Baricitinib is a Janus kinase (JAK) inhibitoe indicated for the treatment of adult patients with moderately to severely active rheumaoid arthiritis who have had an inadquate response to one or more TNF antagonist therapies was intially approved y USFDA in 2018. On November 19, 2020, the US-FDA issued an Emergency Use Authorization (EUA) for emergency use of Baricitinib, in combination with remdisivir, for the treatment of suspected or laboratory confirmed coronavirus disease 2019 (COVID-19) in certain hospitalized patients requiring supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO). US-FDA further reissued the Letter of Authorization on July 28, 2021, to no longer require that baricitinib be used in combination with remdesivir. Again on Decmber 20, 2021, US-FDA reissued the July 28, 2021 EUA of baricitinib for treatmment of COVID-19. Also, on 14 Jan 2022, WHO has strongly recommended the use of Baricitinib in patients with severe or critical COVID-19.
Baricitinib is a reversible Janus kinase (JAK) inhibitor that is selective for JAK1 and JAK2, which are intracellular enzymes involved in the stimulation of haematopoiesis and immune cell function via a signalling pathway. The JAK/STAT pathway mediates the signaling of multiple cytokines and interruptionh this pathway is therefore a useful way to modulate the immunopathology seen with SARS-CoV-2 infection.
Treatment of COVID-19 in hospitalized adults and pediatric patients 2 years of age or older requiring supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO)
Moderate to Severe Rheumatoid Arthiritis
Severe Alopecia areata
Dosage and Administration
The recommended dosage for adults is 4 mg once daily orally for 14 days or until hospital discharge, whichever occurs first. Children above 9 years: 4 mg once daily orally for 14 days or until hospital discharge, whichever occurs first. Children 2-9 years old: 2 mg once daily orally, for 14 days or until hospital discharge, whichever occurs first. Can be taken with or without food.
Do not initiate treatment in patients with absolute lymphocyte count (ALC) <500 cells/mm3, absolute neutrophil count (ANC) <1,000 cells/mm3, or Hb level <8 g/dL. Dosing interruption or discontinuation may be required if serious infections or other serious adverse reactions (e.g. MI, DVT) occur, or according to the severity of the patient's laboratory abnormalities.