1.1 Upadacitinib is recommended as an option for treating active non- radiographic axial spondyloarthritis with objective signs of inflammation (shown by elevated C-reactive protein or MRI) that is not controlled well enough with non-steroidal anti-inflammatory drugs (NSAIDs) in adults. It is recommended only if:
• tumour necrosis factor (TNF)-alpha inhibitors are not suitable or do not control the condition well enough and
• the company provides upadacitinib according to the commercial arrangement.
1.2 Assess response to upadacitinib after 16 weeks of treatment. Continue treatment only if there is clear evidence of response, defined as a reduction in:
• the Bath Ankylosing
Spondylitis Disease Activity Index (BASDAI) score to 50% of the pretreatment value or by 2 or more units and
• the spinal pain visual analogue scale (VAS) by 2 cm or more.
Reason for decision: