J Rheumatol. 2021 Sep 15:jrheum.210346.Oral baricitinib maintained lower levels of radiographic progression than initial csDMARD or placebo through 5 years in patients with active RA.It is well known that persistent joint inflammation in RA can lead to irreversible structural damage that impacts on patient physical function and quality-of-life. To this end, van der Heijde, et al. evaluated the effect of baricitinib on inhibiting radiographic progression of structural joint damage over 5 years in patients with active RA. Results from their analysis suggest that early introduction of an agent that inhibits radiographic progression, such as baricitinib, is more effective in preventing long-term radiographic progression than initial csDMARD or placebo.