JOIN USCovid-19: Researchers write to Principal Scientific Advisor against plasma therapy
As relatives of Covid patients spend harrowing time looking for plasma donors for their near and dear ones, a group of scientists and public health professionals have requested the Principal Scientific Advisor to remove “plasma therapy” as an “off-level treatment” from India’s official treatment guideline on the basis of available scientific knowledge, which hasn't found any additional benefits of such a therapy.
Researchers said removing the use of plasma therapy would not only save the patients' families from unnecessary harassment but may also reduce the chances of developing more virulent strains through its irrational use.
The existing treatment guidelines issued by the Indian Council of Medical Research (ICMR) and All India Institute of Medical Sciences (AIIMS) recommend plasma therapy as an off-level use, which by definition implies “unapproved” use.
The guidelines issued by the National Institutes of Health, USA and the Infectious Disease Society of America don’t recommend plasma therapy.
In a letter to the Principal Scientific Advisor K Vijayraghavan, researchers cited results from three studies, none of which could find any evidence in support of plasma therapy.
The first such study was the PLACID trial conducted by the ICMR involving 39 public and private hospitals across India. The study found no difference in 28-day mortality or progression to severe disease among patients with moderate Covid-19 treated with convalescent plasma.
While small beneficial effects were found for resolution of shortness of breath and fatigue, experts had cautioned to interpret such results carefully.
The UK Recovery trial on 11,588 patients also found no difference in death or in the proportion of patients discharged from the hospitals.
The trial reported "no significant difference in the primary endpoint of 28-day mortality (18 per cent convalescent plasma vs 18 per cent usual care alone". Similar conclusions were drawn from a third study carried out in Argentina.
Notwithstanding such evidence, plasma therapy is being prescribed rampantly across hospitals in India, forcing the family members of the Covid-19 patients to run from pillar to post looking for donors.
The desperation of the families is understandable as they would like the best for their loved ones when a doctor prescribes such a therapy.
The researchers offered to work with the PSA office to review the scientific literature so that the Centre can take an informed decision on the controversial treatment.
"We request you to urgently review the guideline and remove the unnecessary therapy, which has no benefit but is causing harassment to the patients and their families,” they wrote.