New Delhi: The World Health Organisation (WHO) has recommended two new drugs for treatment of Covid-19 — Baricitinib and Sotrovimab — in detailed guidelines published in the British Medical Journal (BJM) last week.
The extent to which these medicines will save lives depends on how widely available and affordable they will be, it said in a statement released 14 January.
Baricitinib — an oral drug used in the treatment of rheumatoid arthritis — has been recommended by WHO for severe or critical cases of Covid-19.
Baricitinib belongs to a class of drugs called ‘Janus kinase inhibitors’ that suppress the overactive immune system. WHO recommends that it be administered with corticosteroids like dexamethasone — another drug recommended for use in severe Covid patients.
The agency has also conditionally recommended the use of a monoclonal antibody drug, Sotrovimab.
Sotrovimab has been recommended for treating mild or moderate Covid in patients who are at a high risk of hospitalisation. This includes patients who are older, immunocompromised, have underlying conditions like diabetes, hypertension, and obesity, and those who are unvaccinated.
The WHO said that Sotrovimab is an alternative to Casirivimab-Imdevimab, a monoclonal antibody cocktail it had recommended for Covid treatment in September 2021.
“Studies are ongoing on the effectiveness of monoclonal antibodies against Omicron, but early laboratory studies show that Sotrovimab retains its activity,” the agency said in its statement.
The WHO’s latest recommendations are the eighth version and seventh update of its guidelines on drugs for Covid-19, based on evidence from seven trials involving over 4,000 patients with non-severe, severe, and critical forms of Covid.
The two newly recommended drugs have been invited for WHO prequalification, which assesses the quality, efficacy and safety of priority health products to increase access in lower income countries.
Also Read: WHO approves Glaxo and Eli Lilly drugs to treat Covid amid Omicron surge
WHO in discussions ‘to secure equitable access’ to new drugs
WHO is in discussions with manufacturers to secure global supply capacity and equitable and sustainable access to the newly recommended therapeutics. The therapeutics pillar of WHO’s Access to COVID-19 Tools Accelerator (ACT-A) has been engaging with pharmaceutical companies to seek comprehensive access plans for low- and middle-income countries, so that these treatments can be rapidly deployed everywhere and not just in rich countries, it said in the statement.
The ACT-A — a global collaboration of governments, scientists, businesses, civil society, philanthropists and health organizations to accelerate development, production and equitable access to Covid-19 tests, treatments, and vaccines — is also looking to expand licensing scope to make the products more affordable, the WHO further said.
Guidelines advise against use of Remdesivir, Ivermectin
The panel of experts developing the guidelines also looked at two other drugs for severe and critical Covid cases — Ruxolitinib and Tofacitinib. However, given their “uncertain effects”, WHO made a recommendation against their use.
The agency has also recommended against the use of Ivermectin and convalescent plasma therapies outside clinical trial settings.
For Remdesivir, the expert panel concluded that “most well-informed patients would not prefer intravenous treatment with Remdesivir given the low certainty evidence”.
“Any beneficial effects of Remdesivir, if they do exist, are likely to be small and the possibility of important harm remains,” it added.
In India, Remdesivir has emergency use authorisation for moderate and severe hospitalised Covid patients on oxygen.
The panel strongly recommended against the use of Hydroxychloroquine and Lopinavir-Ritonavir, both of which were thought to be beneficial to Covid patients in the early days of the pandemic.
In September last year, the Indian Council of Medical Research had dropped use of Ivermectin and Hydroxychloroquine from Covid treatment guidelines.
Also Read: 2021 mistakes being repeated, stop unwarranted tests & medicines: Top doctors write to govt