Upadacitinib: A Convenient and Effective Alternative Treatment for Spondyloarthritis

Treatment guidelines for adults with active non-radiographic axial spondyloarthritis recommend the use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and Tumor Necrosis Factor-alpha (TNF-alpha) inhibitors. If these first-line treatments don’t work or aren’t suitable, doctors may consider secukinumab or ixekizumab (IL-17 inhibitors). Clinical trials show that upadacitinib, an oral Janus Kinase (JAK) inhibitor, can reduce symptoms and improve the quality of life in Spondyloarthritis (SpA) patients. This effectiveness rivals that of biologics. Clinicians use the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score and/or Visual Analogue Scale (VAS) score to measure this. A cost comparison shows that upadacitinib costs about the same and provides similar health benefits as secukinumab and ixekizumab.

The update suggests considering upadacitinib as an alternative to the National Institute for Health and Care Excellence (NICE) recommended Interleukin (IL)-17 inhibitors. This is especially important if conventional therapy doesn’t control the condition well enough or if TNF-alpha inhibitors aren’t suitable or effective.

Clinical and patient experts highlighted the convenience of upadacitinib over IL-17 inhibitors owing to its oral administration.