A repurposed arthritis medication could reduce the need for ventilation and improve survival rates for people hospitalised with severe Covid. The drugs baricitinib and interleukin-6 inhibitors have similar effects in testing. The WHO recommends doctors select whichever drug is more readily available and that they have the best clinical experience in administering. The drug guidelines provided by the WHO are a living document that is routinely updated as new research comes available.
The arthritis drugs, called Janus Kinase Inhibitors, are recommended for use in combination with corticosteroids.
Corticosteroids block the inflammatory pathways the body uses to respond to diseases.
Janus Kinase Inhibitors have a similar effect by preventing the activation of signal molecules for inflammation.
Inflammation in the lungs can cause injury to the organs and limit airflow.
The WHO has warned against two other arthritis drugs (ruxolitinib and tofacitinib) because small trials suggest a possible increase in serious side effects and failure to show positive results.
The WHO said these drugs “Should be considered only if neither baricitinib nor IL-6 receptor blockers are available.”
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The WHO recommendations for these drugs are dependent on the severity of the disease.
Corticosteroids have no observed benefit in people who have not been hospitalised.
The benefits are specifically for people who would otherwise need a respirator.
The living guidelines used by the WHO are a useful tool for doctors in areas where research is being conducted faster than a single person can keep up to date on all of the different studies being conducted.
The WHO team aggregates available information from different studies and converts this into clinical recommendations divided into the different situations a doctor may face.
