(CNN) — The World Health Organization on Thursday released its eighth update to guidelines on drug treatments for COVID-19, adding a recommendation for the use of a type of immune-suppressing drug.
The organization “strongly recommended” the use of baricitinib, a time of Janus kinase inhibitor (JAK), for people with severe Covid-19 when used with corticosteroids, according to guidelines published in the British Medical Journal.
JAKs are immune-suppressing treatments frequently used for autoimmune conditions like rheumatoid arthritis. This recommendation was made after reviewing evidence that the drug “improves survival and reduces the need for ventilation, with no observed increase in adverse effects,” the WHO said in a news release.
Baricitinib is recommended as an alternative to interleukin-6 receptor blockers, which WHO recommended for use in July 2021.
“Baricitinib and IL-6 receptor blockers have similar effects; when both are available, choose one based on issues including cost and clinician experience,” the authors wrote.
In the new guidelines, WHO also issued a conditional, or weak, recommendation against the use of ruxolitinib and tofacitinib, two other JAK treatments, as there was unclear evidence that they had any benefit and some evidence suggesting that tofacitnib could increase serious side effects.
WHO updated its guidance on monoclonal antibody treatments as well, adding a conditional recommendation for sotrovimab, developed by GlaxoSmithKline, in those with mild Covid-19 at a high risk for hospitalization after evidence showed a “substantial” decrease in hospitalization risk.
This recommendation is similar to the one made for casirivimab-imdevimab, developed by Regeneron and sold as REGEN-COV. In the new guidelines, the organization said there is not enough data to recommend one treatment instead of another, but this decision could change based on data on effectiveness against the Omicron variant.
“Following the publication of a previous conditional recommendation for casirivimab-imdevimab, pre-clinical evidence has emerged suggesting that this monoclonal antibody combination lacks neutralization activity against the omicron variant in vitro. Sotrovimab has been reported to retain activity against Omicron in pseudovirus assays but with higher concentrations being required for neutralization,” the guidance authors wrote.
