The extent to which these medicines will save lives depends on how widely available and affordable they will be. According to the statement released by the WHO, the first drug, baricitinib, is strongly recommended for patients with severe or critical Covid-19. It is part of a class of drugs called Janus kinase (JAK) inhibitors that suppress the overstimulation of the immune system. WHO recommends that it be given with corticosteroids.
Baricitinib is an oral drug, used in the treatment of rheumatoid arthritis. It provides an alternative to Interleukin-6 receptor blockers (other arthritis drugs), recommended by WHO in July 2021.
WHO has also conditionally recommended the use of a monoclonal antibody drug, sotrovimab, for treating mild or moderate Covid-19 in patients who are at high risk of hospitalisation. This includes patients who are older, immunocompromised, have underlying conditions like diabetes, hypertension, and obesity, and those unvaccinated.
Sotrovimab is an alternative to casirivimab-imdevimab, a monoclonal antibody cocktail recommended by WHO 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 panel of experts developing the guidelines also looked at two other drugs for severe and critical Covid-19: ruxolitinib and tofacitinib. Given their uncertain effects, WHO made a conditional recommendation against their use.
The recommendations, forming the eighth update of WHO’s living guidelines on therapeutics and Covid-19, are based on evidence from seven trials involving over 4 000 patients with non-severe, severe, and critical Covid-19.
The WHO stated that it is in discussions with manufacturers to secure global supply capacity and equitable and sustainable access to the newly recommended therapeutics. “The Access to Covid-19 Tools Accelerator (ACT-A) Therapeutics pillar 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, not just in rich countries. The ACT-A is also looking to expand licensing scope to make the products more affordable.”