The first drug, baricitinib, is a Janus kinase (JAK) inhibitor — a class of drugs used to treat autoimmune diseases, blood and bone marrow cancers, and rheumatoid arthritis.
According to the WHO Guideline Development Group, it is “highly recommended” for patients with severe or critical illness in combination with corticosteroids.
The group of international experts based their recommendation on “moderate assurance” that it improves survival and reduces the need for ventilation.
No increase in side effects was observed.
The experts note that it has a similar effect to other arthritis drugs called interleukin-6 (IL-6) inhibitors. Therefore, when both drugs are available, they recommend choosing the best option based on cost, availability, and clinician experience.
It is not recommended to take both medicines at the same time.
The experts also advise against the use of two other JAK inhibitors (ruxolitinib and tofacitinib) for patients with severe or critical cases of COVID-19 infection.
According to them, studies conducted with these drugs have not shown any benefits arising from taking either drug, and suggested a possible increase in serious side effects with tofacitinib.
In the same update, WHO makes a conditional recommendation for the use of a monoclonal antibody known as sotrovimab in patients with non-severe cases.
According to them, the drug should only be administered to patients at the highest risk of hospitalization. In those at lower risk, it showed only “trivial benefits.”
A similar recommendation has been made before for another monoclonal antibody, casirivimab-imdevimab, and the experts say there isn’t enough data to recommend one over the other.
For both, the effectiveness against new variants, such as Omicron, is still uncertain.
The group will update their guidelines for monoclonal antibodies when more data becomes available.
These recommendations are based on new evidence from seven studies involving more than 4,000 patients with non-serious, severe and critical infections.
Developed by WHO with the methodological support of the MAGIC Evidence Ecosystem Foundation, the guidelines provide reliable guidance and help physicians make better decisions with their patients.
According to the agency, the guidelines are helpful in rapidly changing areas of research because they allow researchers to update summaries of evidence as new information becomes available.
The latest guidelines also update recommendations for the use of interleukin-6 receptor blockers and systemic corticosteroids for patients with severe or critical COVID-19; conditional recommendations for the use of casirivimab-imdevimab (another monoclonal antibody treatment) in selected patients; and against the use of restorative plasma, ivermectin and hydroxychloroquine, regardless of disease severity.