Abstract:Objective To investigate the efficacy and safety of baricitinib in combination with iguratimod in the treatment of refractory rheumatoid arthritis (RRA). Methods Fifteen RRA patients admitted to Affiliated Southeast Hospital of Xiamen University from August 2021 to December 2022 were selected and treated with iguratimod (25 mg, bid) combined with baricitinib (4 mg, qd) for 24 weeks. The changes in swelling joint count (SJC), tenderness joint count (TJC), hypersensitive C-reactive protein (hs-CRP), Disease Activity Score using 28 joint counts (DAS28) CRP, and adverse reactions were observed after 12 and 24 weeks of treatment. Results All 15 patients with RRA had different degrees of remission. Compared with before treatment, TJC and SJC decreased, while hs-CRP levels and DAS28-CRP decreased after 12 weeks and 24 weeks of treatment (P＜0.05). After 24 weeks of treatment, 3 cases achieved clinical remission (DAS28-CRP≤2.6), and 6 cases achieved low disease activity (2.6＜DAS28-CRP≤3.2), with a compliance rate of 60.0% (9/15). All patients had good tolerance, without any adverse reactions such as herpes zoster, thrombotic events, liver and kidney damage. Conclusion Baricitinib combined with iguratimod is highly effective and safety in treating patients with RRA.