II. Indications
-
Rheumatoid Arthritis
- Refractory to non-biologic DMARD
-
Alopecia Areata
- Severe Alopecia Areata in adults
III. Dosing
-
Rheumatoid Arthritis (refractory to non-biologic DMARD)
- Take 2 mg orally once daily
-
Alopecia Areata
- Start 2 mg orally once daily
- May advance to 4 mg orally once daily if lack of response to 2 mg/day
IV. Efficacy
-
Alopecia Areata
- Hair regrowth starts 8 to 12 weeks after starting Baricitinib and continues up through 36 weeks
- Best efficacy is with 4 mg dose
- Up to a third of patients will achieve <20% scalp baldness
V. Adverse Effects
- See Janus Kinase Inhibitor
- Common (5% of patients)
- Upper Respiratory Infections
- Urinary Tract Infection
- Hyperlipidemia
- Headaches
- Nasopharyngitis
- Acne
- Increased Serum Creatinine kinase levels
- Serious
- Class effects include serious infections, opportunistic infections (e.g. Tb reactivation, Shingles reactivation), malignancy
- Major cardiovascular events (0.5%)
- Malignancy including non-melanoma Skin Cancer (0.4%)
VI. Safety
- Avoid in pregnancy (Unknown safety)
- Avoid in Lactation
- Wait at least 4 days after last dose to begin Breast Feeding