Research in Brief

The Janus kinase inhibitor baricitinib might be a safe and effective treatment option for patients with juvenile idiopathic arthritis, according to a phase 3 trial by Athimalaipet Ramanan and colleagues. After a 2-week safety and pharmacokinetic period, 219 patients with polyarticular juvenile idiopathic arthritis, extended oligoarticular juvenile idiopathic arthritis, enthesitis-related arthritis, or juvenile psoriatic arthritis and an inadequate response or intolerance to disease-modifying antirheumatic drugs (DMARDs) received open-label baricitinib for a 12-week lead-in period. 163 (74%) patients had a Juvenile Idiopathic Arthritis-American College of Rheumatology 30 response at week 12 and were randomly assigned to placebo (n=81) or baricitinib (n=82) in the 32-week double-blind withdrawal period. Time to disease flare during withdrawal (primary outcome) was 27·14 weeks (95% CI 15·29–not estimable) in the placebo group, and not evaluable for patients in the baricitinib group (<50% had a flare; hazard ratio 0·24 [95% CI 0·13–0·45], p<0·0001). Serious adverse events occurred in six (3%) patients who received baricitinib during the open-label phase, and in four (5%) of 82 patients in the baricitinib group and three (4%) of 81 patients in the placebo group during the double-blind phase. Opioid analgesia for acute low back pain and neck pain (the OPAL trial): a randomised placebo-controlled trialOpioids should not be recommended for acute non-specific low back pain or neck pain given that we found no significant difference in pain severity compared with placebo. This finding calls for a change in the frequent use of opioids for these conditions. Full-Text PDF Baricitinib in juvenile idiopathic arthritis: an international, phase 3, randomised, double-blind, placebo-controlled, withdrawal, efficacy, and safety trialBaricitinib was efficacious with an acceptable safety profile in the treatment of polyarticular juvenile idiopathic arthritis, extended oligoarticular juvenile idiopathic arthritis, enthesitis-related arthritis, and juvenile psoriatic arthritis, after inadequate response or intolerance to standard therapy. Full-Text PDF