This new recommendation supersedes previous recommendations on its use and is based on new evidence obtained. The document states that these drugs are unlikely to work against currently circulating variants, such as Omicron. In the same update, the WHO makes a conditional recommendation for the use of the antiviral drug Remdesivir in patients with severe Covid-19, and a recommendation against its use in patients with critical Covid-19.
These guidelines are based on the results of five randomized trials involving 7,643 patients, which saw 13 fewer deaths per 1,000 patients with severe Covid-19 taking Remdesivir, yet 34 more deaths per 1,000 patients with critical Covid-19 who took the medicine.
The commission considered the demonstrated benefits of remdesivir to be modest and of moderate certainty for key outcomes such as mortality and mechanical ventilation, resulting in only a conditional recommendation.
The WHO also advises that three drugs used to treat arthritis – the IL-6 receptor blockers Tocilizumab or Sarilumab and the JAK inhibitor Baricitinib – can be combined in patients with severe or critical Covid-19.
This recommendation is based on new trial data confirming a survival benefit for baricitinib with few or no serious adverse effects when given in combination with corticosteroids and IL-6 receptor blockers.
However, the group of experts recognizes some objections in terms of costs and resources associated with these drugs, which according to them could aggravate health inequalities.
Previously, the WHO had made a strong recommendation for the use of Nirmatrelvir and Ritonavir, and a conditional recommendation for Molnupiravir in high-risk patients with non-severe Covid-19.
The WHO advises against the use of Ivermectin and Hydroxychloroquine in patients with Covid-19 regardless of the severity of the disease.