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Agents that inhibit components of the pro\u2010inflammatory cascade have garnered interest as potential treatment options with hopes that dampening the proinflammatory process may improve clinical outcomes. Baricitinib is a reversible Janus\u2010associated kinase (JAK)\u2010inhibitor that interrupts the signaling of multiple cytokines implicated in COVID\u201019 immunopathology. It may also have antiviral effects by targeting host factors that viruses rely for cell entry and by suppressing type I interferon driven angiotensin\u2010converting\u2010enzyme\u20102 upregulation. However, baricitinib\u2019s immunosuppressive effects may be detrimental during acute viral infections by delaying viral clearance and increasing vulnerability to secondary opportunistic infections. The lack of reliable biomarkers to monitor patients\u2019 immune status as illness evolves complicates deployment of immunosuppressive drugs like baricitinib. Furthermore, baricitinib carries the risk of increased thromboembolic events, which is concerning given the proclivity towards a hypercoagulable state in patients with COVID\u201019. In this article, we review available data on baricitinib with an emphasis on immunosuppressive and antiviral pharmacology, pharmacokinetics, safety, and current progress in COVID\u201019 clinical trials.<\/jats:p>","DOI":"10.1002\/phar.2438","type":"journal-article","created":{"date-parts":[[2020,6,15]],"date-time":"2020-06-15T14:09:04Z","timestamp":1592230144000},"page":"843-856","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":193,"title":["Baricitinib: A Review of Pharmacology, Safety, and Emerging Clinical Experience in COVID\u201019"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1333-0378","authenticated-orcid":false,"given":"Sarah C.J.","family":"Jorgensen","sequence":"first","affiliation":[{"name":"Department of Pharmacy Sinai Health System Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher L.Y.","family":"Tse","sequence":"additional","affiliation":[{"name":"Leslie Dan Faculty of Pharmacy University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Burry","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Sinai Health System Toronto Ontario Canada"},{"name":"Leslie Dan Faculty of Pharmacy University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda D.","family":"Dresser","sequence":"additional","affiliation":[{"name":"Leslie Dan Faculty of Pharmacy University of Toronto Toronto Ontario Canada"},{"name":"Antimicrobial Stewardship Program University Health Network Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,7,27]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.5394"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2020.03.041"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1985"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30566-3"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30628-0"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)13412-5"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI137244"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2020.102537"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2020.102567"},{"key":"e_1_2_12_11_1","unstructured":"Center for Drug Evaluation and Research.US Food and Drug Administration. 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