Interní Med. 2018; 20(5): 274-277 | DOI: 10.36290/int.2018.061

Baricitinib in treating rheumatoid arthritis

MUDr. Hana Ciferská, Ph.D.

Revmatologický ústav, Praha

Revmatologická klinika 1. LF UK Praha

In the last decade, there has been a major advancement in the treatment of rheumatoid arthritis (RA) through novel therapeuticagents introduced gradually in the clinical practice. Inhibition of Janus kinase (JAK) directly affects the crucial processes involvedin the pathogenesis of RA. Baricitinib is a JAK1/2 selective inhibitor which has been shown to have good efficacy, tolerance, and,so far, even safety in phase II and III trials. The RA BEGIN and RA BUILD phase III trials were focused on a population of patientswith failure of the previous therapy with diseases-modifying drugs, whereas the RA BEACON trial was aimed at patients with failureof the previous biological therapy. Groups of patients were receiving monotherapy with baricitinib and combination therapyusing methotrexate with a good effect. The RA BEAM trial was a comparative study of the efficacy and safety of baricitinib andadalimumab in patients with RA. Concerns about serious adverse haematological effects have not been confirmed. A decrease inthe neutrophil count was typically noted at week 16 of the study and was reversible. The most frequent adverse effects includedupper respiratory tract infections, elevated liver tests, and dyslipidaemia. An advantage of baricitinib is the oral administrationthat distinguishes it from the biological drugs available so far. Its introduction in the treatment is a good alternative to well-establisheddrugs, whether conventional or biological ones.

Keywords: baricitinib, bDMARD, csDMARD, tsDMARD, methotrexate, adalimumab, rheumatoid arthritis, JAK, Janus kinase

Received: July 22, 2018; Accepted: August 6, 2018; Published: December 1, 2018  Show citation