Upadacitinib (3) – Rinvoq®

Ankylosing spondylitis

Characteristics

Start date 01.02.2021 – Marketing authorisation: 22.01.2021
Resolution 15.07.2021
INN Upadacitinib
Brand name Rinvoq®
Pharm. company AbbVie Deutschland GmbH & Co. KG
G-BA Procedure ID D-639
ATC code L04AF03 IMMUNOSUPPRESSANTS (L04A)
ICD-10 codes (AIS) M45.00, M45.01, M45.02, M45.03, M45.04, M45.05, M45.06, M45.07, M45.08, M45.09
Alpha-ID codes (AIS) I28627Ankylosing spondylitis, I80914Spondylitis in chronic polyarthritis
DDD 15 mg O
Therapeutic area Musculoskeletal system diseases Axial spondyloarthritis / Ankylosing spondylitis (Bechterews disease)
Reason for procedure New therapeutic indication
Specialty Bundling

Therapeutic indication of the resolution

RINVOQ is indicated for the treatment of active ankylosing spondylitis in adult patients who have responded inadequately to conventional therapy.

Subpopulation Indication Comparator
a1) Adults with active radiographic axial spondyloarthritis who have had an inadequate response to conventional therapy. A TNF-α inhibitor (etanercept or adalimumab or infliximab or golimumab or certolizumab pegol) or an IL17 inhibitor (secukinumab).
a2) Adults with active radiographic axial spondyloarthritis who have had an inadequate response to, or intolerance to, previous biologic antirheumatic drug (bDMARD) therapy. Switching to another biological disease-modifying antirheumatic drug: TNF-α inhibitor (adalimumab or certolizumab pegol or etanercept or golimumab or infliximab) or IL17 inhibitor (secukinumab).

Studies and Results

No. of studies
(best subpopulation)
0 (Data not accepted)
Study design
(best subpopulation)
Data not accepted (Dossier: H2H vs. ACT (off-label))
Reason for dividing into subpopulations (G-BA) Previous treatment

  • Clinical trials
    • The SELECT-AXIS-1 trial submitted with the dossier is a placebo-controlled RCT.
    • The study included adult patients with active ankylosing spondylitis who had shown an inadequate response to treatment with non-steroidal anti-inflammatory drugs (NSAIDs) or who were intolerant to them.
    • They were randomised 1:1 to receive either upadacitinib 15 mg once daily or placebo.

a1) Adults with active radiographic axial spondyloarthritis who have responded inadequately to conventional therapy

  • For adult patients with active radiographic axial spondyloarthritis who have responded inadequately to conventional therapy, the additional benefit of upadacitinib compared with the appropriate comparator therapy is not proven.
  • Overall, for adults with active radiographic axial spondyloarthritis (axSpA) who have responded inadequately to conventional therapy, the additional benefit of upadacitinib compared with the appropriate comparator therapy is not proven.
  • Overall assessment
    • In its dossier for the assessment of the additional benefit of upadacitinib, the pharmaceutical manufacturer does not present any suitable direct comparative studies against the appropriate comparator therapy.
    • Furthermore, no indirect comparisons were submitted to address the issues raised in the benefit assessment.
    • In this placebo-controlled registration trial, the appropriate comparator therapy was not implemented; consequently, no suitable data are available from this trial for the early benefit assessment.

a2) Adults with active radiographic axial spondyloarthritis who have had an inadequate response to, or who are intolerant of, prior treatment with biological anti-rheumatic drugs (bDMARDs)

  • For adult patients with active radiographic axial spondyloarthritis who have responded inadequately to prior treatment with biological anti-rheumatic drugs (bDMARDs) or who are intolerant to such treatment, the additional benefit of upadacitinib compared with the appropriate comparator therapy is not proven.
  • Overall, for adults with active radiographic axSpA who have responded inadequately to prior treatment with biological anti-rheumatic drugs (bDMARDs) or who are intolerant to such treatment, the additional benefit of upadacitinib compared with the appropriate comparator therapy is not proven.
  • Overall assessment
    • In its dossier for the assessment of the additional benefit of upadacitinib, the pharmaceutical manufacturer does not present any direct comparative studies against the appropriate comparator therapy.
    • Furthermore, no indirect comparisons were submitted to address the issues raised in the benefit assessment.

Courtesy translation only, please refer to the German original.

Associated procedures

Upadacitinib (8) Rinvoq® AbbVie Deutschland GmbH & Co. KG Musculoskeletal system diseases Giant cell arteritis 13,100–15,900 20% Hint for minor additional benefit
Upadacitinib (7) Rinvoq® AbbVie Deutschland GmbH & Co. KG Digestive system diseases Morbus Crohn, pretreated 18,900–35,350 100% additional benefit not proven
Upadacitinib (5) Rinvoq® AbbVie Deutschland GmbH & Co. KG Digestive system diseases Ulcerative colitis (UC), pre-treated 5,300–25,000 100% additional benefit not proven
Upadacitinib (6) Rinvoq® AbbVie Deutschland GmbH & Co. KG Musculoskeletal system diseases Axial spondyloarthritis (AS), non-radiographic 19,500 100% additional benefit not proven
Upadacitinib (4) Rinvoq® AbbVie Deutschland GmbH & Co. KG Skin diseases Atopic dermatitis (AD), ≥ 12 years 57,300–62,850 33% Indication of considerable additional benefit
Upadacitinib (2) Rinvoq® AbbVie Deutschland GmbH & Co. KG Skin diseases Psoriasis arthritis (PA) 29,100 69% Hint for considerable additional benefit
Upadacitinib (3) Rinvoq® AbbVie Deutschland GmbH & Co. KG Musculoskeletal system diseases Ankylosing spondylitis 7,800–16,800 100% additional benefit not proven
Upadacitinib (1) Rinvoq® AbbVie Deutschland GmbH Musculoskeletal system diseases Rheumatoid arthritis (RA) 88,709–188,210 34% Hint for considerable additional benefit


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