Don’t use these antibodies to treat COVID-19, WHO strongly advises

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In a study from WHO, scientists showed the antibody drugs sotrovimab and casirivimab-imdevimab are not recommended for patients with COVID-19.

These drugs work by binding to the SARS-CoV-2 spike protein, neutralizing the virus’s ability to infect cells.

The strong recommendation replaces previous conditional recommendations for their use and is based on emerging evidence from laboratory studies that these drugs are not likely to work against currently circulating variants, such as omicron.

After weighing up all the evidence, the team judged that almost all well-informed patients would not choose to receive sotrovimab or casirivimab-imdevimab.

In the same guideline update, WHO makes a conditional recommendation for the use of the antiviral drug remdesivir in patients with severe COVID-19, and a conditional recommendation against its use in patients with critical COVID-19.

These recommendations are based on results from five studies involving 7,643 patients.

The studies found 13 fewer deaths per 1,000 patients with severe COVID-19 taking remdesivir, but 34 more deaths per 1,000 patients with critical COVID-19 taking the drug.

These new findings provided sufficiently trustworthy evidence to demonstrate benefits in patients with severe COVID-19, but not critical COVID-19.

The panel considered the benefits of remdesivir to be modest and of moderate certainty for key outcomes such as mortality and mechanical ventilation, resulting in a conditional recommendation.

WHO also advises that three drugs used to treat arthritis—the IL-6 receptor blockers tocilizumab or sarilumab and the JAK inhibitor baricitinib—may now be combined, in addition to corticosteroids, in patients with severe or critical COVID-19.

This advice is based on new evidence confirming a survival benefit for baricitinib with little or no serious adverse events when given in combination with corticosteroids and IL-6 receptor blockers.

However, the panel acknowledges some cost and resource implications associated with these drugs, which they say could exacerbate health inequities.

Living guidelines 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 become available.

If you care about COVID, please read studies about drug combo that may treat COVID-19 effectively, and flies, roaches not likely to spread COVID-19.

For more information about health, please see recent studies that ginger and chili peppers work together to lower cancer risk, and results showing this cancer drug may lower death risk in people hospitalized in COVID-19.

The study was published in The BMJ.

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