Rinvoq — Medica
non-radiographic axial spondyloarthritis
Initial criteria
- age ≥ 18 years
- Objective signs of inflammation demonstrated by at least ONE of the following: a) elevated C-reactive protein (CRP) beyond the upper limit of normal; OR b) sacroiliitis reported on magnetic resonance imaging (MRI)
- Patient meets ONE of the following: a) 3‑month trial of at least one tumor necrosis factor inhibitor; OR b) unable to tolerate a 3‑month trial of at least one tumor necrosis factor inhibitor
- Medication prescribed by or in consultation with a rheumatologist
Reauthorization criteria
- Patient has been established on therapy for at least 6 months
- Patient meets ONE of the following: a) beneficial clinical response from baseline by objective measure (e.g., ASDAS, ASQoL, BASDAI, BASFI, BAS-G, BASMI, DFI, HAQ‑S, CRP, ESR); OR b) improvement from baseline in at least one symptom such as decreased pain or stiffness, or improved function or activities of daily living
Approval duration
initial 6 months; reauth 1 year