How it works
Baricitinib is an oral inhibitor of Janus kinases, with preferential activity against JAK1 and JAK2. These enzymes participate in intracellular signaling from multiple cytokines involved in inflammatory and immune responses. Inhibition of JAK1/JAK2 reduces cytokine signaling and helps suppress excessive immune-mediated inflammation.
Who may be prescribed this medicine
Baricitinib is a systemic immunomodulatory medicine, and individual risks should be evaluated before treatment.
Clinical research
Baricitinib has been extensively studied in randomized Phase 3 clinical trials for rheumatoid arthritis. In the RA-BEAM study, 70% of patients receiving baricitinib achieved an ACR20 response at week 12 compared with 40% receiving placebo. The study also demonstrated reduced radiographic progression of joint damage.
In the RA-BEACON trial, which included patients with an inadequate response or intolerance to biological therapies, an ACR20 response at week 12 was achieved by 55% of patients receiving baricitinib 4 mg compared with 27% receiving placebo.
For severe alopecia areata, the BRAVE-AA1 and BRAVE-AA2 Phase 3 trials evaluated once-daily baricitinib. At week 36, a SALT score of 20 or less was achieved in 38.8% and 35.9% of patients receiving 4 mg, compared with 6.2% and 3.3% with placebo, respectively.
Baricitinib has also been studied in hospitalized patients with COVID-19. In the ACTT-2 trial, baricitinib plus remdesivir was compared with remdesivir plus placebo, providing clinical evidence supporting its use in selected hospitalized patients.
Clinical trial results do not mean that baricitinib is appropriate for every patient. Kidney and liver function, blood counts, infection status, cardiovascular risk factors, and potential drug interactions should be assessed by a healthcare professional.
Baricitinib is used for:
The medicine acts by inhibiting JAK1 and JAK2, enzymes involved in cytokine signaling, thereby reducing excessive inflammatory immune activity.
The tablets are taken orally with or without food. The dosage is determined by the treating physician according to the indication, kidney and liver function, other medical conditions, and concomitant medicines. Rheumatoid arthritis, alopecia areata, and hospitalized COVID-19 have different dosing regimens, so the dose and treatment duration should not be changed without medical supervision.
JAK inhibitors also carry important warnings concerning serious infections, malignancies, major cardiovascular events, and thrombosis; individual risk factors should be evaluated before and during treatment.
