A World Health Organization (WHO) panel on Friday strongly recommended baricitinib, a drug used for treatment of rheumatoid arthritis, for patients with severe or critical Covid-19 in combination with corticosteroids.
The recommendation by WHO Guideline Development Group of international experts, published in The BMJ, is based on evidence that it improves survival and reduces the need for ventilation, with no observed increase in adverse effects.
The WHO experts noted that baricitinib, a type of drug known as a Janus kinase (JAK) inhibitor, has similar effects to other arthritis drugs called interleukin-6 (IL-6) inhibitors. The health body advised not to use both drugs at the same time, but to choose one based on cost, availability, and clinician experience.
Further, the expert panel also advised against the use of two other JAK inhibitors — ruxolitinib and tofacitinib — for patients with severe or critical Covid-19. While trials have not shown any benefit, they have suggested a possible increase in serious side effects with tofacitinib.
The WHO also made a conditional recommendation for the use of the monoclonal antibody sotrovimab in patients with non-severe Covid-19, but only in those at highest risk of hospitalisation, reflecting trivial benefits in those at lower risk.
Similar recommendation has been made by the global health body for another monoclonal antibody drug — casirivimab-imdevimab.
The experts also noted that data is insufficient to recommend one monoclonal antibody treatment over another, while they acknowledge that their effectiveness against new variants like Omicron is still uncertain.
The WHO panel’s recommendations are based on new evidence from seven trials involving over 4,000 patients with non-severe, severe, and critical Covid-19 infection.