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The following is a summary of “Baricitinib Dose Reduction in Patients With Rheumatoid Arthritis Achieving Sustained Disease Control: Final Results From the RA-BEYOND Study,” published in the April 2025 issue of Journal of Rheumatology by Edwards et al. 

Researchers conducted a retrospective study to assess the impact of baricitinib dose step-down in patients with rheumatoid arthritis (RA) after 96 weeks of sustained disease control on 4 mg daily.  

They enrolled patients from a phase III trial into a long-term extension (LTE), randomizing those on baricitinib 4 mg for ≥15 months with sustained Clinical Disease Activity Index (CDAI)  low disease activity (LDA) or remission (REM) to continue 4 mg or taper to 2 mg. Rescue to 4 mg or csDMARD adjustment was allowed, and efficacy and safety were assessed through 96 weeks using Nonresponder imputation (NRI). 

The results showed 59.9% in the 2-mg group and 70.2% in the 4-mg group maintained LDA; REM was maintained by 30.8% and 36.6%, respectively. Rescue rates were 22.5% for 2 mg and 14.7% for 4 mg; 76.2% and 75.6% of 112 rescued patients regained LDA at 12 and 24 weeks. 

Investigators found that continued baricitinib 4 mg-maintained disease control better than tapering to 2 mg. They also observed that 76% of patients on 2 mg maintained or regained LDA/REM after returning to 4 mg. 

Source: jrheum.org/content/52/4/316