The World Health Organization (WHO) recommended two new drugs to treat patients with COVID-19, one for patients with critical disease, and the other deemed effective for non-severe cases. For both, the effectiveness against new variants, like Omicron, is still uncertain. The recommendations are based on new evidence from seven trials involving over 4,000 patients with non-severe, severe, and critical infections.
Severe
cases
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.
According
to the WHO Guideline Development Group, it is “strongly recommended” for
patients with severe or critical disease in combination with corticosteroids.
The
group of international experts based their recommendation on “moderate
certainty evidence” that it improves survival and reduces the need for
ventilation.
There
was no observed increase in adverse effects.
The
experts note that it has a similar effect as other arthritis drugs called
interleukin-6 (IL-6) inhibitors. Because of that, when both drugs are
available, they suggest choosing the best option based on cost, availability,
and clinician experience. But it is not recommended to use both drugs at the
same time.
Non-severe
cases
WHO
makes a conditional recommendation for the use of a monoclonal antibody known
as sotrovimab in patients with non-severe cases. The drug should only be
administered to patients at the highest risk of hospitalisation. In those at
lower risk, it only showed “trivial benefits”.
A
similar recommendation has been made previously, for another monoclonal
antibody drug, casirivimab-imdevimab, and the experts say there is insufficient
data to recommend one over the other.
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