OBJECTIVE: This study aimed to assess the relative efficacy and safety of 
once-daily baricitinib 2 mg and 4 mg administration in patients with active 
rheumatoid arthritis (RA).
METHODS: In this network meta-analysis, randomized controlled trials (RCTs) 
examining the efficacy and safety of baricitinib in patients with active RA were 
included. A Bayesian network meta-analysis was conducted to combine the direct 
and indirect evidence from the RCTs.
RESULTS: Seven RCTs involving 3461 patients met the inclusion criteria. There 
were ten pairwise comparisons, including seven direct comparisons and five 
interventions. The ACR20 response rate was significantly higher in the 
baricitinib 4 mg in combination with disease-modifying antirheumatic drugs 
(DMARD) group than in the placebo+DMARD group (odds ratio, OR 3.13; 95% credible 
interval, CrI 2.32-4.33). Compared with the placebo+DMARD group, the baricitinib 
4 mg, baricitinib 2 mg + DMARD, and adalimumab 40 mg + methotrexate (MTX) groups 
showed a significantly higher ACR20 response rate. The ranking probability based 
on the surface under the cumulative ranking curve (SUCRA) indicated that 
baricitinib 4 mg + DMARD was likely to elicit the best ACR20 response rate 
(SUCRA = 0.7930), followed by baricitinib 4 mg (SUCRA = 0.7034), baricitinib 
2 mg + DMARD (SUCRA = 0.6304), adalimumab 40 mg + MTX (SUCRA = 0.3687), and 
placebo+DMARD (SUCRA = 0.0045). By contrast, the safety based on the number of 
treatment-emergent adverse events (TEAEs) did not differ significantly among the 
five interventions.
CONCLUSION: Baricitinib 2 mg and 4 mg administered once daily, in combination 
with DMARD, were efficacious interventions for active RA that had no significant 
risk of TEAE development.