Publication Libster R, NEJM, 2021 (published paper)
Dates: 2020-06-04 to 2020-10-25
Funding: Public/non profit (The Bill & Melinda Gates Foundation; The Fundacion INFANT Pandemic Fund)
Conflict of interest: Yes
Blinding: double blinding
Multicenter / Argentina |
Follow-up duration (days): 25
|Inclusion criteria||Age ≥ 75 or age 65-74 with at least 1 of the following comorbidities: arterial hypertension, diabetes, obesity, chronic obstructive pulmonary disease, heart disease, chronic kidney disease
Last 48 hours: (A)Axillary temperature ≥ 37.5oC or febrile equivalent, combined with (a) dry cough and/or (b) breathing difficulty and/or (c) odinophagia and/or (d) anosmia/dysgeusia and/or (e) any of the following symptoms: fatigue, anorexia, myalgias or rhinorrhea.
Confirmed diagnosis SARS-Cov2 by RT-PCR
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|Exclusion criteria||Severe respiratory disease, Cardiac insufficiency, Chronic renal failure, Primary hypogammaglobulinemias, Myelodysplastic syndromes, Chronic linfoproliferative syndromes,Monoclonal gammapathies,Known hypersensitibility, Active cancer, HIV, HBV or HCV infection,Chronic administration of immunosuppressants, Body transplant history,Chronic liver disease, Chronic lung disease with oxygen requirement|
Convalescent plasma (250 ml)
Duration : 1 day
Duration : 1 day
160 participants (n1=80 / n2= 80)
|Characteristics of participants|
Mean age : 77.2
Severity : Mild: n=160 / Moderate: n=0/ Severe: n=0 Critical: n=0
|In the register|
Development of severe respiratory disease defined as a respiratory rate (RR)>30 and/or an O2 sat<93% [ Time Frame: From 12 hours post infusion to day 15 post infusion ]
|In the report|
Development of severe respiratory disease defined as a respiratory rate (RR)≥ 30 and/or an O2 sat < 93% when breathing room air determined between 12 hours after infusion of the investigational product (IP) and day 15 of study participation
Yes. In English
|Risk of bias
The overall risk of bias reported in the table corresponds to the highest risk of bias for the outcomes assessed for the systematic review
In addition to the study report, the pre-print article, the trial registries, study protocol, statistical analysis plan and supplementary materials were used in data extraction and assessment of the risk of bias
There were no substantive differences between the pre-print article and the trial registries, study protocol and statistical analysis plan in the study population, procedures, treatments or outcomes.
Quote: "On July 22 2020, we amended the protocol to include a fourth secondary endpoint including any of the three endpoints described above, alone or in combination."
Of note, masking was quadruple (Participant, Care Provider, Investigator, Outcomes Assessor) in the trial registry.
The study was terminated after achieving 76% of its target sample size due to a decline in COVID-19 cases.
Quote: "Eventually, COVID-19 cases in the region decreased considerably and, by late September and early October, we were enrolling one subject per week. This enrollment pace projected at best ~5 months to complete the study in the unlikely case of the virus remaining in circulation at a constant rate. Consequently, after discussions with the DSMB and having enrolled 76% of the target population, the principal investigator (FPP) and lead sub-investigators (RL, GPM and DW) decided it would be logistically impossible, and ethically questionable given the urgency of the problem, to continue the study, and stopped to examine the results."
Four subjects in the intervention group and two subjects in the control group lost eligibility by reaching the primary endpoint before receiving the intervention product. A modified ITT analysis was also conducted