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It has been announced that the convalescent plasma arm of the RECOVERY trial has been closed on advice of the Data Monitoring Committee (DMC).
Prof Peter Openshaw, Professor of Experimental Medicine at Imperial College London, said:
“The aim of giving plasma from those who have recovered from COVID to those suffering from disease is intended to provide antibody to neutralise the virus and lessen the impact of infection. It seems a rational approach and convalescent plasma is a relatively cheap source of antibody. Worldwide, the use of convalescent plasma is widespread in patients with serious COVID but the benefits in patients admitted to hospital with serious disease have not been conclusively proven.
“The RECOVERY trial has again delivered a resounding result. This new study on 10,406 hospitalised patients shows no significant difference in the 28-day mortality regardless of treatment with plasma: 18% of them died in each limb of the study.
“This result contrasts with the recent publication in the New England Journal of Medicine (Libster et al, https://www.nejm.org/doi/full/10.1056/NEJMoa2033700) of a trial of high-titre plasma therapy in the prevention of severe COVID in older adults treated in the first 3 days of illness, before they became severely ill. In that study, patients over 65 (mean age 77 years) showed a relative risk reduction of 48% in the development of severe disease. The Libster study suggests that antibody is important in protection, but needs to be present in the very earliest stages to be beneficial. This same conclusion should apply to antibody induced by vaccines, and tallies with the solid prevention of severe disease now seen in several vaccine studies.
“The different outcomes of these studies shows the vital importance of administering the appropriate treatment at the right time and of not giving unproven treatments, however rational they may seem.”
Dr Gail Miflin, Chief Medical Officer for NHS Blood and Transplant, said:
“These preliminary results from RECOVERY are disappointing but show the value of this large clinical trial in determining how best to treat patients with COVID. Although today’s results are preliminary, and we await the full results with interest, there is no doubt that this trial will provide a real answer to an important question.
“People have travelled many miles to donate, taken time away from work, and overcome fears about coming back into a hospital environment. Some of them had been seriously ill or were bereaved. We cannot thank them enough for all they have done.
“We are enormously grateful to them and the hundreds of colleagues who have worked incredibly hard over many months. We can be incredibly proud of what we have achieved together. NHSBT has helped deliver the largest ever randomised control trial of convalescent plasma. This world leading trial could only be completed because of the immense professionalism, expertise and hard work of NHSBT colleagues, donors and partners.”
Background from NHSBT:
Following these results, we are temporarily suspending plasma donation for one week. We will also be suspending booking new appointments. We are asking donors to please keep appointments booked for the future while we explore all options, and we will update them soon. Our donor contact teams will be contacting them with the news.
All our previous output on this subject can be seen at this weblink:
www.sciencemediacentre.org/tag/covid-19
Declared interests
Dr Gail Miflin: “NHS Blood and Transplant has led the plasma collection programme which enabled the RECOVERY trial to report its interim analysis of convalescent plasma.”
None others received.