A World Health Organization (WHO) panel has given the green light to two new drugs to treat COVID-19.
US-based Eli Lilly’s baricitinib (Olumiant), a Janus kinase inhibitor, and GlaxoSmithKline and Vir Biotechnology’s sotrovimab, a monoclonal antibody, were recommended in new WHO guidelines, published in the British Medical Journal.
Baricitinib, administered with corticosteroids, was strongly recommended as a treatment for patients with severe or critical illness. The drug, developed by Incyte and licenced to Lilly, is also used to treat rheumatoid arthritis. It prevents the overstimulation of the immune system and is said to improve survival and reduce the need for ventilation in covid-19 patients, with no observed increase in adverse effects.
The other therapy recommended by WHO, GSK-Vir’s sotrovimab, is aimed at treating individuals with mild or moderate Covid-19 who are at increased hospital admission risk, such as older, immunocompromised people with underlying conditions including hypertension, diabetes and obesity – and those who have not received Covid-19 vaccines. The organisation has previously approved the monoclonal antibody casirivimab-imdevimab but found insufficient data to recommend one monoclonal antibody treatment over another.
However, WHO acknowledged that the activity of the monoclonal antibodies against new variants of covid-19, such as Omicron, were currently uncertain. It will update its guidelines once new data is available.
WHO did not recommend using baricitinib and sotrovimab simultaneously but advised on choosing a therapy based on cost, availability and clinician experience.
The new recommendations are based on evidence from seven trials involving more than 4,000 patients with non-severe, severe, and critical covid-19. They are the latest raft of guidelines from the WHO, which has recommended the use of interleukin 6 receptor blockers and systemic corticosteroids in patients with severe or critical covid-19; conditional recommendations for the use of casirivimab-imdevimab in selected patients, and has recommended against the use of convalescent plasma, ivermectin, and hydroxychloroquine in patients with covid-19 regardless of disease severity.
In December, the UK’s Medicines and Healthcare Products Regulatory Agency (MHRA) approved sotrovimab for over-12s with mild to moderate covid-19 who were at high risk of developing severe disease, following evidence that it reduced the risk of hospital admission and death by 79% in high-risk adults with symptomatic covid-19.