Upadacitinib for severe atopic dermatitis

Upadacitinib (Rinvoq)¹ is now available for primary care clinicians to approve by Special Authority for severe atopic dermatitis. 

Patients may qualify if they are already using Rinvoq and previously met all criteria.

Otherwise, they must have moderate-to-severe disease, as indicated by an EASI ≥16 or a DLQI ≥10. They need to have had insufficient benefit from topical corticosteroids or calcineurin inhibitors after a 28 day trial in the past six months, unless contraindicated. 

They must also have trialled at least one systemic therapy, such as methotrexate, for three months with inadequate benefit or contraindication. An EASI or DLQI score must have been obtained for the most recent prior treatment course, ideally during treatment or within 1 month of stopping treatment. The latest score must be less than one month old at application. The usual dose is 15–30 mg daily.