Twelfth version of living guideline issued for drugs for COVID-19

In the living guideline developed by the World Health Organization and published in The BMJ, recommendations on drug options for the treatment of COVID-19 have been updated.

Arnav Agarwa, M.D., from McMaster University in Hamilton, Ontario, Canada, and colleagues produced the 12th version of the living guideline discussing the role of drugs in the treatment of COVID-19. New evidence was reviewed to update the earlier versions of these guidelines.

The authors updated recommendations for remdesivir, conditionally recommending its use in patients with severe COVID-19 and conditionally recommending against its use in critical COVID-19. The benefits of remdesivir are considered to be modest and of moderate certainty for key outcomes. Use of interleukin-6 receptor blockers (tocilizumab or sarilumab) may be combined with the Janus kinase inhibitor baricitinib, in addition to corticosteroids, for severe or critical COVID-19. Strong recommendations are provided against the use of sotrovimab and casirivimab-imdevimab for patients with nonsevere COVID-19, replacing the previous conditional recommendations for their use. There is a need for clinical trial evidence to confirm the clinical efficacy of new monoclonal antibodies that reliably neutralize circulating severe acute respiratory syndrome coronavirus 2 strains in vitro.

"Existing and emerging evidence demonstrates remaining uncertainties concerning treatment effects for all outcomes of importance to patients," the authors write. "There is also a need for better evidence on values and preferences of patients with COVID-19."

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