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SARS VirusPLASM-ARNCT04383535

Convalescent Plasma and Placebo for the Treatment of COVID-19 Severe Pneumonia

A study testing Convalescent SARS COVID-19 plasma in people with SARS Virus and SARS-CoV-2, run by Hospital Italiano de Buenos Aires at 1 site in Argentina.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

A multicenter randomized, double-blind, placebo-controlled clinical trial of Convalescent SARS COVID-19 plasma versus Placebo to evaluate the effect between arms on an ordinal score of six mutually exclusive categories of clinical status at day 30 after study initiation. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
SARS Virus, SARS-CoV-2, COVID-19
What is being tested?
Convalescent SARS COVID-19 plasma
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
333 participants
Where
1 siteArgentina
Study dates
15 May 2020to 27 Sep 2020
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Confirmed diagnosis of Covid-19 through qualitative polymerase-reverse transcriptase (qRT-PCR -GeneDX Co, Ltd o similar).
  • Imagining-diagnosed pneumonia (Rx or CT scan).
  • MSOFA score (Modified SOFA) of 2 or more (modified organic failure assessment)
  • Informed consent.

Who cannot join

  • Pregnant women
  • Women at reproductive age not willing to avoid unprotected sexual intercourse up to Day 30 after study initiation.
  • Women in the breastfeeding period
  • Patients receiving experimental treatments under development within 30 days prior to study initiation.
  • Patients with a previous history of allergic reactions to blood or blood-components transfusion.
  • Diagnosis or clinical suspicion of an alternative microbiological cause for pneumonia besides COVID-19
  • Use of systemic corticosteroids within 15 days prior to entering the study.

Trial locations and contacts

1 site in 1 country.

Argentina1 site
  • Hospital Italiano de Buenos Aires

    Ciudad Autonoma de Buenos Aire, Buenos Aires F.D., 1181

Other trials in Argentina

About this study

Official title: Randomized, Double-blind, Placebo-controlled Clinical Trial of Convalescent Plasma for the Treatment of COVID-19 Pneumonia With Severity Criteria

A multicenter randomized, double-blind, placebo-controlled clinical trial of Convalescent SARS COVID-19 plasma versus Placebo to evaluate the effect between arms on an ordinal score of six mutually exclusive categories of clinical status at day 30 after study initiation.

Read the detailed description

Introduction

The use of convalescent plasma in the treatment of infectious diseases has been empirically performed for more than a century. It is based upon the assumption that providing exogenous neutralizing antibodies may provide protection while affected patients mount their own immune response. This therapeutic approach appears of particular interest in the context of the current pandemic, in which there is no specific vaccine available nor adequately proven effective pharmacological treatments.

Study purpose, hypothesis and general design

Purpose of the study: evaluate the effectiveness and safety of convalescent plasma in the treatment of SARS-CoV-2 pneumonia (Covid-19) Hypothesis: Convalescent plasma significantly improves the clinical outcome in patients with Covid-19 pneumonia and severity criteria.

Multicenter randomized, double-blind, placebo.controlled clinical trial. Placebo will be a saline solution.

  1. Methodological sustain for including a control arm with placebo Quality evidence about the effectiveness of convalescent plasma in the treatment of Covid-19 pneumonia is not yet available. Although case series and anecdotal reports appear encouraging, the implementation of its use in routine clinical practice requires the validation through controlled clinical trials. In addition the collection, administration and control of plasma is technically demanding and needs a clear support before broadly recommending it. Different scientific institutions and international organisms had clearly suggested to prioritize the application of novel therapeutic techniques with yet unproven efficacy within the context of clinical studies over its empirical use.

On the other hand, for the present study, intervention strategy is proposed in "add-on" modality over the antiviral treatment that each participant may be already receiving, since they represent completely different therapeutic approaches. As such, participation in the present study will not condition the possibility of the participants to receive other treatments, either in intervention or control arms.

  1. Study objectives Primary objective Analyze the difference between arms on an ordinal score of six mutually exclusive categories at day 30 after study initiation. This score includes the following categories
Being tested
Convalescent SARS COVID-19 plasma, Placebo
Keywords
SARS Virus, SARS-CoV-2, COVID-19, Blood Plasma
Medical subject headings
Severe Acute Respiratory Syndrome, COVID-19

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Convalescent SARS COVID-19 plasmaOther

    Convalescent SARS COVID-19 plasma from a pool of 10 donor plasma. The calculation of the volume to be transfused will be from 10 to 15 ml / kg adjusting the volume to the body weight of each patient, at a suggested infusion rate of 5 to 10 ml / kg / h with an intravenous infusion pump. The infusion rate will be adjusted according to the clinical stability of the patient according to the treating physician.

  • PlaceboOther

    Single infusion of saline solution, in addition to standard care. The calculation of the volume to be transfused will be from 10 to 15 ml / kg adjusting the volume to the body weight of each patient, at a suggested infusion rate of 5 to 10 ml / kg / h with an intravenous infusion pump. The infusion rate will be adjusted according to the clinical stability of the patient according to the treating physician.

Study groups in NCT04383535
Study groupRoleWhat they receive
Convalescent SARS COVID-19 plasmaExperimentalConvalescent SARS COVID-19 plasma from a pool of 10 donor plasma, in addition to standard care.
Receives: Other: Convalescent SARS COVID-19 plasma
PlaceboPlacebo comparatorSingle infusion of saline solution, in addition to standard care.
Receives: Other: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Clinical status during follow-up at 30th day

    Ordinal outcome with six mutually exclusive categories to describe the patient's clinical status during follow-up. The six categories are: (1) death; (2) in intensive care; (3) hospitalised but requiring supplemental oxygen; (4) hospitalised and not requiring supplemental oxygen; (5) discharged but unable to resume normal activities; or (6) discharged with full resumption of normal activities.

    Measured: 30th Day since study preparation infusion (Placebo or Convalescent SARS COVID-19 plasma)

Secondary outcomes (13)
  1. Clinical status during follow-up at 7th day

    Ordinal outcome with six mutually exclusive categories to describe the patient's clinical status during follow-up. The six categories are: (1) death; (2) in intensive care; (3) hospitalised but requiring supplemental oxygen; (4) hospitalised and not requiring supplemental oxygen; (5) discharged but unable to resume normal activities; or (6) discharged with full resumption of normal activities.

    Measured: 7th Day since study preparation infusion (Placebo or Convalescent SARS COVID-19 plasma)

  2. Clinical status during follow-up at 14th day

    Ordinal outcome with six mutually exclusive categories to describe the patient's clinical status during follow-up. The six categories are: (1) death; (2) in intensive care; (3) hospitalised but requiring supplemental oxygen; (4) hospitalised and not requiring supplemental oxygen; (5) discharged but unable to resume normal activities; or (6) discharged with full resumption of normal activities.

    Measured: 14th Day since study preparation infusion (Placebo or Convalescent SARS COVID-19 plasma)

  3. Time until hospital discharge (days).

    Hospital discharge or intrahospital death

    Measured: Whenever the patient is discharge from the hospital or die without discharge, through study completion, an average of 14 days from admission

  4. Time until discharge from ICU (days)

    ICU discharge or ICU death

    Measured: Whenever the patient is discharge from ICU or die in ICU, through study completion, an average of 10 days from admission

  5. Time to death

    Death and time to death

    Measured: In a 30 days follow up period

  6. Time until complete functional recovery

    Time until complete functional recovery (according to basal status).

    Measured: Whenever the patient returns to basal functional status until 1 month from discharge

  7. Percentage of participants with adverse events / serious adverse events

    Percentage of participants with adverse events / serious adverse events

    Measured: In a 30 days follow up period

  8. Percentage of patients with negative SARS-CoV-3 PCR at Day 14th

    Percentage of patients with negative SARS-CoV-3 PCR

    Measured: 14th Day since study preparation infusion (Placebo or Convalescent SARS COVID-19 plasma)

  9. D Dimer plasma concentration at Day 14th

    D Dimer plasma concentration

    Measured: 14th Day since study preparation infusion (Placebo or Convalescent SARS COVID-19 plasma)

  10. Ferritin plasma concentration at Day 13th

    Ferritin plasma concentration

    Measured: 13th Day since study preparation infusion (Placebo or Convalescent SARS COVID-19 plasma)

  11. Plasma concentration of neutralizing antibodies at Day 2nd

    Plasma concentration of neutralizing antibodies

    Measured: 2nd Day since study preparation infusion (Placebo or Convalescent SARS COVID-19 plasma)

  12. Plasma concentration of neutralizing antibodies at Day 7th

    Plasma concentration of neutralizing antibodies

    Measured: 7th Day since study preparation infusion (Placebo or Convalescent SARS COVID-19 plasma)

  13. Post-transfusion adverse reactions

    Post-transfusion adverse reactions between study groups

    Measured: In a 30 days follow up period

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted12 May 2020
  2. Study start15 May 2020
  3. Primary completion27 Sep 2020
  4. Study completion27 Sep 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Multicenter randomized (2:1, 222 plasma 111 placebo), double-blind, placebo-controlled clinical trial
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
333 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04383535
Sponsor's protocol ID
5565
Acronym
PLASM-AR
Status last verified
Sep 2020
First submitted
6 May 2020
Last updated
30 Sep 2020
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Maiztegui JI, Fernandez NJ, de Damilano AJ. Efficacy of immune plasma in treatment of Argentine haemorrhagic fever and association between treatment and a late neurological syndrome. Lancet. 1979 Dec 8;2(8154):1216-7. doi: 10.1016/s0140-6736(79)92335-3.

    PubMed 92624
  • Tanne JH. Covid-19: FDA approves use of convalescent plasma to treat critically ill patients. BMJ. 2020 Mar 26;368:m1256. doi: 10.1136/bmj.m1256. No abstract available.

    PubMed 32217555
  • Shen C, Wang Z, Zhao F, Yang Y, Li J, Yuan J, Wang F, Li D, Yang M, Xing L, Wei J, Xiao H, Yang Y, Qu J, Qing L, Chen L, Xu Z, Peng L, Li Y, Zheng H, Chen F, Huang K, Jiang Y, Liu D, Zhang Z, Liu Y, Liu L. Treatment of 5 Critically Ill Patients With COVID-19 With Convalescent Plasma. JAMA. 2020 Apr 28;323(16):1582-1589. doi: 10.1001/jama.2020.4783.

    PubMed 32219428
  • Roback JD, Guarner J. Convalescent Plasma to Treat COVID-19: Possibilities and Challenges. JAMA. 2020 Apr 28;323(16):1561-1562. doi: 10.1001/jama.2020.4940. No abstract available.

    PubMed 32219429
  • Cheng Y, Wong R, Soo YO, Wong WS, Lee CK, Ng MH, Chan P, Wong KC, Leung CB, Cheng G. Use of convalescent plasma therapy in SARS patients in Hong Kong. Eur J Clin Microbiol Infect Dis. 2005 Jan;24(1):44-6. doi: 10.1007/s10096-004-1271-9.

    PubMed 15616839
  • Kalil AC. Treating COVID-19-Off-Label Drug Use, Compassionate Use, and Randomized Clinical Trials During Pandemics. JAMA. 2020 May 19;323(19):1897-1898. doi: 10.1001/jama.2020.4742. No abstract available.

    PubMed 32208486
  • Angus DC. Optimizing the Trade-off Between Learning and Doing in a Pandemic. JAMA. 2020 May 19;323(19):1895-1896. doi: 10.1001/jama.2020.4984. No abstract available.

    PubMed 32227198
  • Luke TC, Kilbane EM, Jackson JL, Hoffman SL. Meta-analysis: convalescent blood products for Spanish influenza pneumonia: a future H5N1 treatment? Ann Intern Med. 2006 Oct 17;145(8):599-609. doi: 10.7326/0003-4819-145-8-200610170-00139. Epub 2006 Aug 29.

    PubMed 16940336
  • Iannizzi C, Chai KL, Piechotta V, Valk SJ, Kimber C, Monsef I, Wood EM, Lamikanra AA, Roberts DJ, McQuilten Z, So-Osman C, Jindal A, Cryns N, Estcourt LJ, Kreuzberger N, Skoetz N. Convalescent plasma for people with COVID-19: a living systematic review. Cochrane Database Syst Rev. 2023 May 10;5(5):CD013600. doi: 10.1002/14651858.CD013600.pub6.

    PubMed 37162745
  • Iannizzi C, Chai KL, Piechotta V, Valk SJ, Kimber C, Monsef I, Wood EM, Lamikanra AA, Roberts DJ, McQuilten Z, So-Osman C, Jindal A, Cryns N, Estcourt LJ, Kreuzberger N, Skoetz N. Convalescent plasma for people with COVID-19: a living systematic review. Cochrane Database Syst Rev. 2023 Feb 1;2(2):CD013600. doi: 10.1002/14651858.CD013600.pub5.

    PubMed 36734509
  • Piechotta V, Iannizzi C, Chai KL, Valk SJ, Kimber C, Dorando E, Monsef I, Wood EM, Lamikanra AA, Roberts DJ, McQuilten Z, So-Osman C, Estcourt LJ, Skoetz N. Convalescent plasma or hyperimmune immunoglobulin for people with COVID-19: a living systematic review. Cochrane Database Syst Rev. 2021 May 20;5(5):CD013600. doi: 10.1002/14651858.CD013600.pub4.

    PubMed 34013969
  • Simonovich VA, Burgos Pratx LD, Scibona P, Beruto MV, Vallone MG, Vazquez C, Savoy N, Giunta DH, Perez LG, Sanchez MDL, Gamarnik AV, Ojeda DS, Santoro DM, Camino PJ, Antelo S, Rainero K, Vidiella GP, Miyazaki EA, Cornistein W, Trabadelo OA, Ross FM, Spotti M, Funtowicz G, Scordo WE, Losso MH, Ferniot I, Pardo PE, Rodriguez E, Rucci P, Pasquali J, Fuentes NA, Esperatti M, Speroni GA, Nannini EC, Matteaccio A, Michelangelo HG, Follmann D, Lane HC, Belloso WH; PlasmAr Study Group. A Randomized Trial of Convalescent Plasma in Covid-19 Severe Pneumonia. N Engl J Med. 2021 Feb 18;384(7):619-629. doi: 10.1056/NEJMoa2031304. Epub 2020 Nov 24.

    PubMed 33232588

Questions about this trial

What is this clinical trial studying?

A study testing Convalescent SARS COVID-19 plasma in people with SARS Virus and SARS-CoV-2, run by Hospital Italiano de Buenos Aires at 1 site in Argentina.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 30 Sep 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Argentina. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Clinical status during follow-up at 30th day (time frame: 30th Day since study preparation infusion (Placebo or Convalescent SARS COVID-19 plasma)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04383535, which also lists 12 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Sep 2020.

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