COVID-19: Is It the End for Convalescent Plasma?

Nicky Broyd

January 18, 2021

The RECOVERY trial has closed recruitment to its randomised study of convalescent plasma treatment for patients hospitalised with COVID-19.

The preliminary analysis on 1873 reported deaths among 10,406 randomised patients showed no significant difference in the primary endpoint of 28-day mortality (18% convalescent plasma vs. 18% usual care alone).

The trial's independent data monitoring committee held a routine meeting last Thursday and "saw no convincing evidence that further recruitment would provide conclusive proof of worthwhile mortality benefit either overall or in any pre-specified subgroup".

Follow-up is continuing before final results are published.

Last week, the international REMAP-CAP trial also reported convalescent plasma did not improve outcomes among ICU patients.

However, The New England Journal of Medicine recently published a study suggesting convalescent plasma led to a 48% relative risk reduction in older patients developing severe disease.

'Resounding Result'

Joint Chief Investigator for RECOVERY, Peter Horby, professor of emerging infectious diseases, Nuffield Department of Medicine, University of Oxford, said: "Whilst the overall result is negative, we need to await the full results before we can understand whether convalescent plasma has any role in particular patient subgroups."

Joint Chief Investigator, Martin Landray, professor of medicine and epidemiology at the Nuffield Department of Population Health, University of Oxford, added: "Once again, the RECOVERY trial is demonstrating the value of large randomised trials to properly assess the role of potential treatments. At this very challenging time, we are incredibly grateful to the hard work of NHS staff and huge contribution made by patients across the whole country."

Peter Openshaw, professor of experimental medicine, Imperial College London, commented via the Science Media Centre: "The RECOVERY trial has again delivered a resounding result." 

He pointed out how RECOVERY's findings differed from the NEJM study:

"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."

Last week, Imperial's Professor Anthony Gordon, chief investigator for REMAP-CAP, said the study had been able to provide important evidence about which patients might benefit from convalescent plasma: "Although it is disappointing that all critically ill patients don’t appear to gain any benefit, this is still vitally important to know. Convalescent plasma is a precious resource, and we can now continue to focus on identifying exactly which patients might benefit the most from treatment – maybe people earlier in their illness or those with weak immune systems."

NHSBT

Plasma was collected from COVID-19 recovered volunteers by NHS Blood and Transplant (NHSBT).

NHSBT CMO, Dr Gail Miflin, said the preliminary RECOVERY results were "disappointing" but praised the donors: "We are enormously grateful to the tens of thousands of people who have given their time and donated plasma and to 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 and partners."

Credit: Mark Sandell


One of the donors, journalist Mark Sandell, commented on Facebook: "I was due to do my 13th convalescent plasma donation on Monday but it's been cancelled because, unfortunately, it doesn't actually help hospital patients with COVID. Still, I got a nice badge when I got to 10; you can never have too many orange Club biscuits, and it got me out of the house during lockdown."
 

 

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