It is also recommended as an option in those who have responded inadequately to, or cannot have other DMARDs, including at least 1 biological DMARD only if the DAS28 >5.1 and they cannot have rituximab. Baricitinib can be used as monotherapy for people who cannot take methotrexate because it is contraindicated or because of intolerance as long as the other criteria for initiation are met.