This information is for anyone with axial spondyloarthritis (axial SpA), including people with ankylosing spondylitis (AS)
JAK inhibitors are the newest class of drugs available to treat axial SpA
These drugs work by limiting the action of Janus kinase enzymes, which are involved in the inflammation that causes the symptoms of axial spondyloarthritis.
Like biologic drugs, these are ‘targeted’ therapies, which work on the immune response. Unlike the biologics, they can be taken in tablet form as they are small molecule therapies.
Have they been approved for use in the UK?
England, Wales and Northern Ireland
The National Institute for Health and Care Excellence (NICE) approved the use of the JAK inhibitor upadacitinib, also known by the brand name, Rinvoq, on 30 September 2022 for treating active ankylosing spondylitis that is not controlled well enough with conventional therapy in adults. NICE then approved upadacitinib (Rinvoq) or treating active non-radiographic axial spondyloarthritis in adults on 01 February 2023.
On 18 October 2023 NICE approved tofacitinib (Xeljanz) for treating active ankylosing spondylitis. It is only available as an option to people who have already tried anti TNF therapy or for whom it is unsuitable.
NICE guidance covers England, Wales and Northern Ireland.
Upadacitinib (Rinvoq) has been approved by the Scottish Medicines Consortium for treating active non radiographic axial spondyloarthritis and active ankylosing spondylitis in adults who have responded inadequately to conventional therapy.
Another JAK inhibitor called tofacitinib (Xeljanz) has also been accepted for use within NHS Scotland for treating active ankylosing spondylitis in adults who have responded inadequately to conventional therapy.
Who can take them?
People diagnosed with non-radiographic axial spondyloarthritis need to have either an MRI showing current inflammation or blood tests showing raised inflammatory markers in order to qualify for upadacitinib under NICE guidance.
It is recommended only if anti TNF medication has been tried and has not been effective OR if you are unable to take anti TNF for medical reasons.