Covid: what are baricitinib and sotrovimab, new drugs authorized by the WHO

The WHO (World Health Organization) has authorized the use of the drugs baricitinib and sotrovimab for the treatment of Covid-19.

According to WHO information, the endorsement of the use of these drugs came after analyzes carried out by international experts who work in a Guideline Development Group of the health agency and whose results were published in the British Medical Journal.

Baricitinib is an anti-inflammatory drug primarily used to treat rheumatoid arthritis, while sotromivab is a new drug that has been tested to treat patients at risk of developing moderate to severe Covid-19. It is being used in the UK among other countries.

In research published by the WHO working group, the use of baricitinib is recommended in critically ill patients, as it increases the likelihood of survival from the complications that the coronavirus can cause, in addition to reducing the need for mechanical ventilation.

Sotrovimab is recommended in moderate cases of Covid, to prevent them from getting worse. The study claims that there are no serious side effects.

The WHO also ruled out the use of two other drugs in the treatment of Covid: ruxolitinib and tofacitinib. The evaluations that were done with them showed no benefit to the patients. In the case of tofacitinib, it was even observed that it could cause adverse effects.

The entity once again advised against the use of remdesivir and ivermectin, two drugs that have gained popularity since the beginning of the pandemic, but have no scientific backing.

This increases the list of authorized drugs for the treatment of Covid-19 to five. For severe cases, three drugs are recommended: corticosteroids, IL-6RB and baricitinib. And in moderate cases, two: REGN-COV and sotrovimab.

The NGO Doctors Without Borders (MSF) has asked governments to do whatever is necessary to ensure that patents are not an obstacle to access to treatment.

what is baricitinib

According to the WHO, baricitinib is a Janus kinase enzyme inhibitor drug. It especially serves to reduce inflammation and is used to treat rheumatoid arthritis.

The research, which included more than 4,000 people, found that this drug in combination with corticosteroids (a variety of hormones used to treat arthritis) can help a patient avoid being put on mechanical ventilation in the most severe cases of coronavirus.

MSF pointed out that in many countries baricitinib is under patent by the US company Eli Lilly, which sells it for a price close to US$ 2,000 (R$ 11,000), and that this can prevent the treatment of patients in countries with less resources.

“In countries like Bangladesh or India, a generic version of this drug can be obtained for less than US$6, but in many countries generic baricitinib is not available because it is under the patent monopoly of Eli Lilly, the company that applied for and obtained patents. in many places, including countries hard hit by the pandemic, such as Brazil, South Africa, Indonesia and Russia,” the organization added.

Eli Lilly, in an email sent to BBC News Mundo (the BBC’s Spanish service), said: “The new guidelines are positive news for healthcare professionals and patients as they provide additional clarity on the potential use of baricitinib in patients hospitalized with Covid-19, according to study data”.

“Lilly is working with hospitals, healthcare providers and governments to facilitate patient access to baricitinib and continues to explore the drug’s potential use in Covid-19 with regulatory agencies.”

“Lilly is actively working with international partners to understand regions with unmet need as the provision of Covid-19 treatments to low/lower middle income countries depends on each country’s ability to accept and approve drugs for emergency use by consumers”, says the company’s statement.

But the WHO also noted in its recommendation that baricitinib “has similar effects to other arthritis drugs called interleukin-6 inhibitors, so when both are available, it is suggested to choose one based on cost, availability and preference.” of the doctor”.

And the agency adds that using both drugs at the same time is not recommended.

Sotrovimab

Sotrovimab is a drug that began to be used by the United Kingdom’s National Health Service (NHS), among others, as a test in the treatment of patients moderately affected by Covid.

According to experts, sotrovimab is a monoclonal antibody that is administered as a transfusion to transplant recipients, cancer patients and other high-risk groups.

And according to research done by the WHO and the NHS, if given quickly after symptoms develop, sotrovimab can help prevent people from becoming seriously ill.

“These new medicines have an important role to play,” Steven Powis, NHS England’s national medical director, told the BBC.

According to Powis, the administration of this drug is focused on patients who have underlying health conditions, such as diabetes or respiratory problems, and who may be severely affected by the virus.

In addition, evidence suggests that the drug should work against the omicron variant.

Access

In Latin America, baricitinib was already authorized for use in the treatment of patients with Covid-19 last July in Mexico.

In most countries in the region, the drug can be obtained for the treatment of arthritis. With the authorization of the WHO it will certainly begin to be used in local treatments.

Sotrovimab has already been approved for use in several European countries, Japan and Saudi Arabia.