New rheumatoid arthritis treatment approved for NHS use

NICE has approved use of the JAK inhibitor baricitinib (Olumiant) for the treatment of severe rheumatoid arthritis (RA) unresponsive to DMARDs.

Olumiant is available as film-coated tablets containing 2mg or 4mg baricitinib to be given once daily. | SCIENCE PHOTO LIBRARY
Olumiant is available as film-coated tablets containing 2mg or 4mg baricitinib to be given once daily. | SCIENCE PHOTO LIBRARY

NICE guidance recommends baricitinib, in combination with methotrexate, as an option for treating active RA in adults who have responded inadequately to intensive therapy with a combination of conventional DMARDs, and whose disease is severe (as defined by a disease activity score [DAS28] >5.1).

Baricitinib with methotrexate is also recommended as an option for treating active RA in adults whose disease is severe, as defined above, and who have responded inadequately to or who cannot have other DMARDs, including at least one biologic, and who cannot be treated with rituximab.

The guidance says that baricitinib can be used as monotherapy in the above circumstances if methotrexate is contraindicated or not tolerated.

Approval is contingent on the manufacturer supplying baricitinib with the discount agreed in the patient access scheme.

Baricitinib, together with tofacitinib (Xeljanz), represents a new class of RA treatments known as JAK inhibitors. Olumiant is contraindicated in patients with active tuberculosis and is not recommended for those with severe renal or hepatic impairment.


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