Medical Information

Baricitinib is a JAK inhibitor with clear contraindications for use in specific patient populations. The following three groups of people need to be particularly vigilant and thoroughly assess the risks before taking medication.

1、 Active infection patients

Absolute prohibition: Baricitinib is prohibited during active infection (such as tuberculosis, viral hepatitis, invasive fungal infection or septicemia), because drugs will inhibit the immune system, leading to the spread or aggravation of infection.

Infection history screening: For individuals with a history of chronic or recurrent infections, latent tuberculosis, or opportunistic infections, comprehensive screening (such as T-SPOT, chest imaging) must be completed before medication, and if necessary, anti infection treatment should be given first.

Monitoring during treatment: If fever, chills, persistent cough, or local redness, swelling, and pain occur during medication, immediate medical evaluation should be sought and medication should not be continued without authorization.

2、 Patients with severe liver function impairment

Severe liver damage should not be used: Baricitinib should not be used in patients with severe liver dysfunction classified as Child Pugh grade C, as drug metabolism is inhibited and may increase the risk of liver toxicity.

Moderate liver damage requires adjustment: Child Pugh B patients should reduce their dosage under the guidance of a doctor and closely monitor changes in transaminase and bilirubin levels.

Pre medication testing: All patients should complete baseline liver function testing before starting treatment, and regularly check ALT and AST levels during treatment. If the levels increase to more than 5 times the upper limit of normal, medication should be discontinued.

3、 Severe renal insufficiency patients

Prohibited for patients with severe kidney damage: Patients with estimated glomerular filtration rate (eGFR) below 30mL/min/1.73m ² are contraindicated, as the drug is mainly excreted through the kidneys and accumulation can cause serious adverse reactions.

Moderate renal impairment reduction: For eGFR between 30-60mL/min, the daily dose should be halved (such as from 4mg to 2mg), and blood creatinine and urine routine should be monitored regularly.

The elderly and high-risk groups: the elderly or those with high renal risk factors such as diabetes and hypertension should evaluate eGFR before use to avoid starting treatment without screening.