- A French clinical trial started on Tuesday to see if transferring plasma from patients cured of the coronavirus can help those at the start of their illness.
- Concretely, 200 former patients are contacted to donate their plasma during a collection from the French Blood Establishment, plasma which will be injected into 30 patients next Tuesday. The goal: to see if this therapeutic plasma prevents them from presenting serious forms of the disease.
- If this clinical trial, which should have results within two weeks, is positive, this therapeutic plasma could be one of the solutions to treat the most serious cases.
In the myriad of clinical trials that have been launched in recent weeks, there is one that stands out for its originality. It is not a question here of proposing to the patients affected by the new coronavirus a drug, or of testing the immune responses of the body, but of relying on the antibodies of a patient to help another patient to better fight against this pathology .
How? 'Or' What ? By transferring the plasma from a cured patient to a sick person at the start of their pathology. 20 Minutes tells you more about this French clinical trial.
Why plasma?
Plasma is the liquid part of the blood which in particular transports antibodies, these proteins which detect and neutralize pathogens. "This plasma will confer passive immunity on the patient to whom these blood bags are transferred," summarizes Karine Lacombe, head of the Infectious and Tropical Diseases Service at Saint-Antoine Hospital (AP-HP), who is leading this clinical trial. This donation of plasma will strengthen its immune defenses and allow it to fight the virus more effectively. "
An innovative initiative? Yes for the coronavirus, but this principle has been known for centuries. "It is the same principle as the vaccine: you are injected with a small molecule of the virus, which allows your immune system to recognize it, your cells keep it in memory," underlines Frédéric Altare, director of research at the National Institute. health and medical research (Inserm) and immunologist. When you meet this virus again, your cells will attack it quickly. Now we know that it takes about a week for the body to secrete these anti-Covid-19 antibodies. This plasma transfer therefore saves time ...
In any case, this is the hypothesis that this test must verify. "There was a study in chimpanzees which showed that it worked very well, and a Chinese study on patients with intubated coronaviruses, specifies the infectiologist. But with only five cases and without a "control group" [of patients who do not receive this plasma] ... To be sure that the improvement is due to plasma, we will have for this trial a group of 30 patients with plasma and another than 30 patients who will receive standard care. "
How will the clinical trial take place?
Tuesday, April 7, the only French clinical trial on this subject, called COVIPLASM, was launched, piloted by Inserm, the French Blood Establishment (EFS) and the Assistance Publique-Hôpitaux de Paris (AP-HP). Concretely, 200 patients healed (that is to say without symptoms for fourteen days), in three regions (Ile-de-France, Grand Est, Bourgogne Franche-Comté), will be contacted by the EFS to invite them to donate their plasma. Objective: collect 600 units of 200 ml of plasma.
[#Coronavirus # COVID19] 🔬 Guest of @ EliMartichoux this morning on @LCI, Pascal Morel, medical director of the EFS, talks about the clinical study #Coviplasm, conducted in partnership with @ APHP and @ Inserm ⤵️https: //t.co/Vz4rydlt8H
- French blood establishment (@EFS_dondesang) April 7, 2020As of next Tuesday, 30 patients, sick for five or six days, will receive this antibody-rich plasma during two transfers, 24 or 48 hours apart, in several hospitals of the AP-HP. "This French trial focuses on patients at the start of their illness with a profile that makes us fear a severe form, that is to say elderly subjects or with other pathologies", details Cathy Bliem, Deputy Director General of the EFS.
Other clinical trials, conducted with our European neighbors, are interested in this therapeutic plasma. “A trial in Germany is testing convalescent plasma for very severe intensive care patients. We can therefore compare our results, she continues. To see which treatment regimen is most suitable and for which patient. In particular, know what dose of plasma to transfer and when. "
Timing and precautions
This experience will go through two phases. First, that of the clinical trial. With rare speed: the authorizations were obtained in a few days; Recruitment has started, since 15 cured patients have already volunteered on Tuesday ... And the first results are expected in two weeks.
If the trial concludes with efficacy and no side effects, the protocol can be extended to other regions and to a large number of patients. This is why the EFS offers on its site to people who have been sick (with or without test), cured for fourteen days and who wish to donate their plasma, to send their contact details to be contacted by email and participate in this quite special collection. . All the same, under certain conditions: they must meet all the classic criteria of blood donors, but also have had a symptomatic form of the coronavirus, without having gone into intensive care.
Obviously, the goal is not to transfer the virus from one body to another. "This plasma is treated: we will be looking for HIV, Covid-19 in particular," reassures Karine Lacombe. If it is contaminated, it is not used. And if ever there were residues of unknown virus, we can impose an inactivation process so that the plasma is free. In addition, the serological tests carried out on this plasma will make it possible to quantify the antibodies (useful for patients who have not benefited from a coronavirus test) and to verify that they are neutralizing.
"A promising path"
Will there be enough volunteers? For the first step, no doubt. The EFS and the doctors are already drowning in proposals ... For the possible second phase, where it will be necessary to appeal to national solidarity, the doctors responsible for the trial have little concern. "Knowing that there is a specific goal can encourage donating plasma," says Karine Lacombe. Especially since these are former patients, sometimes caregivers, who know how much they have suffered. The altruistic approach may be more important. I do not think we will have difficulty finding donors. Even if there are still questions. "We are working to find out how much plasma we would need," adds Cathy Bliem.
Find our file
Why could this revolutionize the handling of Covid-19? "It is a promising therapeutic path," assures Karine Lacombe. But this will not replace all treatments, and it is for patients in intensive care. That is to say less than 20% of the patients, but the most serious. "
Could this plasma be used to imagine drugs to fight Covid-19? "Sometimes antibodies are extracted from the plasma to make blood-derived drugs," explains Cathy Bliem. Today, for example, we have blood donors who have plasma rich in antibodies to fight tetanus or hepatitis B, which can be used by pharmaceutical companies. But in this clinical trial, we do not sample to extract the antibodies, but to use the plasma. "
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Another EFS study to measure immunity rate
During confinement, the donation of blood does not stop. In addition to saving lives, you could help research. Indeed, the EFS will carry out studies, with the Pasteur Institute, on donations to search for the presence of antibodies against the coronavirus in a representative sample of blood donors. Goal ? Attempt to have a photograph of the spread of the virus in France. “The immunity rate in the population by region is very important information. If tomorrow, we know that only 20% of French people have encountered the virus, it will probably be necessary to continue confinement, ”explains Cathy Bliem, of the EFS.
- Coronavirus
- Covid 19
- Health
- Treatment
- Society
- Research
- Blood donation