This study reported that tofacitinib 10mg + MTX and baricitinib 4mg + MTX were the most efficacious interventions for RA patients with inappropriate response to DMARDs or biologics therapy. Also, they do not showed significant SAEs. But, long-term studies are awaited in a large number of patients with active RA that is inadequately responsive to MTX or biologics to determine the relative efficacy and safety of tofacitinib and baricitinib.

In RA patients with inadequate response to DMARDs or biologics the relative effectiveness and safety outcomes of tofacitinib and baricitinib were identified in this study.

The Bayesian network meta-analysis was carried out and the evidence from RCTs was combined to evaluate the safety and efficacy of baricitinib and tofacitinib in combination with DMARDs in RA patients with an inadequate DMARD or biologics. 

It was found out that as per ACR20 response the Tofacitinib 10 mg + methotrexate and baricitinib 4 mg + methotrexate was ranked the most efficacious for active RA with an inadequate DMARD or biologic response. Then was the efficacy of baricitinib 2 mg + methotrexate, tofacitinib 5 mg + methotrexate, and adalimumab + methotrexate. There was no notable difference in the incidence of serious adverse events after all the evaluated treatments.

In this analysis, it was observed that tofacitinib 10 mg + MTX and baricitinib 4 mg + MTX were the most effective treatments in active RA patients with an inadequate DMARD or biologic response and have no significant risk of serious adverse events.