9 August 2017 - NICE has published final guidance on the use of baricitinib for the treatment of patients with moderate to severe rheumatoid arthritis.

Baricitinib, with methotrexate, is recommended as an option for treating active rheumatoid arthritis in adults whose disease has responded inadequately to intensive therapy with a combination of conventional disease-modifying antirheumatic drugs (DMARDs), only if:

• disease is severe (a disease activity score [DAS28] of more than 5.1) and
  
• the company provides baricitinib with the discount agreed in the patient access scheme.
  

Baricitinib, with methotrexate, is recommended as an option for treating active rheumatoid arthritis in adults whose disease has responded inadequately to or who cannot have other DMARDs, including at least 1 biological DMARD, only if:

• disease is severe (a DAS28 of more than 5.1) and
  
• they cannot have rituximab and
  
• the company provides baricitinib with the discount agreed in the patient access scheme.
  

Baricitinib can be used as monotherapy for people who cannot take methotrexate because it is contra-indicated or because of intolerance, when the criteria above are met.

Read NICE Final Appraisal Determination for baricitinib