WHO says 2 drugs can help fight COVID-19

  • The World Health Organization (WHO) has revised its guidelines to strongly recommend the use of two drugs against COVID-19.
  • They recommend an enzyme blocker called baricitinib and a monoclonal antibody treatment called sotrovimab.

As the highly infectious variant of Omicron COVID-19 renders many key treatments ineffective, an expert panel from the World Health Organization (WHO) has recommended the use of two other drugs against the virus.

WHO guidelines, recently published in the British Medical Journal (BMJ), strongly recommends the use of baricitinib as an alternative to interleukin-6 (IL-6) receptor blockers, in combination with corticosteroids, for people with “severe or critical” COVID-19.

Baricitinib is a oral drug often used to treat rheumatoid arthritis. It works by blocking certain enzymes that can lead to inflammation.

The WHO has also given a “conditional recommendation” for the use of the monoclonal antibody drug. sotrovimab in patients with non-severe COVID-19 and restricts its use to those most at risk of hospitalization.

Baricitinib was granted emergency use authorization by the Food and Drug Administration last July to treat hospitalized COVID-19 patients ages 2 and older who need treatments that include supplemental oxygen or a ventilator.

WHO experts noted that baricitinib has similar effects to IL-6 blockers, and when both are available, healthcare professionals should choose based on cost, availability and convenience. clinician experience.

Joan Kapusnik-Uner, PharmD, and Vice President of Clinical Content at First Databank (FDB), explained that IL-6 receptor blockers are a drug that blocks a protein called a cytokine, which is produced as part of our immune response. .

In some people with COVID-19, the immune system can initiate a “cytokine stormwhich can be dangerous for the patient.

She added that it can also activate “B cells where it significantly leads to an increase in antibody production.”

According to the WHO, these recommendations are based on evidence from 7 trials involving more than 4,000 patients with non-severe, severe and critical COVID-19.

“WHO is in discussions with manufacturers to ensure global supply capacity and equitable and sustainable access to newly recommended treatments,” WHO wrote in a statement. declaration.

Kapusnik-Uner told Healthline that sotrovimab “is a recombinant human monoclonal antibody (mAbs) administered by itself in a single IV infusion and was initially identified in 2003 from a SARS-CoV survivor.”

The WHO has also conditionally recommended sotrovimab and another monoclonal antibody combination called Regenerate for non-severe COVID-19 at highest risk of hospitalization.

According to drug manufacturer Regeneron, this antibody cocktail is designed to mimic the action of a well-functioning immune system by using “very powerful antibodies to neutralize the virus”.

Kapusnik-Uner confirmed that sotrovimab is effective against current worrisome variants of COVID-19.

“It does not appear to have reduced effectiveness against variants, including current Delta or Omicron variants,” Kapusnik-Uner said. “A conditional recommendation for sotrovimab in patients with non-serious disease reflects a substantial reduction in the risk of hospitalization in those at higher risk.”

Experts developing the revised WHO guidelines looked at two other drugs used for severe and critical COVID-19 – ruxolitinib, which targets inflammation, and arthritis treatment tofacitinib.

“Given their uncertain effects, WHO has issued a conditional recommendation against their use,” the organization said. wrote.

According to Kapusnik-Uner, new information including evolving evidence and patient outcomes has been gathered on an ongoing basis.

“The ‘certainty of evidence’ has recently been re-rated as very low for these two drugs, primarily due to serious concerns about the quality or imprecision of the data,” she said.

Kapusnik-Uner explained that small trials failed to demonstrate differences in “outcomes of interest,” which included mortality, mechanical ventilation, and length of hospital stay.

The new recommendations are part of the eighth version of its guideline of life developed to provide guidance on managing COVID-19 and to help healthcare professionals make better decisions for patients.

According to WHO experts, living guidelines are useful in rapidly changing research areas like COVID-19, as they allow researchers to update “previously verified and peer-reviewed” evidence summaries as new data becomes available. .

They anticipate that the guidelines for these treatments will be updated when this data becomes available.

The World Health Organization (WHO) has revised its guidelines to strongly recommend the use of two drugs against COVID-19.

They recommend an enzyme blocker called baricitinib and a monoclonal antibody treatment called sotrovimab.

The organization also recommended against using ruxolitinib and tofacitinib because further investigation showed low certainty of evidence for these drugs.

Experts say sotrovimab shows “full activity” for current COVID-19 variants of concern. The WHO recommendation for its use in high-risk patients with non-serious disease reflects the drug’s effectiveness in reducing hospitalizations for this group.

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