Baricitinib, as a JAK inhibitor, should be used with a focus on infection risk, thrombotic events, and medication safety in special populations. Regular monitoring of laboratory indicators and adjustment of treatment plans based on individual patient conditions are necessary.

1. Risk of infection

(1) Before treatment, it is necessary to screen for latent infection such as tuberculosis and hepatitis B virus, and it is forbidden for active infection.

(2) Bacterial, fungal, or viral infections may occur during treatment, and medication should be suspended for severe infections.

(3) The risk of opportunistic infections increases, including herpes zoster recurrence, and requires close monitoring.

2. Thrombosis formation

(1) Use with caution in patients over 65 years old or with a history of thrombosis, as it may increase the risk of deep vein thrombosis.

(2) If symptoms of thrombosis occur (such as difficulty breathing and chest pain), medication should be stopped immediately and medical attention sought.

(3) Combination hormone therapy may further increase the risk of thrombosis.

3. Laboratory monitoring

(1) Regularly monitor lymphocyte count, and adjust dosage if there is persistent hypolymphocytic anemia.

(2) When the neutrophil count is less than 1.0 × 10 ^ 9/L, treatment should be interrupted.

(3) Monitor liver and kidney function monthly, and reduce or discontinue medication for moderate to severe abnormalities.

4. Medication for special populations

(1) Pregnant women: with embryotoxicity, prohibited during pregnancy, contraception is required during medication.

(2) Breastfeeding period: Medication may be secreted into breast milk, it is recommended to discontinue medication or breastfeeding.

(3) Children: The safety of patients under 18 years old has not been established and is not recommended for use.

5. Other precautions

(1) When used in combination with potent OATP1B3/CYP3A inhibitors, the dosage should be reduced to 2mg/day.

(2) Avoid using live vaccines during vaccination as it may reduce vaccine efficacy.

(3) The risk of gastrointestinal perforation increases, especially for patients with concomitant diverticulitis who need to be vigilant.