{"id":12396,"date":"2021-12-15T14:38:00","date_gmt":"2021-12-15T19:38:00","guid":{"rendered":"https:\/\/transfusionontario.org\/un-essai-clinique-important-conclut-que-le-plasma-convalescent-naide-pas-les-patients-atteints-de-la-covid-19\/"},"modified":"2024-07-16T10:25:41","modified_gmt":"2024-07-16T14:25:41","slug":"un-essai-clinique-important-conclut-que-le-plasma-convalescent-naide-pas-les-patients-atteints-de-la-covid-19","status":"publish","type":"post","link":"https:\/\/transfusionontario.org\/fr\/un-essai-clinique-important-conclut-que-le-plasma-convalescent-naide-pas-les-patients-atteints-de-la-covid-19\/","title":{"rendered":"Un essai clinique important conclut que le plasma convalescent n\u2019aide pas les patients atteints de la COVID-19"},"content":{"rendered":"\n<p class=\"has-text-align-left wp-block-paragraph\" style=\"font-size:14px\">Dimpy Modi, Centre des sciences de la sant\u00e9 Sunnybrook, Programme de recherche QUEST de l\u2019Universit\u00e9 de Toronto, analyste de la recherche. <\/p>\n\n<p class=\"wp-block-paragraph\">Dans la foul\u00e9e de la course aux antiviraux et aux vaccins contre la COVID-19 amorc\u00e9e au d\u00e9but de 2020, les anticorps sp\u00e9cifiques des antig\u00e8nes du virus semblaient le meilleur traitement de rechange pour les patients qui r\u00e9cup\u00e9raient de la COVID-19. Le plasma de patients r\u00e9tablis de la COVID-19 (plasma convalescent); ce plasma contient des anticorps sp\u00e9cifiques du SARS-CoV-2. On pensait que la transfusion de plasma convalescent permettrait de supprimer la r\u00e9plication virale chez les malades, puisque cette approche avait servi par le pass\u00e9 \u00e0 combattre d\u2019autres virus (p. ex. SARS-CoV-1, MERS-CoV et influenza). Il n\u2019y avait pas toutefois assez de preuves pour sugg\u00e9rer qu\u2019il s\u2019agissait d\u2019un traitement efficace contre la COVID-19. Pour r\u00e9pondre \u00e0 cette question, les Drs Donald Arnold du Centre de recherche transfusionnelle de McMaster, Jeannie Callum du programme de recherche transfusionnelle QUEST de l\u2019Universit\u00e9 de Toronto et Philippe B\u00e9gin du Centre hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al ont entrepris en mai 2020 un essai international dirig\u00e9 par ces chercheurs canadiens.     <\/p>\n\n<p class=\"wp-block-paragraph\">L\u2019essai CONCOR-1 \u00e9tait un essai randomis\u00e9 contre t\u00e9moin comparant le traitement par plasma convalescent aux soins habituels chez des adultes hospitalis\u00e9s en raison d\u2019une maladie respiratoire de type COVID-19. L\u2019essai regroupait 940 patients hospitalis\u00e9s dans 72 h\u00f4pitaux du Canada, des \u00c9tats-Unis et du Br\u00e9sil. Les chercheurs de l\u2019\u00e9tude avaient \u00e9mis l\u2019hypoth\u00e8se qu\u2019une administration pr\u00e9coce de plasma convalescent pourrait r\u00e9duire l\u2019intubation ou la mortalit\u00e9. L\u2019essai a \u00e9t\u00e9 interrompu en janvier 2021, et les chercheurs ont conclu que l\u2019administration de plasma convalescent ne comportait pas d\u2019avantage. Un nombre plus \u00e9lev\u00e9 d\u2019effets ind\u00e9sirables graves ont \u00e9t\u00e9 observ\u00e9s dans le groupe trait\u00e9 par plasma convalescent que dans le groupe qui recevait les soins usuels. Le plasma de donneur utilis\u00e9 dans cet essai avait une teneur en anticorps tr\u00e8s variable, ce qui a permis la transfusion de produit d\u00e9favorable (titre d\u2019anticorps faible et anticorps non fonctionnels) au groupe de l\u2019\u00e9tude. M\u00eame s\u2019il est en contradiction avec les conclusions d\u2019autres grandes \u00e9tudes sur le plasma convalescent, ce r\u00e9sultat sugg\u00e8re qu\u2019un plasma convalescent de titre \u00e9lev\u00e9 n\u2019est pas utile, mais qu\u2019un plasma convalescent de titre plut\u00f4t faible est nuisible. On se demande si ces profils d\u2019anticorps d\u00e9favorables sont attribuables au fait qu\u2019ils entrent en comp\u00e9tition avec les anticorps du patient et provoquent un impact n\u00e9gatif, s\u2019il en est, sur l\u2019\u00e9volution de la maladie. Des recherches plus pouss\u00e9es sont requises pour comprendre les risques et avantages \u00e9ventuels du plasma convalescent. Pour l\u2019instant, les chercheurs de CONCOR-1 d\u00e9conseillent le recours au plasma convalescent comme traitement de la COVID-19, sauf dans le cadre d\u2019un essai clinique.         <br\/><br\/><strong>Pour plus d\u2019information, la publication est accessible ici :<\/strong><br\/>B\u00e9gin, P., Callum, J., Jamula, E. et al. Convalescent plasma for hospitalized patients with COVID-19: an open-label, randomized controlled trial. Nat Med (2021).   <a href=\"https:\/\/doi.org\/10.1038\/s41591-021-01488-2\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/doi.org\/10.1038\/s41591-021-01488-2<\/a><\/p>\n\n<hr class=\"wp-block-separator has-text-color has-black-color has-css-opacity has-black-background-color has-background is-style-wide\"\/>\n\n<h2 class=\"wp-block-heading\" id=\"Transfusion-Handbook-Committee\">Featured Resource: Transfusion Handbook Committee<\/h2>\n\n<figure class=\"wp-block-image size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"500\" height=\"1000\" src=\"https:\/\/transfusionontario.org\/wp-content\/uploads\/2021\/12\/Transfusion-Committee-Handbook-Promo.png\" alt=\"New to Transfusion Committee?&#10;Have some New Members?&#10;What is the purpose of this committee?&#10;What discussion should be covered?&#10;&#10;A toolkit from O.R.B.C.O.N that can help new members navigate through these responsibilities&#10;&#10;It includes &#10;1. Welcome &amp;amp; introduction into the transfusion committee&#10;- why you may have been asked to join&#10;- what the mandate of the committee is&#10;&#10;2. Item suggestions to include on the agenda for discussions &#10;- Blood utilization and wastage review&#10;- Guidelines\/Policy deveoped and review&#10;- Massive Hemorrhage Protocols&#10;- Disaster and Contingency Planning Related to Blood Transfusion&#10;and more!\" class=\"wp-image-7795\" srcset=\"https:\/\/transfusionontario.org\/wp-content\/uploads\/2021\/12\/Transfusion-Committee-Handbook-Promo.png 500w, https:\/\/transfusionontario.org\/wp-content\/uploads\/2021\/12\/Transfusion-Committee-Handbook-Promo-150x300.png 150w, https:\/\/transfusionontario.org\/wp-content\/uploads\/2021\/12\/Transfusion-Committee-Handbook-Promo-55x110.png 55w\" sizes=\"auto, (max-width: 500px) 100vw, 500px\" \/><\/figure>\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link has-white-color has-text-color has-background wp-element-button\" href=\"https:\/\/transfusionontario.org\/fr\/categorie\/trousses-a-outils\/transfusion-committee-fr\/\" style=\"border-radius:7px;background-color:#083459\">Consultez le manuel du comit\u00e9 de transfusion ici<\/a><\/div>\n<\/div>\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n<figure class=\"wp-block-image size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"450\" src=\"https:\/\/transfusionontario.org\/wp-content\/uploads\/2021\/10\/UofT-TM-Rounds.png\" alt=\"\" class=\"wp-image-7672\" style=\"width:537px;height:auto\" srcset=\"https:\/\/transfusionontario.org\/wp-content\/uploads\/2021\/10\/UofT-TM-Rounds.png 800w, https:\/\/transfusionontario.org\/wp-content\/uploads\/2021\/10\/UofT-TM-Rounds-300x169.png 300w, https:\/\/transfusionontario.org\/wp-content\/uploads\/2021\/10\/UofT-TM-Rounds-768x432.png 768w, https:\/\/transfusionontario.org\/wp-content\/uploads\/2021\/10\/UofT-TM-Rounds-110x62.png 110w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\" \/><\/figure>\n\n<h2 class=\"wp-block-heading\">Universit\u00e9 de Toronto Transfusion Medicine Rounds<\/h2>\n\n<p class=\"wp-block-paragraph\" style=\"font-size:18px\">16 d\u00e9cembre 2021 \u00e0 12h00 \u2013 13h00<\/p>\n\n<p class=\"wp-block-paragraph\">MLT Session: Challenging Serology Cases, presented by Ms. Minda Agpalo, Dr. Waseem Anani, Dr. Celina Montemayor<\/p>\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link has-white-color has-text-color has-background wp-element-button\" style=\"border-radius:7px;background-color:#083459\"> Cliquez ici pour plus d&rsquo;informations <\/a><\/div>\n<\/div>\n\n<figure class=\"wp-block-image size-full is-resized\"><img decoding=\"async\" src=\"https:\/\/transfusionontario.org\/wp-content\/uploads\/2021\/12\/Seasons-Greetings-Fr.png\" alt=\"\" class=\"wp-image-7904\" style=\"width:378px;height:auto\"\/><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>Dimpy Modi, Centre des sciences de la sant\u00e9 Sunnybrook, Programme de recherche QUEST de l\u2019Universit\u00e9 de Toronto, analyste de la recherche. Dans la foul\u00e9e de la course aux antiviraux et [&hellip;]<\/p>\n","protected":false},"author":16,"featured_media":7803,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_tec_requires_first_save":true,"_price":"","_stock":"","_tribe_ticket_header":"","_tribe_default_ticket_provider":"","_tribe_ticket_capacity":"0","_ticket_start_date":"","_ticket_end_date":"","_tribe_ticket_show_description":"","_tribe_ticket_show_not_going":false,"_tribe_ticket_use_global_stock":"","_tribe_ticket_global_stock_level":"","_global_stock_mode":"","_global_stock_cap":"","_tribe_rsvp_for_event":"","_tribe_ticket_going_count":"","_tribe_ticket_not_going_count":"","_tribe_tickets_list":"[]","_tribe_ticket_has_attendee_info_fields":false,"_EventAllDay":false,"_EventTimezone":"","_EventStartDate":"","_EventEndDate":"","_EventStartDateUTC":"","_EventEndDateUTC":"","_EventShowMap":false,"_EventShowMapLink":false,"_EventURL":"","_EventCost":"","_EventCostDescription":"","_EventCurrencySymbol":"","_EventCurrencyCode":"","_EventCurrencyPosition":"","_EventDateTimeSeparator":"","_EventTimeRangeSeparator":"","_EventOrganizerID":[],"_EventVenueID":[],"_OrganizerEmail":"","_OrganizerPhone":"","_OrganizerWebsite":"","_VenueAddress":"","_VenueCity":"","_VenueCountry":"","_VenueProvince":"","_VenueState":"","_VenueZip":"","_VenuePhone":"","_VenueURL":"","_VenueStateProvince":"","_VenueLat":"","_VenueLng":"","_VenueShowMap":false,"_VenueShowMapLink":false,"_tribe_blocks_recurrence_rules":"","_tribe_blocks_recurrence_description":"","_tribe_blocks_recurrence_exclusions":"","footnotes":""},"categories":[138],"tags":[],"class_list":["post-12396","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-bulletin"],"acf":[],"_links":{"self":[{"href":"https:\/\/transfusionontario.org\/fr\/wp-json\/wp\/v2\/posts\/12396","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/transfusionontario.org\/fr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/transfusionontario.org\/fr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/transfusionontario.org\/fr\/wp-json\/wp\/v2\/users\/16"}],"replies":[{"embeddable":true,"href":"https:\/\/transfusionontario.org\/fr\/wp-json\/wp\/v2\/comments?post=12396"}],"version-history":[{"count":0,"href":"https:\/\/transfusionontario.org\/fr\/wp-json\/wp\/v2\/posts\/12396\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/transfusionontario.org\/fr\/wp-json\/wp\/v2\/media\/7803"}],"wp:attachment":[{"href":"https:\/\/transfusionontario.org\/fr\/wp-json\/wp\/v2\/media?parent=12396"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/transfusionontario.org\/fr\/wp-json\/wp\/v2\/categories?post=12396"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/transfusionontario.org\/fr\/wp-json\/wp\/v2\/tags?post=12396"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}