Baricitinib is an oral reversible inhibitor of JAK1 and JAK2 – that is JAK3-sparing – under co-development by Incyte and Eli Lilly. It is currently in development for the treatment of inflammatory conditions including RA, psoriasis, and diabetic kidney disease.
Should baricitinib (Incyte/Eli Lilly) receive approval in rheumatoid arthritis (RA), its uptake will be largely determined by its price. As an oral small molecule, baricitinib has the potential to be positioned early in the RA treatment paradigm, but in order to directly compete with the anti-tumor necrosis factor (TNF) biologics, it will have to demonstrate comparable, if not superior, efficacy and safety to the well-established biologics, and be priced at a lower cost. To date, baricitinib’s clinical performance has been comparable to that of the first-in-class Janus kinase (JAK) inhibitor Xeljanz (tofacitinib; Pfizer). Datamonitor Healthcare believes that if baricitinib is priced in line with Xeljanz, which is comparable to the currently marketed biologics, the molecule will be relegated to late lines of therapy, targeting non-responders to TNF therapy.
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