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JAK inhibitor adverse effect — SCE Rheumatology MCQ

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HardRheumatological pharmacologyJAK inhibitor adverse effectSCE Rheumatology

Baricitinib is selected for rheumatoid arthritis in an adult whose Cockcroft–Gault creatinine clearance is 44 mL/min. They are not taking a strong OAT3 inhibitor. Which dose is specified?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Baricitinib 2 mg once daily

Explanation lettering: D = shown as A · E = shown as C · A = shown as D · C = shown as E

D is correct. The UK SmPC reduces the adult baricitinib dose to 2 mg once daily for creatinine clearance 30–60 mL/min. Four milligrams daily is excessive at this renal function, alternate-day dosing is not the labelled adjustment, and moderate impairment is not an absolute contraindication. A 1 mg adult regimen is not the stated renal dose.

Reference: Baricitinib 4 mg tablets UK SmPC. https://www.medicines.org.uk/emc/product/16006/smpc