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Baricitinib: A Review in Rheumatoid Arthritis

Drugs volume 78, pages 761–772 (2018)Cite this article

Abstract

Baricitinib (Olumiant®) is an oral, targeted synthetic DMARD that inhibits JAK1 and JAK2, which are implicated in the pathogenesis of rheumatoid arthritis (RA). This novel, small molecule is approved for use as monotherapy, or in combination with methotrexate, for the treatment of adults with moderate to severe active RA who responded inadequately to or were intolerant of ≥ 1 DMARD. In pivotal multinational trials, once-daily baricitinib 4 mg, with/without methotrexate (± another csDMARD), improved the signs and symptoms of RA, disease activity and physical function in DMARD-naive patients and in patients with an inadequate response to methotrexate, csDMARDs or TNF inhibitors; baricitinib treatment also slowed structural joint damage in DMARD-naive patients and in those with an inadequate response to methotrexate and csDMARDs. Baricitinib plus methotrexate was more effective than adalimumab plus methotrexate in patients with an inadequate response to methotrexate. The onset of these benefits was generally rapid and sustained over time. Baricitinib was generally well tolerated during up to 5.5 years’ treatment; the most commonly reported adverse drug reactions were upper respiratory tract infections, increased LDL cholesterol, nausea and thrombocytosis. Thus, once-daily baricitinib, as monotherapy or in combination with methotrexate, is an effective and generally well tolerated emerging treatment for patients with moderate to severe active RA who have responded inadequately to or are intolerant of ≥ 1 DMARD, and extends the options available for this population.

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Acknowledgements

During the peer review process, the manufacturer of baricitinib was also offered an opportunity to review this article. Changes resulting from comments received were made on the basis of scientific and editorial merit.

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    Zaina T. Al-Salama & Lesley J. Scott

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  1. Zaina T. Al-Salama
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Correspondence to Zaina T. Al-Salama.

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The preparation of this review was not supported by any external funding.

Conflict of interest

Zaina T. Al-Salama and Lesley J. Scott are salaried employees of Adis/Springer, are responsible for the article content and declare no relevant conflicts of interest.

Additional information

The manuscript was reviewed by: C. Abud-Mendoza, Regional Unit of Rheumatology and Osteoporosis, Hospital Central “Dr. Ignacio Morones Prieto”, Faculty of Medicine, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México; R. Alten, Department of Internal Medicine II, Rheumatology and Clinical Immunology, Schlosspark-Klinik, Charité-University Medicine Berlin, Berlin, Germany; M. T. Nurmohamed, Amsterdam Rheumatology immunology Center, VU University Medical Center and Reade Rheumatology, Amsterdam, Netherlands; C. Richez, Département de Rhumatologie, Hôpital Pellegrin, Bordeaux, France.

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Al-Salama, Z.T., Scott, L.J. Baricitinib: A Review in Rheumatoid Arthritis. Drugs 78, 761–772 (2018). https://doi.org/10.1007/s40265-018-0908-4

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