The World Health Organisation (WHO) has recommended two new drugs for Covid-19, providing yet more options for treating the disease.
The extent to which these medicines will save lives depends on how widely available and affordable they will be.
The first drug, Baricitinib, is strongly recommended for patients with severe or critical Covid-19. It is in a class of drugs called Janus Kinase (JAK) inhibitors that suppress overstimulation of the immune system. The WHO recommends giving it with corticosteroids.
Baricitinib is an oral drug, used in the treatment of rheumatoid arthritis. It provides an alternative to other arthritis drugs called Interleukin-6 receptor blockers, recommended by WHO in July 2021.
The WHO has also conditionally recommended the use of a monoclonal antibody drug, Sotrovimab, for treating mild or moderate Covid patients who are at high risk of hospitalisation. This includes patients who are unvaccinated, older and immunocompromised, with underlying conditions like diabetes, hypertension, and obesity.
Sotrovimab is an alternative to casirivimab-imdevimab, a monoclonal antibody cocktail recommended by the WHO in September of 2021. Studies are ongoing on the effectiveness of monoclonal antibodies against Omicron, but early laboratory studies show that Sotrovimab retains effective action.
The panel of experts developing the guidelines also looked at two other drugs for severe and critical Covid patients: Ruxolitinib and Tofacitinib. Given their uncertain effects, the WHO has made a conditional recommendation against their use.
Today's recommendations, forming the eighth update of the 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 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 the scope of licensing to make the products more affordable.