Once-daily oral treatment1,2
Olumiant is available as a tablet, with a recommended dose of 2 mg once daily
- For patients with moderate renal impairment (estimated glomerular filtration rate (GFR) between 30 and 60 mL/min/1.73 m2) or taking strong Organic Anion Transporter 3 (OAT3) inhibitors, such as probenecid, the recommended dose of Olumiant is 1 mg once daily. Olumiant is not recommended for patients with severe renal or severe hepatic impairment.
- Some conditions such as serious infections and cytopenias (e.g. lymphopenia, neutropenia, anemia) require delay or interruption in therapy.
- It can be used as monotherapy or in combination with methotrexate or other DMARDs.
- It can be taken with or without meals.
Limitation of Use: Not recommended for use in combination with other JAK inhibitors, biologic disease-modifying antirheumatic drugs, or with potent immunosuppressants such as azathioprine and cyclosporine.
The Olumiant tablet, bottle, and cap were designed with RA patients in mind.1
The Olumiant 2 mg tablet, bottle, and cap have been awarded the Arthritis Foundation's Ease of Use Commendation.1
Some items to consider during Olumiant therapy2
Closely monitor patients for the development of signs and symptoms of infection during and after treatment with Olumiant. Interrupt Olumiant if a patient develops a serious infection, an opportunistic infection, or sepsis. A patient who develops a new infection during treatment with Olumiant should undergo prompt and complete diagnostic testing appropriate for an immunocompromised patient; appropriate antimicrobial therapy should be initiated, the patient should be closely monitored, and Olumiant should be interrupted if the patient is not responding to therapy. Do not resume Olumiant until the infection is controlled.
Tuberculosis - Monitor patients for the development of signs and symptoms of TB, including patients who tested negative for latent TB infection prior to initiating therapy.
Viral Reactivation - Viral reactivation, including cases of herpes virus reactivation (e.g. herpes zoster), were reported in clinical studies with Olumiant. If a patient develops herpes zoster, interrupt Olumiant treatment until the episode resolves.
Patients with positive hepatitis B surface antibody and hepatitis B core antibody, without hepatitis B surface antigen; such patients should be monitored for expression of hepatitis B virus (HBV) DNA. Should HBV DNA be detected, consult with a hepatologist. Perform screening for viral hepatitis in accordance with clinical guidelines before starting therapy with Olumiant.
Non-melanoma skin cancers - Periodic skin examination is recommended for patients who are at increased risk for skin cancer.
Neutropenia - Avoid initiation or interrupt Olumiant treatment in patients with an ANC less than 1000 cells/mm3. Evaluate at baseline and thereafter according to routine patient management.
Lymphopenia - Avoid initiation or interrupt Olumiant treatment in patients with an ALC less than 500 cells/mm3. Evaluate at baseline and thereafter according to routine patient management.
Anemia - Avoid initiation or interrupt Olumiant treatment in patients with hemoglobin less than 8 g/dL. Evaluate at baseline and thereafter according to routine patient management.
Liver Enzyme Elevations - Evaluate at baseline and thereafter according to routine patient management. Prompt investigation of the cause of liver enzyme elevation is recommended to identify potential cases of drug-induced liver injury. If increases in ALT or AST are observed and drug-induced liver injury is suspected, interrupt Olumiant until this diagnosis is excluded.
Lipid Elevations - Assessment of lipid parameters should be performed approximately 12 weeks following Olumiant initiation.
Because elderly patients are more likely to have decreased renal function, which will result in increased exposure of baricitinib, care should be taken in dose selection, and it may be useful to monitor renal function.