WHO recommends a treatment that combines two antibodies (casirivimab e imdevimab) for two specific groups of Covid-19 patients.
In a report that publishes today
«The BMJ »The panel of the Guide Development Group of the
WHO ensures that this combination should be used in patients with non-severe Covid-19 who are at increased risk of hospitalization and those with severe or critical Covid-19 who son seronegativos, that is, they have not developed their own antibody response to SARS-CoV-2.
The first recommendation is based on new evidence from three trials that have not yet been peer-reviewed, but show that casirivimab e imdevimab reduce the risk of hospitalization and duration of symptoms in people at higher risk of disease severe, such as unvaccinated, elderly, or immunosuppressed patients.
As for the second, it is based on trial data RECOVERY showing that casirivimab e imdevimab reduce deaths (ranging from 49 less per 1,000 in the seriously ill to 87 less in the critically ill) and the need for mechanical ventilation in seronegative patients.
For all other Covid-19 patients, the document states that the benefits of this antibody treatment are unlikely to be significant.
Casirivimab and imdevimab are monoclonal antibodies which, when used together, bind to the SARS-CoV-2 spike protein, neutralizing the virus’s ability to infect cells.
The recommendations are part of a living guide, developed by the WHO with the methodological support of the MAGIC Evidence Ecosystem Foundation, to provide an updated and reliable guide on the management of Covid-19 and help physicians make better decisions with their patients.
These types of life recommendations are useful in fast-moving research areas like Covid-19 because they allow researchers to update previously peer-reviewed evidence as new information becomes available.
The panel also recognizes implications for access to treatment due to its costs and resources, which can make access difficult for low- and middle-income countries.
For example, tests will be needed rapid serological to identify eligible patients who are seriously ill, treatment should be administered by intravenously with specialized equipment and patients should be monitored to detect allergic reactions.
They also recognize the possibility of new variants emerging in which the antibodies casirivimab and imdevimab may have a reduced effect.
However, they say, given the demonstrated benefits to patients, ‘the recommendations should provide an encouragement to engage all possible mechanisms to improve global access to the intervention and associated tests. ‘
The guide is in addition to previous recommendations for the use of receptor blockers. interleukin-6 and corticosteroidssystemic for patients with severe or critical Covid-19, and against the use of ivermectin and hydroxychloroquine in patients with Covid-19 regardless of the severity of the disease.