Covid-19: two new antiviral treatments recommended by WHO for specific cases

Three and two make five. The World Health Organization (WHO) officially recommended, on Friday January 14, two new treatments against Covid-19 in very specific cases, for a total now increased to five. In an opinion published in the medical journal The BMJ, experts from the specialized agency of the UN recommend treatment with synthetic antibodies, sotrovimab, and a drug usually used against rheumatoid arthritis, baricitinib.

Both are not intended for just any patient. Sotrovimab is recommended for those who have contracted mild Covid but are at high risk of hospitalization. Its benefit for those not at risk is considered too low. Baricitinib is recommended for “patients with severe or critical Covid”, to which it should be administered “in combination with corticosteroids”. That “improves survival rates and reduces the need for mechanical ventilation”.

Anti-Covid treatment recommendations are regularly updated, based on clinical trials conducted on different types of patients. However, the therapeutic arsenal remains limited. In recent months, the WHO has rejected the use of several treatments: the injection of plasma from patients cured of Covid, ivermectin and hydroxychloroquine. The UN agency recommended only 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 the systematic use of corticosteroids for severely affected patients, since September 2020.

Sotrovimab concerns the same type of patients as Ronapreve. “Their efficacy against new variants like Omicron is still uncertain”, however qualify the WHO experts. Similarly, 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 “depending on cost, availability and caregiver experience”, they recommend.

In addition, baricitinib belongs to a family of drugs called “Janus kinase inhibitors” and used against rheumatoid arthritis, an autoimmune disease. However, ruxolitinib and tofacitinib should not be used, say WHO experts, due to lack of data on their efficacy or side effects.