National Institute for Health & Care Excellence (NICE) (UK) recommends Rinvoq to treat psoriatic arthritis

It is recommended only if they have peripheral arthritis with 3 or more tender joints and 3 or more swollen joints and: they have had 2 conventional DMARDs and at least 1 biological DMARD orTNF-alpha inhibitors are contraindicated but would otherwise be considered. Upadacitinib is recommended only if the company provides it according to the commercial arrangement.

Why the committee made these recommendations? People with psoriatic arthritis that is not controlled well enough after 2 conventional DMARDs usually have biological DMARDs. Many of these are already recommended by NICE for treating psoriatic arthritis. Clinical evidence shows that upadacitinib is more effective than placebo for treating active psoriatic arthritis and may be similarly as effective as adalimumab, another biological DMARD. But upadacitinib has not been directly compared with any other biological DMARD for this condition. The results of an indirect comparison are uncertain but suggest that upadacitinib is likely to work as well as other biological DMARDs. The economic model showed that upadacitinib was not cost effective compared with some biological DMARDs for people who had not had a biological DMARD before. But it was cost effective for people who had had at least 1 biological DMARD or who could not have TNF-alpha inhibitors. So upadacitinib is recommended for these people.