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*NICE recommendations include:5

RINVOQ® (upadacitinib) is recommended as an option for treating moderate to severe atopic dermatitis suitable for systemic treatment in adults and young people 12 years and over, only if:

  • the disease has not responded to at least 1 other systemic immunosuppressant, or these are not suitable.
  • the company provides it according to the commercial arrangement.

Stop upadacitinib at 16 weeks if the atopic dermatitis has not responded adequately (≥ 50% reduction in EASI and ≥4 point reduction in DLQI from when treatment started).

For the full NICE recommendations, please refer to the TAG document.5

SMC ADVICE: following a full submission6

UPADACITINIB (RINVOQ®) is accepted for restricted use within NHS Scotland.

Indication under review: for the treatment of moderate to severe atopic dermatitis in adults and adolescents 12 years and older who are candidates for systemic therapy.

SMC restriction: patients who have had an inadequate response to at least one conventional systemic immunosuppressant such as ciclosporin, or in whom such treatment is considered unsuitable.

In patients with moderate to severe atopic dermatitis eligible for systemic therapy, upadacitinib was associated with significantly greater improvements in the signs and symptoms of atopic dermatitis in adults and adolescent patients in three placebo-controlled phase III studies and in adult patients in one phase III comparative study with a monoclonal antibody.

This advice applies only in the context of an approved NHS Scotland Patient Access Scheme (PAS) arrangement delivering the cost-effectiveness results upon which the decision was based, or a PAS/list price that is equivalent or lower.

Learn more about the mechanism of action in atopic dermatitis

 

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  1. RINVOQ Summary of Product Characteristics. 
  2. Guttman-Yassky E, Teixeira HD, Simpson EL, et al. Once-daily upadacitinib versus placebo in adolescents and adults with moderate-to-severe atopic dermatitis (Measure Up 1 and Measure Up 2): results from two replicate, double blind, randomised, controlled phase 3 trials. Lancet. 2021;397(10290):2151–2168.
  3. Simpson EL, Papp KA, Blauvelt A, et al. Efficacy and Safety of Upadacitinib in Patients With Moderate to Severe Atopic Dermatitis Analysis of Follow-up Data From the Measure Up 1 and Measure Up 2 Randomized Clinical Trials. JAMA Dermatol. doi:10.1001/jamadermatol.2022.0029. Published online March 9, 2022.
  4. Blauvelt A, Teixeira H, Simpson E, et al. Efficacy and Safety of Upadacitinib vs Dupilumab in Adults With Moderate-to-Severe Atopic Dermatitis. A Randomized Clinical Trial. JAMA Dermatol. 2021; Published online August 4, 2021. DOI:10.1001/jamadermatol.2021.3023
  5. © NICE 2022 Abrocitinib, tralokinumab or upadacitinib for treating moderate to severe atopic dermatitis. Available from www.nice.org.uk/guidance/.All rights reserved. Subject to Notice of rights NICE guidance is prepared for the National Health Service in England. All NICE guidance is subject to regular review and may be updated or withdrawn. NICE accepts no responsibility for the use of its content in this publication. 
  6. SMC Medicines Advice ID SMC2417. Available at: https://www.scottishmedicines.org.uk/medicines-advice (this link is to an external website which is not under the control of AbbVie. AbbVie is not responsible for content of any such site or any further links from such site).

UK-RNQD-220168. Date of preparation: August 2022

Adverse events should be reported. Reporting forms and information can be found at https://yellowcard.mhra.gov.uk or via the MHRA Yellow Card app, available in the Google Play or Apple App Stores. 
Adverse events should also be reported to AbbVie on GBPV@abbvie.com