H5N1 serotheraphy as treatment for flu?

Hot off the press: A meta-analysis in the Annals of internal medicine describes 8 clinical trials on the use of serum from influenza-convalescent persons to treat patients with the Spanish influenza pneumonia. The research was conducted by US military researchers Thomas Luke and colleagues of the Bureau of Medicine and Surgery, U.S. Navy.

Luke et al. found that flu patients who received transfusion of blood plasma, serum or whole blood from recovering patients clinically improved and had lower risk for death, especially when treated within 4 days of onset of pneumonia. The case-fatality rate was 16% among treated patients and 37% among controls. Those who were treated within 4 days of pneumonia complications had only a case-fatality rate of 19% while the rate increased to 59% for those treated after 4 days.

One explanation for clinical improvement is that the virus may be neutralized by anti-influenza antibodies in the blood. The authors cite other human animal studies that suppor their hypothesis. On the other hand, they admit that the trials studied were limited in size, was methodically of poor quality, not randomized nor standardized, and biased toward selection of patients with more serious illnesses. Nevertheless, they recommend that a “central body of experts” convene to consider h5N1 plasma therapy.

The Luke et al. 2006 paper appears in this issue of Annals of Internal Medicine.

Tags: avian influenza, clnical trials, H5N1, meta-analysis, pandemic flu, pneumonia complications, research, serotherapy