The eighth version (seventh update) of a living guideline is released. It replaces earlier versions. The latest update includes a strong recommendation for the use of baricitinib as an alternative to interleukin-6 (IL-6), a conditional recommendation for the use of sotrovimab in patients with non-severe covid-19 and a conditional recommendation against the use of ruxolitinib and tofacitinib for patients with severe or critical covid-19.
‘‘A living WHO guideline on drugs for COVID-19’’ has been updated on 13 January 2022 based on new evidence from seven trials involving over 4,000 patients with non-severe, severe, and critical covid-19 infection.
The new update includes
- A strong recommendation for the use of baricitinib (as an alternative to interleukin-6 (IL-6) receptor blockers), in combination with corticosteroids, in patients with severe or critical covid-19
- A conditional recommendation against the use of ruxolitinib and tofacitinib for patients with severe or critical covid-19
- A conditional recommendation for the use of sotrovimab in patients with non-severe covid-19, restricted to those at highest risk of hospitalisation.
WHO has strongly recommended the drug baricitinib (hitherto used to treat rheumatoid arthritis) for patients with severe or critical covid-19 in combination with corticosteroids. This was based on moderate certainty evidence that it improves survival and reduces the need for ventilation, with no observed increase in adverse effects.
WHO has 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.
‘‘Living guidelines on drugs for COVID-19’’ is developed by the World Health Organization to provide trustworthy guidance on the management of covid-19 and help doctors make better decisions with their patients. These are useful in fast moving research areas like covid-19 because they allow researchers to update previously vetted and peer reviewed evidence summaries as new information becomes available.
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References:
Agarwal A., et al 2020. A living WHO guideline on drugs for covid-19. BMJ 2020; 370. (Published 04 September 2020). Updated 13 January 2022. DOI: https://doi.org/10.1136/bmj.m3379
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