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WHO recommends two new drugs to treat COVID-19 patients – Global issues

The first drug, baricitinib, is a Janus kinase (JAK) inhibitor, a class of drugs used to treat autoimmune conditions, blood and bone marrow cancers, and rheumatoid arthritis.

Follow WHO Guidelines Development Group, it is “especially recommended” for patients who are critically ill or critically ill when combined with corticosteroids.

An employee works on a COVID-19 vaccine production line in India

The international team of experts based their recommendation on “moderately certain evidence” that it improves survival and reduces the need for ventilation.

No increase in adverse events was observed.

Experts note that it has similar effects to other arthritis drugs called interleukin-6 (IL-6) inhibitors. Therefore, when both drugs are available, they recommend choosing the best option based on cost, availability, and clinician experience.

It is not recommended to use both drugs at the same time.

Experts also advise against using the other two JAK inhibitors (ruxolitinib and tofacitinib) in patients with severe or critical COVID-19 infections.

According to them, the trials that went through using these drugs did not show any benefit arising from either drug and showed a possible increase in serious side effects with tofacitinib.

The case is not serious

In the same update, WHO conditionally recommend the use of a monoclonal antibody called sotrovimab in non-severe patients.

According to them, the drug should only be used for patients at highest risk of hospitalization. In people with lower risks, it showed only “small benefits”.

A similar recommendation has been made in the past for another monoclonal antibody drug, casirivimab-imdevimab, and experts say there isn’t enough data to recommend one drug over another.

Doctors prepare oxygen cylinders for use in the COVID-19 ward at a hospital in Uganda.

Doctors prepare oxygen tanks for use in the COVID-19 ward at a hospital in Uganda., By © UNICEF / Maria Wamala

For both, effectiveness against new variants, such as Omicron, remains uncertain.

The team will update their guidance on monoclonal antibodies as more data becomes available.

Recommendations

These recommendations are based on new evidence from seven trials involving more than 4,000 patients with non-severe, severe, and critical infections.

Developed by WHO with methodological support from the MAGIC Evidence Ecosystem Foundation, this guide provides reliable guidance and helps physicians make better decisions with their patients.

According to the agency, these guidelines are useful in fast-growing areas of research, because they allow researchers to update evidence summaries as new information becomes available.

The latest guidelines also update recommendations for the use of interleukin-6 receptor blockers and systemic corticosteroids in patients with severe or critical COVID-19; conditional recommendation for the use of casirivimab-imdevimab (another monoclonal antibody treatment) in selected patients; and against the use of convalescent plasma, ivermectin and hydroxychloroquine, regardless of disease severity.

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