Related Experiment Video
Updated: Oct 3, 2025
08:36
Scaled-Up Preparation of an Intermediate of Upatinib, ACT051-3
Published on: April 7, 2023
1.2K
Baricitinib for relapsing giant cell arteritis: a prospective open-label 52-week pilot study
Matthew J Koster1, Cynthia S Crowson2, Rachel E Giblon2
1Department of Internal Medicine, Division of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA koster.matthew@mayo.edu.
Annals of the Rheumatic Diseases
|February 22, 2022
Summary
Baricitinib effectively treated relapsing giant cell arteritis (GCA), allowing most patients to discontinue glucocorticoids. This JAK inhibitor shows promise for GCA management, warranting further clinical trials.
Area of Science:
- Immunology
- Rheumatology
- Pharmacology
Background:
- Preclinical models show Janus kinase (JAK) inhibition suppresses T cells in vascular inflammation.
- Prospectively investigating JAK inhibition in giant cell arteritis (GCA) patients is lacking.
Purpose of the Study:
- To evaluate the safety and efficacy of baricitinib in patients with relapsing GCA.
- To assess the potential for glucocorticoid (GC) discontinuation with baricitinib treatment.
Main Methods:
- A prospective, open-label, pilot study involving 15 patients with relapsing GCA.
- Patients received baricitinib (4 mg/day) with a tiered GC entry and accelerated taper regimen.
- Disease activity and adverse events were monitored over 52 weeks.
Main Results:
- 14 out of 15 patients completed 52 weeks of baricitinib treatment.
- 93% of patients experienced adverse events, most commonly infections and gastrointestinal issues.
- Only 7% of patients relapsed, and 13 patients achieved complete steroid discontinuation and remission.
Conclusions:
- Baricitinib (4 mg/day) was well-tolerated and facilitated GC discontinuation in most relapsing GCA patients.
- This proof-of-concept study supports further investigation of JAK inhibition for GCA.
- Larger randomized trials are necessary to confirm baricitinib's utility in GCA treatment.
More Related Videos
Related Concept Videos
01:24Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
249
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
249
01:21Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
231
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
231
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
282
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
282
01:18Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists
236
Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
236
01:23Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
267
Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
267
01:29Drugs for Treatment of Ulcerative Colitis in IBD
256
Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
256