Generic name |
upadacitinib |
|
---|---|---|
Strength |
15 mg, 30 mg |
|
Form |
extended release tablets |
Special Authority criteria |
Approval period |
---|---|
Initial: For the treatment of patients 12 years of age and older with moderate to severe atopic dermatitis (AD) if the following criteria are met:
AND
AND
Please note that upadacitinib will not be covered for use in combination with any other immunomodulatory agents (including biologics) or other JAK inhibitor treatment for moderate to severe AD. |
6 months |
Renewals:
AND
Please note that upadacitinib will not be covered for use in combination with any other immunomodulatory agents (including biologics) or other JAK inhibitor treatment for moderate to severe AD. |
1 year |
EASI score and vIGA-AD score must be calculated within the 3-month period immediately preceding the special authority request