Targeted synthetic DMARDs (tsDMARDs) for rheumatoid arthritis

As an alternative to biological DMARD therapy, targeted synthetic DMARDs (tsDMARDs) may be used for treatment of moderate to severe active RA with an insufficient response or intolerance to other csDMARDs. It is a PBS requirement that at least 2 csDMARDs must be trialled prior to assessing the need for a tsDMARD. If indicated for the management of RA, the usual dosages for tsDMARDs (listed in alphabetical order) areHo Lee, 2020:

baricitinib 4 mg orally, daily baricitinib baricitinib baricitinib

OR

tofacitinib 5 mg orally, twice daily tofacitinib tofacitinib tofacitinib

OR

upadacitinib 15 mg orally, daily. upadacitinib upadacitinib upadacitinib

For more detail on considerations for use of tsDMARDs, see Specific considerations for use of biological or targeted-synthetic disease-modifying antirheumatic drugs (b/tsDMARDs).