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WHO recommends two more COVID-19 treatments

Friday January 14th 2022

A drug used to treat rheumatoid arthritis has been recommended for patients with severe or critical COVID-19, the World Health Organization announced today.

The WHO Guideline Development Group of international experts write in today’s edition of *The BMJ* that baricitinib, a Janus kinase (JAK) inhibitor, is “strongly recommended” because there is evidence it improves survival and reduces the need for ventilation.

The approval comes as the WHO group says baricitinib has similar effects to other interleukin-6 (IL-6) inhibitors, also used to treat arthritis. They say ruxolitinib and tofacitinib, also JAK inhibitors, should not be used for patients with severe or critical COVID-19 because there is not sufficient evidence from small trials to demonstrate any benefit. They add there may also be an increase in serious side effects with tofacitinib.

The guideline makes a conditional recommendation for sotrovimab, a monoclonal antibody, to treat non-severe COVID-19 patients if they are at the highest risk of hospitalisation.

WHO has made a similar recommendation for casirivimab-imdevimab, another monoclonal antibody drug, adding there are insufficient data to recommend one monoclonal antibody treatment over another.

The organisation also acknowledges that it remains uncertain how effective these classes of medicines are against new variants, such as omicron.

The new recommendations follow new evidence from seven trials involving more than 4,000 patients with non-severe, severe, and critical COVID-19 infection.

They complement the previous recommendations for treating COVID-19 with interleukin-6 receptor blockers and systemic corticosteroids if patients have severe or critical disease; conditional recommendations for the use of casirivimab-imdevimab in selected patients; and against the use of convalescent plasma, ivermectin and hydroxychloroquine.

Agarwal A, Rochwerg B, Lamontagne F et al. Rapid Recommendations: A living WHO guideline on drugs for COVID-19. *BMJ* 14 January 2022

[abstract]

Tags: Flu & Viruses | Pharmaceuticals | World Health

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