Contraindications and inapplicable groups of baricitinib/alemin

Baricitinib (Baricitinib), as a JAK inhibitor, has a wide range of clinical applications, especially in the treatment of rheumatoid arthritis, COVID-19 and alopecia areata. However, despite its good efficacy, there are still some contraindications and limitations of use that patients need to pay special attention to when using this drug.

First of all, baricitinib has no clear contraindications, which means that the vast majority of patients can use the drug under the guidance of a doctor. However, there are some use limitations and inapplicable groups, especially for some patients with weakened immune systems. When using baricitinib, it is most critical to avoid concomitant use with other JAK inhibitors, biologic DMARDs (such as TNF-α inhibitors), or drugs with strong immunosuppressive effects. For example, when used in combination with drugs such as azathioprine and cyclosporine, it may increase the risk of immunosuppression, leading to serious side effects such as infection.

In addition, baricitinib is not suitable for patients with a history of severe infection or active infection. Because baricitinib interferes with the immune response by inhibiting the JAK-STAT signaling pathway, it may reduce the patient's immune defense ability and increase the risk of infection. Particularly for patients with existing severe infections, the use of baricitinib may aggravate the progression of the infection, therefore, the use of baricitinib should be avoided in these patients.

In addition, baricitinib is not suitable for patients with severe liver and renal impairment. Baricitinib is metabolized primarily by the liver, and excretion is dependent on the kidneys. Therefore, in patients with hepatic and renal impairment, the use of baricitinib may result in excessive drug concentrations and increase the risk of side effects. In these patients, the use of baricitinib requires special caution and dose adjustment based on individual hepatic and renal function.

Reference materials:https://www.ema.europa.eu/en/medicines/human/EPAR/olumiant