The World Health Organization (WHO) has recommended two new drugs for Covid-19 based on evidence from seven trials involving over 4,000 patients with non-severe, severe, and critical Covid-19.

In its eighth update of therapeutics and COVID-19, WHO strongly recommended baricitinib, which is for patients with severe or critical Covid-19. It is part of a class of drugs called Janus kinase (JAK) inhibitors that suppress the overstimulation of the immune system. WHO recommends that it is given 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.

New drug for patients who are at high risk of hospitalisation

It has also conditionally recommended the use of a monoclonal antibody drug, sotrovimab, for treating mild or moderate Covid-19 in patients who are at high risk of hospitalisation. This includes patients who are older, immunocompromised, having underlying conditions like diabetes, hypertension, and obesity, and those unvaccinated.

Sotrovimab is an alternative to casirivimab-imdevimab, a monoclonal antibody cocktail recommended by WHO in September 2021. Studies are ongoing on the effectiveness of monoclonal antibodies against Omicron but early laboratory studies show that sotrovimab retains its activity.

The extent to which these medicines will save lives depends on how widely available and affordable they will be.

The panel of experts developing the guidelines also looked at two other drugs for severe and critical Covid-19: ruxolitinib and tofacitinib. Given their uncertain effects, WHO made a conditional recommendation against their use.