Adding hyperimmune anti-coronavirus antibodies to treatment does not improve outcomes for adults in hospital with COVID-19
25 Jan 2022
Adding hyperimmune anti-coronavirus antibodies (hIVIG) to treatment does not improve outcomes for adults in hospital with COVID-19. This is according to results from the ITAC trial, published today in The Lancet.
The trial looked at a solution of antibodies. Antibodies are natural proteins made by the body to fight infections. The antibodies were donated by healthy people who had recovered from COVID-19. The antibodies were extracted from the liquid part of blood (called plasma). The antibodies were then purified and concentrated, to make a stronger solution. The solution, called hIVIG had several times more antibodies than are typically found in people who have recovered from COVID-19.
The hIVIG was given as an infusion, with an anti-viral medicine called remdesivir. The ITAC trial recruited nearly 600 adults who were in hospital with COVID-19. The participants had had COVID-19 symptoms for up to 12 days. They did not have life-threatening COVID-19 infection requiring intensive care.
Participants in the trial were randomised to receive either hIVIG plus remdesivir, or a dummy medicine (placebo), plus remdesivir. The main goal of the trial was to see if the health of participants who had the hIVIG was better than the health of those that received the placebo. This was measured seven days after the infusion. Being ‘better’ or ‘worse’ was measured by various outcomes, including what sort of COVID-19 symptoms were ongoing, if any complications had happened and if the participant was alive.
The trial showed that, seven days after starting treatment, participants in both groups (hIVIG and placebo) had the same chance of feeling better. Although not all participants had natural anti-coronavirus antibodies (made by their immune system) when they joined the trial, the subset of participants in the hIVIG group that did have their own coronavirus antibodies were significantly more likely to be doing worse after seven days, than people in placebo group who had their own natural anti-coronavirus antibodies. This difference, seen after seven days in those with natural antibodies, did not persist, and after 28 days was no longer seen. More research needs to be done to find out why this is the case.