AbbVie’s Rinvoq expands reimbursement in Korea for psoriatic arthritis

AbbVie’s JAK inhibitor Rinvoq (ingredient: upadacitinib) has become the first drug in its class to receive reimbursement for the treatment of adult patients with active and progressive psoriatic arthritis (PsA) in Korea, signaling a major expansion of treatment options in a therapeutic area historically dominated by injectable biologics.

The new reimbursement status, which took effect on June 1, was celebrated through a media briefing held on Wednesday in Seoul. The session highlighted the clinical rationale behind the reimbursement decision and the potential benefits of Rinvoq as the only reimbursed oral JAK inhibitor for PsA in Korea.

Professor Hong Seung-jae of the Department of Rheumatology at Kyung Hee University Medical Center noted that psoriatic arthritis is a chronic inflammatory disease affecting both the skin and joints, often impairing quality of life and daily functioning, particularly as it tends to strike during patients’ most productive years.

Psoriatic arthritis is considered a rare disease in Korea, with a prevalence of approximately 0.017 percent. Diagnosis can be challenging due to its diverse clinical presentations, which may include peripheral arthritis, nail dystrophy, enthesitis, and axial involvement. Up to 30 percent of patients with psoriasis eventually develop joint symptoms, often after years of cutaneous disease.

“Treatment goals in PsA focus on achieving remission or at least low disease activity, targeting both joint inflammation and skin symptoms,” Professor Hong said. “Rinvoq has demonstrated consistent efficacy in improving both domains starting as early as 12 weeks, regardless of prior biologic treatment, making it a highly practical option.”

While biologic DMARDs (bDMARDs) have been a mainstay of PsA treatment, many patients face logistical and psychological barriers to injectable therapies.

“Patients often delay treatment because of the burden of storing or visiting clinics for injectables,” Hong explained. “An oral medication like Rinvoq reduces that barrier, enabling earlier and more consistent therapy.”

The reimbursement was based on positive results from the global phase 3 SELECT-PsA1 and SELECT-PsA2 trials. SELECT-PsA1 enrolled patients with inadequate response to conventional DMARDs, while SELECT-PsA2 enrolled those who had failed at least one bDMARD.

In SELECT-PsA1, 70.6 percent of patients taking Rinvoq 15 mg achieved ACR20 (20 percent improvement in joint symptoms) at week 12, compared to 36.2 percent in the adalimumab group. Longer-term follow-up confirmed sustained efficacy, with ACR50 and ACR70 rates of 53.6 and 38 percent, respectively, at 104 weeks.

In SELECT-PsA2, patients previously unresponsive to biologics also benefited, with an ACR20 response rate of 56.9 percent at week 12, significantly outperforming the adalimumab group (24.1 percent). Treatment effects were sustained through 152 weeks.

Under current Korean reimbursement criteria, Rinvoq is covered for adults with active and progressive PsA who have been treated with at least two DMARDs for a total of six months (three months each) without sufficient efficacy or who discontinued due to adverse events. After initiation, reimbursement is maintained if joint symptoms improve by at least 30 percent after three months, with assessments required every six months thereafter.

Professor Hong emphasized that Rinvoq’s oral formulation is particularly advantageous for patients previously treated with oral DMARDs.

“Many patients find it easier to continue on another oral option rather than transitioning to injections,” he said. “This contributes to better adherence, which is crucial in managing a chronic systemic disease like PsA.”

Hong further added that the early onset of Rinvoq’s clinical effect supports its use even earlier in the treatment pathway.

However, Hong also pointed to limitations in the current reimbursement framework, particularly in other rheumatic diseases. While Rinvoq is reimbursed for six of its seven approved indications in Korea, including rheumatoid arthritis, atopic dermatitis, and Crohn’s disease, it is only reimbursed as a second-line therapy in ankylosing spondylitis.

“Treatment delays caused by current reimbursement rules, such as requiring radiographic evidence or biologic failure before covering Rinvoq, limit patient access to early intervention,” Hong said. “Policymakers should consider updating reimbursement criteria to reflect the importance of early, effective treatment and the benefits of oral therapies in chronic disease management.”