WHO recommends two new drugs to treat covid patients—how the drugs work

Both the drugs may have different mechanisms of action but the studies have proven mortality benefit if used with steroids in patients with a serious infection,

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World Health Organisation on Friday (January 14, 2022) came up with two new drugs for covid-19, providing the world with two additional options to treat covid patients. This came as the country is reeling under covid third wave and Omicron threat at the same time.

The WHO in its release mentioned that extent to which both these drugs will save lives depends on how widely the medicines will be available and affordable at the same time.

The name of the first drug is baricitinib. This drug is recommended particularly for those patients with severe or critical covid-19. It is an oral drug and is used in the treatment of rheumatoid arthritis.

This drug belongs to the family of drugs called Janus kinase (JAK) inhibitors. It suppresses the overstimulation of the immune system. This oral drug also provides an alternative to other arthritis drugs known as Interleukin-6 receptor blockers, which was recommended by WHO in July 2021.

Another drug is Sotrovimab. It is developed by GlaxoSmithKline with US partner Vir Biotechnology Inc. This drug is an investigational monoclonal antibody to be used in treating conditions caused by covid-19. This should be consumed by patients with mild or moderate covid-19 who are exposed to the risk of hospitalization, recommended WHO. Patients with underlying conditions such as diabetes, hypertension, obesity, or those who are unvaccinated are highly recommended to take this oral drug Sotrovimab.

Also Read: WHO recommends 2 new Covid-19 drugs; check their use, availability, efficacy

The drug has also been authorized by the US Food and Drug Administration (FDA) for emergency use for treating mild to moderate covid-19 patients above 12 years.

How do the drugs work?

In the severe phase of covid-19 in patients, there is an inflammation that triggers severe disease in the body. This has to be mediated with the help of certain inflammatory markers which are infused by Baricitinib, Dr. Sanjay Pujari, member of ICMR national covid-19 taskforce was quoted as saying to the Indianexpress.com

The disease expert stated that they have been using baricitinib for a long time now. He also mentioned that during waves of infections with Delta, there was a shortage of tocilizumab. Baricitinib was the only alternative drug at that time.

Both the drugs may have different mechanisms of action but the studies have proven mortality benefit if used with steroids in patients with a serious infection, said Dr. Pujari.

Another infectious disease expert said that the antibody cocktail casirivimab-imdevimab can’t help patients with the Omicron variant. On the other hand, sotrovimab can be used in mild illness with both Delta and Omicron patients.

Drugs’ availability in India

Baricitinib is affordable and is also widely available. The drug Is given to control hyper inflammation which a patient starts to feel between days 7 and 14.

Usually, at that moment, patients start feeling breathless and that is the time when we give them steroids and add tocilizumab. In case there is a spike in patients hospitalization, we use an alternative which is a widely used drug—baricitinib.

Another drug–Sotrovimab is not available in India, for now at least. However, experts said that the currently available monoclonal antibodies should be used only if we have patients with Delta variant otherwise not.

The latest WHO recommendations come as the eighth update of WHO’s living guidelines Covid-19. The recommendation is based on evidence from seven trials that involve over 4,000 patients with non-severe, severe, and critical Covid-19 cases.

The approval will be granted in India by the national regulator who may further ask for recommendations of national agencies like WHO itself, Prof K Srinath Reddy, president of the Public Health Foundation of India told Indian Express.

Baricitinib drug for now however has long been recommended in the US and Europe.

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