Although upadacitib is a new type of medication for AS, it has already been approved and is being used in the UK for rheumatoid arthritis (RA). It is a selective, reversible Janus kinase (JAK) inhibitor. It works on the immune response by targeting the enzyme JAK. The other big thing that’s different about this medication is that it is taken in tablet form rather than as an injection.
The clinical trials show Rinvoq is effective in AS and has a safety profile consistent with that observed in RA.
Although it’s been approved by the EMA, it will still have to be approved by the National Institute for Health and Care Excellence (NICE) and the Scottish Medicines Consortium (SMC) in the same way as other biologic medications. This is because it is a high cost medication.
NICE and the SMC will decide if it should be used within the UK for AS and what restrictions they will put on its use. For example, anti TNF can only be used for people with severe active ankylosing spondylitis or severe non-radiographic axial spondyloarthritis who have tried non-steroidal anti-inflammatory drugs (NSAIDs), but they have not worked or caused side effects.
These approvals are likely to take some time but it’s good to know there’s potentially a new option on its way.