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Convalescent Plasma for the Treatment of Patients With WNV - a Double- Blind Randomized Controlled Study

Phase 3
Completed
Conditions
West Nile Fever With Neurologic Manifestation (Diagnosis)
West Nile Fever Without Complications
Interventions
Drug: plasma rich with WNV neutralizing antibodies
Drug: Saline
Registration Number
NCT06590207
Lead Sponsor
Sheba Medical Center
Brief Summary

Name of the study:

Administering neutralizing convalescent plasma to hospitalized patients with West Nile fever - a double-blind randomized controlled study.

The purpose of this study is to test the safety and effectiveness of giving blood plasma from convalescents rich in neutralizers as treatment against West Nile fever.

Detailed Description

The study is performed in Sheba Medical Center ( and will be expanded in the soon future to other Medical centers in Israel).

Hospitalized patients diagnosed by blood/CSF PCR or IgM, with West Nile Virus will be recruited to the study.

After signing an informed consent they will be randomized (2:1) to receive either blood plasma rich in neutralizing antibodies or saline as placebo.

Number of participants in this center: 130 Age range: 60 years old and older, 18-60 years old with immunosuppression.

Inclusion criteria:

* Hospitalized patients with positive WNV-PCR with fever/neurological symptoms, and 72 hours have not yet passed since the positive result.

* Age 60 or older.

* Age over 18 and younger than 60 with immunosuppression (hypogammaglobulinemia, solid organ transplants, bone marrow transplants, hemato-oncological malignancies).

Exclusion criteria:

* Age younger than 60 without immunosuppression.

* More than 72 hours have passed since the diagnosis of West Nile fever.

* Pregnant women.

Reference to the inclusion of pregnant women, special populations - children and those lacking judgment- not relevant: excludes pregnant women and special populations.

The duration of the medical trial includes the follow-up period after the trial:

The duration of the treatment is one day, single dose of plasma/saline. The follow-up period is 90 days.

The clinical follow-up plan (during and at the end of the treatment):

A total of 10 visits will be conducted. On day 1, the following will be performed: screening, Medical history \& Physical examination, IV Convalescent Plasma vs. Saline, Urine and blood for PCR, functional \& neurologic assesment, IgG and IgM from serum, blood test for CBC \& renal function.

On day 2-7 and 30 and 90, AE will be collected. On day 3, 5, 7 Urine and blood for PCR will be collected. Neurologic assesment will be conducted on all visits. Serology will be collected also on day 30 and 90.

After discharge, a follow-up visit will be performed either by a visit to the clinic or via phone call.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
200
Inclusion Criteria
  • Hospitalized patients with positive WNV-PCR with fever/neurological symptoms, and 72 hours have not yet passed since the positive result.
  • Age 60 or older.
  • Age over 18 and younger than 60 with immunosuppression (hypogammaglobulinemia, solid organ transplants, bone marrow transplants, hemato-oncological malignancies).
Exclusion Criteria
  • Age younger than 60 without immunosuppression.
  • More than 72 hours have passed since the diagnosis of West Nile fever.
  • Pregnant women. Criteria for exclusion from the experiment: none Reference to the inclusion of pregnant women, special populations - children and those lacking judgment- not relevant: excludes pregnant women and special populations

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
200ml of neutralizing plasmaplasma rich with WNV neutralizing antibodiesThe plasma of the convalescents: produced in the blood bank of Sheba Medical Center, from the blood of Sheba workers who participated in the SPRI study (Helsinki 0196-23) and whose blood was found to have neutralizing antibodies to WNV (above 1:524). The blood units from the volunteers who will donate will meet all the requirements of a normal blood donation and will only include men or women who were not pregnant, and the units will pass all the tests accepted at the blood bank before donation.
SalineSaline200 ml Saline
Primary Outcome Measures
NameTimeMethod
Unfavorable outcom = Composite outcome of mortality or functional deterioration on day 30day 28-32

functional deterioration will be defined using Barthel Index

Secondary Outcome Measures
NameTimeMethod
unfavorable outcome on day 90day 88-92

same as primary outcome but on day 90

Serious adverse eventsday 2-32

Allergic reaction, pulmonary congestion, hemolysis

Mortalityday 28-92

Mortality by day 90

Functional deterioration by day 30 & 9028-92 days

decrease in Barthel index from pre-infection baseline

Neurologic deterioration by day 30 & 9028-92 days

combined neurologic score of Barthel index, glasgow outcome score and modified minimental score

Trial Locations

Locations (1)

Sheba Medical Center

🇮🇱

Ramat-Gan, Israel

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