Two new treatments recommended by WHO, for a total of five

Two new treatments for the coronavirus were officially recommended by the World Health Organization (WHO) on Friday, for a total of five.

In an opinion published in the medical journal The BMJ, WHO experts recommend treatment with synthetic antibodies, sotrovimab, and a drug commonly used against rheumatoid arthritis, baricitinib.

Very specific conditions

Both are not intended for just all patients. Sotrovimab is recommended for patients who have contracted mild Covid but are at high risk of hospitalization. Its benefit for patients who are not at risk is considered too low.

Baricitinib is recommended for “patients with severe or critical Covid”, to which it must be administered “in combination with corticosteroids”. In these patients, it “improves survival rates and reduces the need to be placed on mechanical ventilation.”

Three treatments recommended so far

Until then, the WHO recommended three treatments: synthetic antibodies sold under the name Ronapreve, since September 2021, a class of drugs called “interleukin 6 antagonists” (tocilizumab and sarilumab), since July 2021 , and systematic corticosteroids for severely ill patients, since September 2020.

Sotrovimab affects the same type of patients as Ronapreve. “Their effectiveness against new variants such as Omicron is still uncertain”, however qualify the WHO experts. Likewise, baricitinib “has the same effects” as interleukin 6 antagonists, and should be administered to the same patients. “When both are available”, it is therefore necessary to choose which of the two to use “according to the cost, the availability and the experience of the caregivers”, recommend the experts of the WHO.

Several rejected drugs

Baricitinib belongs to a family of medicines called ‘Janus kinase inhibitors’ and used for rheumatoid arthritis, an autoimmune disease. However, the other drugs in this family (ruxolitinib and tofacitinib) should not be used against Covid, say WHO experts. There is a lack of data on their efficacy or side effects in this indication.

The WHO anti-Covid treatment recommendations are regularly updated, based on clinical trials carried out on different types of patients. However, the therapeutic arsenal remains small. In recent months, the WHO has rejected the use of several treatments: the injection of plasma from patients cured of Covid, ivermectin and hydroxychloroquine.