Covid-19: two new treatments recommended by WHO

In an opinion published in the medical journal The BMJ, WHO experts recommend treatment with synthetic antibodies, sotrovimab, and a drug commonly used against rheumatoid arthritis, baricitinib.

Both are not intended for just any patient.

Sotrovimab is recommended for patients who have contracted mild Covid but are at high risk of hospitalization. Its benefit for patients who are not at risk is considered too low.

Baricitinib is recommended for “patients with severe or critical Covid”, to whom it must be administered “in combination with corticosteroids”.

In these patients, this “improves survival rates and reduces the need for mechanical ventilation”.

Until then, the WHO recommended three treatments: synthetic antibodies sold under the name Ronapreve, since September 2021, a class of drugs called “interleukin 6 antagonists” (tocilizumab and sarilumab), since July 2021, and systematic corticosteroids for severely affected patients, since September 2020.

Sotrovimab concerns the same type of patients as Ronapreve. “Their efficacy against new variants like Omicron is still uncertain”, however qualify the experts of the WHO.

Similarly, baricitinib “has the same effects” as interleukin-6 antagonists, and should be administered to the same patients.

“When both are available”, you have to choose which of the two to use “depending on the cost, availability and experience of caregivers”, recommend WHO experts.

Baricitinib belongs to a family of drugs called “Janus kinase inhibitors” and is used against rheumatoid arthritis, an autoimmune disease.

However, the other drugs in this family (ruxolitinib and tofacitinib) should not be used against Covid, say WHO experts. There is a lack of data on their efficacy or side effects in this indication.

WHO anti-Covid treatment recommendations are regularly updated, based on clinical trials conducted on different types of patients.

However, the therapeutic arsenal remains limited. In recent months, the WHO has rejected the use of several treatments: plasma injection of recovered Covid patients, ivermectin and hydroxychloroquine.

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