05 July 2022

A UK clinical trial has reopened to see if convalescent plasma from “super donors” can help individuals with weakened immune systems fight COVID-19.

It is hoped the high levels of antibodies these super donors produce after infection and vaccination can control the virus in people whose immune systems are compromised.

Professor Lise Estcourt, head of NHS Blood and Transplant’s clinical trials unit and who is leading the new trial, said: “It’s really important because this is a group of patients who are still dying from COVID. This is something that could be beneficial to them.”

She said: “There’s a signal from REMAP-CAP that convalescent plasma can help immunosuppressed people but only if it comes from super donors with very high antibody levels.

“It would be a valuable treatment because some immunosuppressed people do not respond to the vaccine and monoclonal antibodies – which are often given to immunosuppressed people - may not work against emerging variants.

“It could also be of particular use in the developing world, where access to more expensive treatments is limited.

“Only a full, randomised controlled trial can provide a definite answer. We have now reopened the plasma arm of the trial to get enough data for a result either way.

RECOVERY and REMAP-CAP, two landmark trials, found convalescent plasma had no overall benefit for COVID patients. However, closer examination of the REMAP-CAP data suggested plasma with the highest levels of antibodies was promising for patients who were immunosuppressed.

This resulted in the plasma arm of the REMAP-CAP trial being reopened to investigate specifically if donated plasma with extremely high levels of antibodies can save these people’s lives and reduce the time they spend in intensive care.

More than 15 UK hospitals are to take part in the trial, and more are expected to join in the next few weeks.

Plasma has been donated by patients who have been infected with COVID and vaccinated against the virus. Professor Anthony Gordon, chief investigator for REMAP-CAP, said: “The REMAP-CAP trial was designed to be adaptive, providing high quality evidence to guide best treatments for severely ill patients with COVID-19 around the world.

“As we move to a different stage of the pandemic we are pleased to be able to provide that evidence to ensure high-risk patients continue to receive the right combination of treatments.” 

Source: NHS Blood and Transplant

https://www.nhsbt.nhs.uk/news/first-patient-randomised-into-super-donor-plasma-trial/

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