The WHO has given the go-ahead to treat COVID-19 with Baricitinib, a drug used against rheumatoid arthritis. Magazine British Medical Journal, BMJ for its acronym in English, has published an update of the table of medicines that the Organization has selected in which it is stated that this drug “is highly recommended” for patients with “critical or severe” COVID-19.
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Patients with severe COVID-19 have signs of pneumonia or breathing difficulties, and those with critical illness have acute respiratory problems or require life-sustaining treatment.
In addition to Baricitinib, the WHO also recommends for patients with COVID-19 in its most severe stages other drugs that are also used against rheumatoid arthritis, such as interleukin-6 inhibitors, which they would also have, experts say , similar effects. However, it is recommended that both are not used at the same time and it is suggested that factors such as cost or availability be taken into account when choosing one.
Both cases, Baricitinib or interleukin-6 inhibitors, can be combined, says the WHO, with corticosteroids, hormones that are also used to treat, in addition to rheumatoid arthritis, diseases such as asthma or allergies. The experts say their recommendation is based on the certainty that these drugs improve survival and reduce the need for external ventilation. They also say that an increase in adverse effects has not been observed in its use.
But not all treatments for rheumatoid arthritis are valid, stresses the WHO. While experts do recommend baricitinib or interleukin-6 inhibitors, they do not favor the use of ruxolitinib and tofacitinib for patients with severe coronavirus. In the case of these drugs, they say, in the trials that have been carried out, no benefits have been shown regarding mortality or the use of respirators and, however, “a possible increase in serious adverse effects” appears with the second from them.
On the other hand, for patients who do not have severe COVID-19, the WHO recommends the use of sotrovimab, although for those who are at higher risk of hospitalization. These individuals, experts say, are generally unvaccinated, elderly, or have chronic illnesses such as diabetes.
Also for patients who do not have the coronavirus in serious condition, the WHO endorses the use of casirivimab and imdevimab – although they accept them in severe or critical cases – as long as they are patients who have not acquired antibodies against COVID-19 in a natural.
The Organization continues to position itself against the use of corticosteroids for patients with non-severe COVID-19, as well as the use of Remdesivir, hydroxychloroquine, convalescent plasma, Lopinavir/ritonavir (used against HIV) or ivermectin, which it only considers it in the context of clinical trials.
The recommendations issued by the WHO are based on the study of seven trials in which more than 4,000 patients with non-severe, severe and critical COVID-19 have participated. In developing these guidelines, experts have considered the benefits and harms or feasibility issues.