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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.
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:
Exclusion criteria:
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 200ml of neutralizing plasma | Experimental | The 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. |
|
| Saline | Placebo Comparator | 200 ml Saline |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| plasma rich with WNV neutralizing antibodies | Drug | 200 ml plasma of the convalescents: produced in the blood bank, 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. |
| Measure | Description | Time Frame |
|---|---|---|
| Unfavorable outcom = Composite outcome of mortality or functional deterioration on day 30 | functional deterioration will be defined using Barthel Index | day 28-32 |
| Measure | Description | Time Frame |
|---|---|---|
| unfavorable outcome on day 90 | same as primary outcome but on day 90 | day 88-92 |
| Serious adverse events | Allergic reaction, pulmonary congestion, hemolysis |
| Measure | Description | Time Frame |
|---|---|---|
| Mechanical ventilation | Mechanical ventilation | 2-92 days |
| ICU | ICU | 2-92days |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Michaela Va Smilovici-Ofir, Phd | Sheba research grants and academic collaboration director | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sheba Medical Center | Ramat Gan | Israel | 5265601 | Israel |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28622360 | Background | Bassal R, Shohat T, Kaufman Z, Mannasse B, Shinar E, Amichay D, Barak M, Ben-Dor A, Bar Haim A, Cohen D, Mendelson E, Lustig Y. The seroprevalence of West Nile Virus in Israel: A nationwide cross sectional study. PLoS One. 2017 Jun 16;12(6):e0179774. doi: 10.1371/journal.pone.0179774. eCollection 2017. | |
| 17597458 | Background |
| Label | URL |
|---|---|
| Treatment and Prevention of West Nile Virus Disease | View source |
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double-blind randomized controlled study.
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The study will be conducted in a double-blind manner - the preparation/placebo will be provided by the pharmacy in a sealed bag.
|
|
| Saline | Drug | Placebo |
|
| day 2-32 |
| Mortality | Mortality by day 90 | day 28-92 |
| Functional deterioration by day 30 & 90 | decrease in Barthel index from pre-infection baseline | 28-92 days |
| Neurologic deterioration by day 30 & 90 | combined neurologic score of Barthel index, glasgow outcome score and modified minimental score | 28-92 days |
| Planitzer CB, Modrof J, Kreil TR. West Nile virus neutralization by US plasma-derived immunoglobulin products. J Infect Dis. 2007 Aug 1;196(3):435-40. doi: 10.1086/519392. Epub 2007 Jun 18. |
| 25667322 | Background | Srivastava R, Ramakrishna C, Cantin E. Anti-inflammatory activity of intravenous immunoglobulins protects against West Nile virus encephalitis. J Gen Virol. 2015 Jun;96(Pt 6):1347-1357. doi: 10.1099/vir.0.000079. Epub 2015 Feb 9. |
| 31625835 | Background | Gnann JW Jr, Agrawal A, Hart J, Buitrago M, Carson P, Hanfelt-Goade D, Tyler K, Spotkov J, Freifeld A, Moore T, Reyno J, Masur H, Jester P, Dale I, Li Y, Aban I, Lakeman FD, Whitley RJ; National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group. Lack of Efficacy of High-Titered Immunoglobulin in Patients with West Nile Virus Central Nervous System Disease. Emerg Infect Dis. 2019 Nov;25(11):2064-2073. doi: 10.3201/eid2511.190537. |
| 38546642 | Background | Mbonde AA, Gritsch D, Harahsheh EY, Kasule SN, Hasan S, Parsons AM, Zhang N, Butterfield R, Shiue H, Norville KA, Reynolds JL, Vikram HR, Chong B, Grill MF. Neuroinvasive West Nile Virus Infection in Immunosuppressed and Immunocompetent Adults. JAMA Netw Open. 2024 Mar 4;7(3):e244294. doi: 10.1001/jamanetworkopen.2024.4294. |
| 41874260 | Derived | Regev-Yochay G, Barda N, Shusterman Y, Magiel E, Ganmore I, Baharav N, Belkin A, Margalit I, Indenbaum V, Lustig Y, Weiss-Ottolenghi Y, Joseph G, Tomer E, Maggio N, Canetti M, Yonath H, Leshem E, Levy I, Peretz Y, Amit S, Miller L, Misgav M, Landa N, Shinar E, Brod M, Wieder-Finesod A, Harats D, Yahav D. West Nile Virus-Neutralizing Plasma for West Nile Virus Disease. NEJM Evid. 2026 Apr;5(4):EVIDoa2500169. doi: 10.1056/EVIDoa2500169. Epub 2026 Mar 24. |
| ID | Term |
|---|---|
| D004194 | Disease |
| ID | Term |
|---|---|
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D012965 | Sodium Chloride |
| ID | Term |
|---|---|
| D002712 | Chlorides |
| D006851 | Hydrochloric Acid |
| D017606 | Chlorine Compounds |
| D007287 | Inorganic Chemicals |
| D017670 | Sodium Compounds |
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