Baricitinib

Nakayamada Shingo, Tanaka Yoshiya

doi:10.14961/cra.35.146

<p>Baricitinib is a molecularly targeted synthetic anti-rheumatic drug（tsDMARD）targeting JAK1/2. Results of phase III clinical trials using baricitinib for rheumatoid arthritis（RA）have shown feasible efficacy and tolerable safety in patients who showed inadequate response to biological DMARDs（bDMARDs）as well as conventional synthetic DMARDs such as methotrexate（MTX）. In particular, baricitinib is the first JAK inhibitor to show significantly higher clinical efficacy than TNF inhibitors for MTX-refractory RA. In Japan, baricitinib 4 mg once daily orally is approved for the treatment of RA, atopic dermatitis, alopecia areata and pneumonia caused by SARS-CoV-2. Approximately 70% of this drug is renally excreted and the dose should be reduced to 2 mg or avoided for patients with renal dysfunction. Serious side effects of baricitinib include infection, gastrointestinal perforation, lymphopenia, liver dysfunction and interstitial lung disease. Since serious infections occur at a rate similar to other bDMARDs, the patients should be monitored carefully and regularly for adverse effects. Although JAK inhibitors are potent therapies for RA, more cautious consideration and measurement for their risk-benefit ratio are needed, after considering the safety results of ongoing post marketing surveillance.</p>

Baricitinib

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