Demand for plasma therapy high, but government doubts efficacy | Bengaluru News

by karwar

Bengaluru: Although the Indian Council of Medical Research has trashed plasma therapy, saying it is of no use in treating Covid-19, the demand for the therapy from family members of patients in the state has only risen. However, while doctors in private hospitals say the therapy cannot be dismissed, the state government is not proactively advocating it in its hospitals.
“Our doctors are sceptical about it,” said Jawaid Akhtar, additional chief secretary, health and family welfare department.
At Bangalore Medical College and Research Institute (BMCRI), the biggest government Covid facility where thousands have been treated till date, only 40 patients have been administered plasma therapy. “Of the 40, 22 survived,” said Dr CR Jayanthi, dean-cum-director, BMCRI.
The state was at first keen on the therapy and in April, a team of researchers from HCG cancer hospital, Bengaluru, and BMCRI received approval from the Drug Controller General of India (DCGI) to study the use of convalescent plasma in treating Covid-19 patients.
Dr US Vishal Rao, associate dean, HCG and member of the state’s Covid experts’ committee, said the study analysed 900 patients in 55 hospitals who received the therapy and the success rate was more than 60%. He likened the therapy to an orphan drug since it has no backing from the pharma industry.
“I am not saying it’s a magic drug, but the ICMR study did not check for antibodies in plasma samples administered to patients,” said Dr Rao. “If plasma does not have the required antibodies, it may not be effective. It’s like giving saline. Lack of evidence is not absence of evidence. Several ministers, top bureaucrats and doctors were administered the therapy. But when it comes to regulations, there is not much support for it.”
Dr Ravindra Mehta, chief of pulmonology, Apollo Hospitals, said that with plasma therapy, the higher the antibody titres, the higher the degree of immune response. But this crucial aspect was missing in the ICMR study.
“At the beginning of the pandemic, plasma was taken from asymptomatic patients who have lower antibody titres. It was used in multiple stages across hospitals and there was no uniformity, which also adds to the limitations of the ICMR study,” Dr Mehta said. The ICMR study involved only 400 patients.
Dr Rao said one can’t “provide patients in ICU with oxygen and then pray”. “If we close plasma therapy research and give away the last ray of hope, I think it is an injustice made to humanity,” he said.
Dr Satish KS, senior pulmonologist, Fortis Hospital, said timing matters in Covid treatment. He said plasma therapy works best in the initial phase of the infection, ideally within five days.
“ICMR must take another look,” he said. “The antibodies in the form of plasma should be given when the patient is battling infection, not after 10 days, when the virus may not be present in the body and definitely not when the patient is in the ICU or on ventilator. We are all learning. Plasma given at the right time will yield results.”
At Apollo Hospitals, Jayanagar, 130 of the 1,400 patients treated so far have received the treatment. “We are continuing with plasma therapy. Most of our 130 patients have got two doses of plasma 48 hours apart. It should be used in case by case basis given the pandemic. It deserves a larger study,” Dr Mehta said.

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