UN cautions that COVID-19 plasma treatment still experimental

London: The World Health Organisation on Monday cautioned that using blood plasma from COVID-19 survivors to treat other patients is still considered an experimental therapy, voicing the concern as a US boost for the treatment has many scientists afraid formal studies will be derailed.

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On Sunday, the US Food and Drug Administration authorised what’s called “emergency use” of the treatment under its special powers to speed the availability of promising experimental drugs during a public health crisis. The action isn’t the same as approving plasma as safe and effective, and numerous rigorous studies are underway to find out if it really works.

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So far, “The results are not conclusive,” WHO’s chief scientist Dr Soumya Swaminathan said during a press briefing. “At the moment, it’s still very low-quality evidence.”

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Convalescent plasma is a century-old treatment that was used to fight off flu and measles outbreaks in the days before vaccines, and was tried more recently during the Ebola outbreak. When the body encounters a new germ, it makes proteins called antibodies that are specially targeted to fight the infection. The antibodies float in plasma – the yellowish, liquid part of blood – which is collected from COVID-19 survivors and given to patients infected with coronavirus.

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Swaminathan said WHO considered plasma therapy to be experimental and that it should continue to be evaluated. She said the treatment is difficult to standardize: Plasma must be collected individually, and people produce different levels of antibodies.

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“Of course, countries can do an emergency listing if they feel the benefits outweigh the risks,” she said. “But that’s usually done when you’re waiting for the more definitive evidence.”

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More data needed

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In a letter describing the FDA’s emergency action, the agency’s chief scientist said the treatment “should not be considered a new standard of care” for coronavirus infections, and that more data from studies will be available in the coming months.

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But already, so many COVID-19 patients have requested plasma rather than agreeing to be part of a research study that many scientists fear they won’t get a clear answer on whether the treatment really works – and if it does, how and when it should be used for the best outcomes.

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Martin Landray, of the University of Oxford said that while the therapy offers “huge promise,” there was still no proof it works.

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“There is a huge gap between theory and proven benefit,” he said in a statement.

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If just a few thousand patients took part in the research “we would have the answer,” said Landray, who is conducting a plasma study in the UK. “If effective, convalescent plasma could be rapidly used worldwide. If not, it could be abandoned,”

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Uncertainty

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Stephen Griffin, an associate professor of medicine at the University of Leeds, said there was still considerable uncertainty about the immune system’s response to COVID-19, making any potential use of convalescent plasma challenging.

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The FDA’s action was announced during a Sunday press briefing by US President Donald Trump, who called it a “breakthrough.”

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“It appears that the lessons from hydroxychloroquine have not been learned,” Griffin said, referring to the malaria drug touted by Trump and others as a potential treatment for the coronavirus.

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The FDA also granted hydroxychloroquine an emergency authorisation before suspending it months later after several trials showed the drug didn’t work against COVID-19 and raised the risk of heart, kidney, liver and other problems.

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The Morning and Evening Brief

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