Baricitinib is an oral JAK1 and JAK2 inhibitor under investigation in rheumatoid arthritis (RA) subjects. In a 52-week Phase III trial, 1,307 patients suffering from RA who were taking methotrexate were randomized to baricitinib, placebo, or the TNF inhibitor adalimumab (Humira). Disease activity was measured on several standard RA disease activity scales. Baricitinib was superior to placebo in all measures (P > 0.001) and outperformed adalimumab in the American College of Rheumatology criteria at 12 weeks (70% vs. 61%; P = 0.014). Infections were more common with baricitinib. The authors concluded baricitinib was associated with significant clinical improvements as compared with placebo and adalimumab. (N Engl J Med 2017;376:652-662)