on the futility of plasma therapy in one of the world’s top medical journals.

In an editorial, British Medical Journal noted that the desperation generated by the pandemic led to several treatment options that are exceptions rather than norms.

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"But the medical community should not succumb to such exceptions allowed in a pandemic. Rather, high-quality clinical research should be a part of the response," the study said.

The warning comes along with the publication of the ICMR’s PLACID trial that categorically showed convalescent plasma was not associated with a reduction in progression to severe Covid-19 or all cause mortality.

The study found no difference in 28 day mortality or progression to severe disease among patients with moderate Covid-19 treated with convalescent plasma.

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While small beneficial effects were found for resolution of shortness of breath and fatigue, experts have cautioned to interpret such results carefully because of a design limitation of the study.

In its editorial, the BMJ said the PLACID trial was a rigorous randomized controlled study on a topic of enormous global importance, ethically designed and implemented.

“The desperation engendered by Covid-19 demands that we strongly resist the urge to succumb to pandemic research exceptionalism. High quality clinical research must be an integral part of a coordinated international response. Specifically, scientific validity is a necessary component of ethical research. Low quality research not only wastes scarce resources, it is also inherently unethical,” it added.

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The caution comes at a time when a section of doctors in several parts of India including Karnataka and Kerala decided to continue with the convalescent plasma therapy ignoring the ICMR study findings that the therapy doesn't work.

The proponents cited initial studies with much smaller number with unclear results to justify the therapy.

The ICMR team pointed out that while use of convalescent plasma as treatment for Covid-19 is allowed for off-label use in India, such authorisation has been paralleled by questionable practices like calls for donors on social media and the sale of convalescent plasma on the black market with exorbitant price tags in India.

Moreover, it’s a resource-intensive process for which the resources and facilities are available in only a few hospitals.