The Omicron variant is one of the highly infectious COVID-19 variants that renders many key treatments ineffective. Recently, World Health Organization (WHO) panel has recommended using two more drugs against the virus.
The WHO guidelines, recently published in the British Medical Journal (BMJ), strongly recommended the use of baricitinib as an alternative to interleukin-6 (IL-6) receptor blockers, combined with corticosteroids, for people who experience ‘critical or severe’ COVID-19.
Baricitinib is an oral drug that is useful to treat rheumatoid arthritis. It works by blocking specific enzymes that may lead to inflammation.
The WHO also gave ‘conditional recommendation’ for using the monoclonal antibody drug sotrovimab in the patients that suffer from non-severe COVID-19 and restricted its use for those at the high hospitalization risk.
Baricitinib helps to calm the immune system
Baricitinib was granted emergency use authorization by the FDA last July to treat hospitalized COVID-19 patients 2 years and older who need treatments that include ventilator or a supplemental oxygen. The WHO experts noted that baricitinib has similar effects to IL-6 blockers, and when both are available, healthcare professionals must make a choice on the basis of clinician experience, availability, and cost.
In a few people with COVID-19, the immune system can launch a ‘cytokine storm’ that might be dangerous for the patients. According to the WHO, the recommendations were based on the evidence from the seven trials that involved over 4,000 patients who experiences critical, severe, and non-severe COVID-19.
Sotrovimab has ‘full activity’ against variants
Sotrovimab is a recombinant human monoclonal antibody (mAbs) given by itself as one of the single IV infusions originally identified in 2003 from the SARS-CoV survivor.
The WHO also recommended sotrovimab conditionally and another monoclonal antibody drug combination named Regeneron for non-severe COVID-19 at a high hospitalization risk.
As per the drugmaker Regeneron, the antibody cocktail is designed to clone the action of the immune system that functions well with the use of ‘very potent antibodies and neutralize the virus.’
COVID-19 drugs not recommended by WHO
There are two drugs that are no longer recommended by the WHO experts. The reason is that during the development of revised WHO guidelines, experts examined two other drugs used for critical and severe COVID-19 – ruxolitinib, which targets inflammation, and the arthritis treatment tofacitinib.
According to the experts, the drugs had uncertain effects which is why WHO made conditional recommendations against their use.
New information that includes the evidence and patient results are gathered in an ongoing manner. The ‘certainty of evidence’ was recently re-rated as very low for both these drugs, primarily because of the serious concerns regarding the imprecision or data quality.
There’s also an underlying explanation that small trials failed to demonstrate the differences in ‘outcomes of interest’ and it included mechanical ventilation, mortality, and length of the hospital stay.
WHO recommends part of a ‘living guideline’
The new recommendations are now part of WHO’s 8th version of its living guideline. The development of the guideline was to provide guidance to manage COVID-19 and help the healthcare professional to make better decisions for patients.
According to the WHO experts, living guidelines are a big help during the fast-moving research areas like COVID-19 as it allows researchers to update ‘previously vetted and peer-reviewed evidence summaries as new data become available.
The researchers also anticipate the guidelines for these treatments will be updated when you make the data available.
The World Health Organization (WHO) has revised its guidelines to strongly recommend the use of two drugs against COVID-19. They also recommended an enzyme blocker known as baricitinib and a monoclonal antibody treatment known as sotrovimab.
The organization was also against the use of tofacitinib and ruxolitinib because, during further investigation, it was revealed that the drugs have low certainty.
Sotrovimab has come out to be a ‘full activity’ drug for the current variant (Omicron) of COVID-19. The WHO also recommends its use in high-risk patients.
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