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Efficacy of Convalescent Plasma Therapy in the Early Care of COVID-19 Patients. (PLASCOSSA)

Primary Purpose

COVID-19

Status
Terminated
Phase
Phase 3
Locations
France
Study Type
Interventional
Intervention
Transfusion of SARS-CoV-2 Convalescent Plasma.
Transfusion of standard Plasma.
Sponsored by
Direction Centrale du Service de Santé des Armées
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for COVID-19 focused on measuring SARS-CoV-2, COVID 19, Convalescent plasma

Eligibility Criteria

18 Years - 90 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Age 18-90 years ;
  2. COVID-19 confirmed case ;
  3. Cases showing respiratory symptoms, checking at least one of the following criteria:

    1. Cough, dyspnea, respiratory rate > 24 breaths/min
    2. Oxygen saturation < 95% at rest in ambient air
    3. PaO2 < 70mmHg
    4. Scanographic pulmonary compatible with COVID in the absence of any other etiology
  4. Risk of deterioration, checking at least one of the following comorbidity criteria :

    1. Chronic respiratory pathology
    2. Diabetes
    3. Cancer pathology
    4. Cardiovascular disease
    5. Chronic kidney failure
    6. Congenital or acquired immunodeficiency
    7. Cirrhosis at stage B
    8. Major sickle cell syndrome
    9. BMI > 30 kg/m2

OR one of the biological criteria :

  1. D-dimer 1 µg/mL,
  2. Lymphocytes < 0.8 G/L,
  3. Ferritin > 300 µg/L,
  4. Troponin I > 11 pg/mL or Troponin T > 24.8 pg/mL

Exclusion Criteria:

  • Patients admitted in intensive care within the first 6 hours of hospital care,
  • Patients after 10 days from the start of symptoms
  • Age < 18 years and > 90 years
  • Long-term oxygen-dependent patients (at home),
  • Decompensated chronic cardiac, respiratory, urological pathology
  • Patient refusing administration of blood products,
  • Allergic reaction to plasma products,
  • IgA deficiency,
  • Contraindication to transfusion
  • Ig transfusion within 30 days,
  • Patient currently participating to another clinical trial,
  • Pregnant women,
  • No affiliated to the social security,
  • Person deprived of liberty by a legal or administrative decision, person under guardianship

Sites / Locations

  • HIA Percy
  • HIA Laveran
  • HIA Bégin
  • HIA Sainte Anne

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

SARS-CoV-2 patients treated with convalescent plasma

SARS-CoV-2 patients treated with standard plasma

Arm Description

Subjects will receive an intravenous injection of SARS-CoV-2 Convalescent Plasma.

Subjects will receive an intravenous injection of standard Plasma.

Outcomes

Primary Outcome Measures

Survival time without needs of a ventilator.
Survival time without needs of ventilator, i.e. the time until oxygen supply (patient previously in ambient air), or an increase by more than 6L/min of O2 for more than 24 hours, or the use of non-invasive ventilation, or intubation, or death.

Secondary Outcome Measures

Morbidity
The percentage of patients i) not hospitalized, without limitation of activities, ii) Not hospitalized, with activity limitation, iii) Hospitalized without oxygen therapy, iv) Hospitalized with oxygen therapy, v) Hospitalized with intensive oxygen therapy or non- invasive ventilation (NIV), vi) Hospitalized and intubated or on extracorporeal membrane oxygenation (ECMO), vii) Dead.
Morbidity
Difference of the SOFA (Sequential Organ Failure Assessment) mean score per patient between the two groups.
Mortality
Length of stay
Effect on viral pharyngeal specimen clearance
Quantitative SARS-CoV2 PCR carried out on pharyngeal specimen.
Effect on viral blood specimen clearance
Quantitative SARS-CoV2 PCR carried out on blood specimen.
Effect on hemostasis disorders
Effects on biological hemostasis parameters disorders.
Kinetics of appearance of neutralizing antibodies
Anti-SARS-Cov2 immunoglobulin G/A level and anti-SARS-Cov2 neutralizing antibody levels.
Transfusion endotheliopathy effect
Evolution of biological endotheliopathy parameters
Transfusion biological Inflammation effect
Evaluation of biological dosages on inflammation effects
Transfusion hemovigilance
Number of transfusion adverse events
Decrease in the consumption of antibiotics

Full Information

First Posted
April 24, 2020
Last Updated
April 6, 2022
Sponsor
Direction Centrale du Service de Santé des Armées
Collaborators
University Hospital, Grenoble
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1. Study Identification

Unique Protocol Identification Number
NCT04372979
Brief Title
Efficacy of Convalescent Plasma Therapy in the Early Care of COVID-19 Patients.
Acronym
PLASCOSSA
Official Title
Evaluation Of Efficacy Of COVID-19 Convalescent Plasma Versus Standard Plasma In The Early Care Of COVID-19 Patients Hospitalized Outside Intensive Care Units.
Study Type
Interventional

2. Study Status

Record Verification Date
April 2022
Overall Recruitment Status
Terminated
Why Stopped
Reluctance of patients and physicians in this transfusion study setting. Blood products have expired. New variants have appeared since the plasma collection period. Some recent publications question the effectiveness of transfusion.
Study Start Date
September 14, 2020 (Actual)
Primary Completion Date
June 1, 2021 (Actual)
Study Completion Date
June 1, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Direction Centrale du Service de Santé des Armées
Collaborators
University Hospital, Grenoble

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
COVID-19 (Corona Virus Disease 2019) hospitalized patients evolution is marked by the risk of worsening of the respiratory system during the second week of the disease. To date, treatments are currently being evaluated and none of them have shown to be effective in the care of these patients. The use of convalescent plasma is a passive immunotherapy. It has often been used in respiratory virus epidemic situations (during the 1918 or 2009 influenza pandemic, or during SARS-CoV-1 or MERS-CoV pandemic). Effects reported in literature are in favour of a beneficial impact of transfusion of these plasma without serious adverse effects reported. PlasCoSSA is a randomized, controlled, triple-blinded, parallel clinical trial. This study tests the efficacy of convalescent plasma transfusion therapy in the early care of COVID-19 hospitalized patients outside intensive care units.
Detailed Description
During SARS-CoV-2 infection, two clinical-biological phases can be observed: an initial viral phase followed by an immunological phase whose onset has been associated with more severe prognosis. Hospitalized patients with comorbidities or clinical risk factors have a higher risk of respiratory functions deterioration and significant risk to need intensive care. Early transfusion of convalescent plasma (2 units of 200-230 mL of apheresis plasma inactivated by amotosalen) would prevent this secondary worsening and reduce the risk to be transferred to intensive care, length of stay and mortality. Considering clinical and biological manifestations of the disease, including coagulation disorders, endothelial alterations, immunological disorders, it seems interesting to compare this convalescent plasma with a SARS-CoV-2 lacking antibodies plasma.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
COVID-19
Keywords
SARS-CoV-2, COVID 19, Convalescent plasma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
18 (Actual)

8. Arms, Groups, and Interventions

Arm Title
SARS-CoV-2 patients treated with convalescent plasma
Arm Type
Experimental
Arm Description
Subjects will receive an intravenous injection of SARS-CoV-2 Convalescent Plasma.
Arm Title
SARS-CoV-2 patients treated with standard plasma
Arm Type
Active Comparator
Arm Description
Subjects will receive an intravenous injection of standard Plasma.
Intervention Type
Drug
Intervention Name(s)
Transfusion of SARS-CoV-2 Convalescent Plasma.
Intervention Description
2 Convalescent Plasma units of 200-230mL each, inactivated by amotosalen.
Intervention Type
Drug
Intervention Name(s)
Transfusion of standard Plasma.
Intervention Description
2 Standard Plasma units of 200-230mL each, inactivated by amotosalen.
Primary Outcome Measure Information:
Title
Survival time without needs of a ventilator.
Description
Survival time without needs of ventilator, i.e. the time until oxygen supply (patient previously in ambient air), or an increase by more than 6L/min of O2 for more than 24 hours, or the use of non-invasive ventilation, or intubation, or death.
Time Frame
Day 30
Secondary Outcome Measure Information:
Title
Morbidity
Description
The percentage of patients i) not hospitalized, without limitation of activities, ii) Not hospitalized, with activity limitation, iii) Hospitalized without oxygen therapy, iv) Hospitalized with oxygen therapy, v) Hospitalized with intensive oxygen therapy or non- invasive ventilation (NIV), vi) Hospitalized and intubated or on extracorporeal membrane oxygenation (ECMO), vii) Dead.
Time Frame
Day 15
Title
Morbidity
Description
Difference of the SOFA (Sequential Organ Failure Assessment) mean score per patient between the two groups.
Time Frame
Day 30
Title
Mortality
Time Frame
Day 30
Title
Length of stay
Time Frame
Day 30
Title
Effect on viral pharyngeal specimen clearance
Description
Quantitative SARS-CoV2 PCR carried out on pharyngeal specimen.
Time Frame
At inclusion and Day 7
Title
Effect on viral blood specimen clearance
Description
Quantitative SARS-CoV2 PCR carried out on blood specimen.
Time Frame
At inclusion and Day 7
Title
Effect on hemostasis disorders
Description
Effects on biological hemostasis parameters disorders.
Time Frame
At inclusion, Day 1 and every 48 hours
Title
Kinetics of appearance of neutralizing antibodies
Description
Anti-SARS-Cov2 immunoglobulin G/A level and anti-SARS-Cov2 neutralizing antibody levels.
Time Frame
At inclusion, Day 7
Title
Transfusion endotheliopathy effect
Description
Evolution of biological endotheliopathy parameters
Time Frame
At inclusion, Day 1, Day 7
Title
Transfusion biological Inflammation effect
Description
Evaluation of biological dosages on inflammation effects
Time Frame
At inclusion, Day 1, Day 7
Title
Transfusion hemovigilance
Description
Number of transfusion adverse events
Time Frame
30 days
Title
Decrease in the consumption of antibiotics
Time Frame
30 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
90 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age 18-90 years ; COVID-19 confirmed case ; Cases showing respiratory symptoms, checking at least one of the following criteria: Cough, dyspnea, respiratory rate > 24 breaths/min Oxygen saturation < 95% at rest in ambient air PaO2 < 70mmHg Scanographic pulmonary compatible with COVID in the absence of any other etiology Risk of deterioration, checking at least one of the following comorbidity criteria : Chronic respiratory pathology Diabetes Cancer pathology Cardiovascular disease Chronic kidney failure Congenital or acquired immunodeficiency Cirrhosis at stage B Major sickle cell syndrome BMI > 30 kg/m2 OR one of the biological criteria : D-dimer 1 µg/mL, Lymphocytes < 0.8 G/L, Ferritin > 300 µg/L, Troponin I > 11 pg/mL or Troponin T > 24.8 pg/mL Exclusion Criteria: Patients admitted in intensive care within the first 6 hours of hospital care, Patients after 10 days from the start of symptoms Age < 18 years and > 90 years Long-term oxygen-dependent patients (at home), Decompensated chronic cardiac, respiratory, urological pathology Patient refusing administration of blood products, Allergic reaction to plasma products, IgA deficiency, Contraindication to transfusion Ig transfusion within 30 days, Patient currently participating to another clinical trial, Pregnant women, No affiliated to the social security, Person deprived of liberty by a legal or administrative decision, person under guardianship
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Nathalie KOULMANN
Organizational Affiliation
Direction Centrale du Service de Santé des Armées (DCSSA)
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Catherine VERRET
Organizational Affiliation
Service de Santé des Armées-Direction de la Formation de la Recherche et de l'Innovation
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Christophe MARTINAUD
Organizational Affiliation
Centre de Transfusion Sanguine des Armées
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Jean-Luc BOSSON
Organizational Affiliation
Statistical and methodological investigator - Laboratoire TIMC UMR 5525 CNRS Equipe Themas
Official's Role
Principal Investigator
Facility Information:
Facility Name
HIA Percy
City
Clamart
ZIP/Postal Code
92140
Country
France
Facility Name
HIA Laveran
City
Marseille
ZIP/Postal Code
13013
Country
France
Facility Name
HIA Bégin
City
Saint-Mandé
ZIP/Postal Code
94160
Country
France
Facility Name
HIA Sainte Anne
City
Toulon
ZIP/Postal Code
83000
Country
France

12. IPD Sharing Statement

Plan to Share IPD
No
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Links:
URL
https://sfar.org/download/traitement-anticoagulant-pour-la-prevention-du-risque-thrombotique-chez-un-patient-hospitalise-avec-covid-19-et-surveillance-de-lhemostase/
Description
Anticoagulant treatment for the prevention of thrombotic risk in a patient hospitalized with COVID-19 and monitoring of hemostasis.
URL
https://clinicaltrials.gov/ct2/show/NCT04323800
Description
Efficacy and Safety Human Coronavirus Immune Plasma (HCIP) vs. Control (SARS-CoV-2 Non-immune Plasma) Among Adults Exposed to COVID-19 - Full Text View - ClinicalTrials.gov
URL
https://www.has-sante.fr/jcms/c_1264081/fr/transfusion-de-plasma-therapeutique-produits-indications
Description
Transfusion of therapeutic plasma: products, indications (Haute Autorité de Santé, France)
URL
https://www.hcsp.fr/explore.cgi/avisrapportsdomaine?clefr=790
Description
Coronavirus SARS-CoV-2 management of people at risk of severe forms (Haut Conseil de la Santé Publique; 2020)

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Efficacy of Convalescent Plasma Therapy in the Early Care of COVID-19 Patients.

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