An international team of experts from the World Health Organization (WHO) is recommending two new drugs to be added to the therapeutic “arsenal” against Covid-19. These are the drug baricitinib (a JAK kinase inhibitor also used against rheumatoid arthritis) and the monoclonal antibody sotrovimab.
The first drug is strongly recommended to be used, in combination with corticosteroids, in patients with severe or life-threatening Covid-19. The recommendation is based on intermediate evidence that baricitinib improves the chance of survival and reduces the need for intubation of patients, without increasing the observed side effects.
WHO (Guideline Development Group) experts point out that the drug has similar effects to other anti-arthritic drugs, interleukin-6 (IL-6) inhibitors. Therefore, when both types of drugs are available, physicians can choose whichever they judge based on their cost, availability and clinical experience, but co-administration of both drugs is not recommended.
Experts also do not recommend the use of two other JAK inhibitors (ruxolitinib and tofacitinib) in patients with severe or critical Covid-19, due to insufficient clinical evidence to date that these drugs have any benefit, while the latter may cause and increased side effects.
Regarding sotrovimab monoclonal antibody, the WHO recommends its use in patients with non-severe Covid-19, but only in those who are more at risk of being hospitalized, as the benefits of the drug seem small for those at low risk of hospitalization. A similar recommendation was made by the WHO for the “cocktail” of casirivimab-indevimab monoclonal antibodies. Experts say that there is insufficient data to show a preference for one treatment over another, while acknowledging that the effectiveness of monoclonal antibodies against the Omicron variant is still uncertain.
The WHO panel of experts also continues to oppose the use of recovering blood plasma, ivermectin and hydroxychloroquine in patients with Covid-19, regardless of the severity of the disease.
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