Treatment with baricitinib, an orally administered inhibitor of Janus kinases 1 and 2, improved clinical features in patients with active RA and an inadequate response to methotrexate, and was more effective than adalimumab or placebo. 70% of patients treated with 4mg baricitinib daily achieved an ACR20 response by week 12, compared with 61% of those treated with 40mg adalimumab every other week and 40% of the placebo group. Baricitinib treatment also improved radiographic progression of joint damage, and was associated with reduced neutrophil counts and increased levels of creatinine and LDL cholesterol.