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A Study to Investigate the Safety and Efficacy of Elsubrutinib and Upadacitinib Given Alone or in Combination in Participants With Moderately to Severely Active Systemic Lupus Erythematosus (SLE)

Phase 2
Completed
Conditions
Systemic Lupus Erythematosus (SLE)
Interventions
Registration Number
NCT03978520
Lead Sponsor
AbbVie
Brief Summary

The main objective of this study was to evaluate the safety and efficacy of elsubrutinib, upadacitinib (UPA), and ABBV-599 (elsubrutinib/upadacitinib) High Dose and Low Dose combinations vs placebo for the treatment of signs and symptoms of Systemic Lupus Erythematosus (SLE) in participants with moderately to severely active SLE and to define doses for further development.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
341
Inclusion Criteria
  • Participant has clinical diagnosis of Systemic Lupus Erythematosus (SLE) at least 24 weeks prior to Screening, meeting at least 4 of the 11 revised Criteria for Classification of SLE according to the 1997 Update of the 1982 American College of Rheumatology (ACR) OR meeting at least 4 of the 2012 SLICC classification criteria, including at least 1 clinical criterion and 1 immunologic criterion.

  • At Screening, must have at least one of the following:

    • antinuclear antibody (ANA)+ (titer ≥ 1:80)
    • anti-dsDNA+
    • anti-Smith+
  • SLEDAI-2K (SLE Disease Activity Index) ≥ 6 despite background therapy as reported and independently adjudicated (clinical score ≥ 4, excluding lupus headache and/or organic brain syndrome) at Screening:

    • If 4 points of the required entry points are for arthritis, there must also be a minimum of 3 tender and 3 swollen joints.
    • If participant has rash and Principal Investigator (PI) considers it to be attributable to SLE, participant must consent to skin photograph collection for adjudication.
    • Score must be re-confirmed at the Baseline visit.
  • Physician's Global Assessment (PhGA) ≥ 1 during screening period.

  • Must be on background treatment, stable for 30 days prior to Baseline and throughout the study with antimalarial(s), prednisone (or prednisone equivalent) (≤ 20 mg), azathioprine (≤ 150 mg), mycophenolate (<2 g), leflunomide (≤ 20 mg), cyclosporine, tacrolimus, and/or methotrexate (MTX) (≤ 20 mg).

    • No combinations of the above with immunomodulators other than prednisone (or equivalents) and antimalarials.
Exclusion Criteria
  • Participant using intravenous (IV) or intramuscular (IM) corticosteroids greater than or equal to a 40 mg prednisone-equivalent bolus within 30 days of planned randomization.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Elsubrutinib placebo/upadacitinib placeboPlacebo for elsubrutinibPlacebo capsule for elsubrutinib once a day by mouth for up to 48 weeks; placebo film-coated tablet for upadacitinib once a day by mouth for up to 48 weeks
Elsubrutinib placebo/upadacitinib placeboPlacebo for upadacitinibPlacebo capsule for elsubrutinib once a day by mouth for up to 48 weeks; placebo film-coated tablet for upadacitinib once a day by mouth for up to 48 weeks
ABBV-599 High Dose (Elsubrutinib 60 mg/upadacitinib 30 mg)Elsubrutinib60 mg elsubrutinib capsule once a day by mouth for up to 48 weeks; 30 mg upadacitinib film-coated tablet once a day by mouth for up to 48 weeks
ABBV-599 High Dose (Elsubrutinib 60 mg/upadacitinib 30 mg)Upadacitinib60 mg elsubrutinib capsule once a day by mouth for up to 48 weeks; 30 mg upadacitinib film-coated tablet once a day by mouth for up to 48 weeks
Elsubrutinib placebo/upadacitinib 30 mgPlacebo for elsubrutinibPlacebo capsule for elsubrutinib once a day by mouth for up to 48 weeks; 30 mg upadacitinib film-coated tablet once a day by mouth for up to 48 weeks
Elsubrutinib placebo/upadacitinib 30 mgUpadacitinibPlacebo capsule for elsubrutinib once a day by mouth for up to 48 weeks; 30 mg upadacitinib film-coated tablet once a day by mouth for up to 48 weeks
ABBV-599 Low Dose (Elsubrutinib 60 mg/upadacitinib 15 mg)Elsubrutinib60 mg elsubrutinib capsule once a day by mouth for up to 24 weeks; 15 mg upadacitinib film-coated tablet once a day by mouth for up to 24 weeks
ABBV-599 Low Dose (Elsubrutinib 60 mg/upadacitinib 15 mg)Upadacitinib60 mg elsubrutinib capsule once a day by mouth for up to 24 weeks; 15 mg upadacitinib film-coated tablet once a day by mouth for up to 24 weeks
Elsubrutinib 60 mg/upadacitinib placeboElsubrutinib60 mg elsubrutinib capsule once a day by mouth for up to 24 weeks; placebo film-coated tablet for upadacitinib once a day by mouth for up to 24 weeks
Elsubrutinib 60 mg/upadacitinib placeboPlacebo for upadacitinib60 mg elsubrutinib capsule once a day by mouth for up to 24 weeks; placebo film-coated tablet for upadacitinib once a day by mouth for up to 24 weeks
Primary Outcome Measures
NameTimeMethod
Percentage of Participants Achieving SLE Responder Index (SRI)-4 and Steroid Dose ≤ 10 mg Prednisone Equivalent Once a Day (QD) at Week 24Baseline, Week 24

SLE Responder Index (SRI)-4 is defined as follows with all criteria compared to Baseline:

* ≥ 4-point reduction in Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) score

* No worsening of the overall condition (\< 0.3 point increase in Physician's Global Assessment \[PhGA\])

* No new British Isles Lupus Assessment Group (BILAG) A or more than 1 new BILAG B disease activity scores (i.e., no organ system changes from baseline B/C/D/E to A and no more than 1 organ system changes from baseline C/D/E to B). A letter score is assigned to each organ system with following indications: A = severe, B = moderate, C = mild, D = inactive with prior history, and E = inactive with no history.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants Achieving British Isles Lupus Assessment Group (BILAG) Based Combined Lupus Assessment (BICLA) Response at Week 24Baseline, Week 24

BICLA is a composite responder index. Achievement of BICLA response is defined as improvement in all initial A and B BILAG scores, with no more than one new BILAG B score without worsening of the overall condition (no worsening in Physician's Global Assessment \[PhGA\], \< 0.3 point increase) and no worsening of the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) score.

Percentage of Participants Achieving SLE Responder Index (SRI)-4 at Week 24Baseline, Week 24

SLE Responder Index (SRI)-4 is defined as follows with all criteria compared to Baseline:

* ≥ 4-point reduction in Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) score

* No worsening of the overall condition (\< 0.3 point increase in Physician's Global Assessment \[PhGA\])

* No new British Isles Lupus Assessment Group (BILAG) A or more than 1 new BILAG B disease activity scores (i.e., no organ system changes from baseline B/C/D/E to A and no more than 1 organ system changes from baseline C/D/E to B). A letter score is assigned to each organ system with following indications: A = severe, B = moderate, C = mild, D = inactive with prior history, and E = inactive with no history.

Percentage of Participants Achieving Lupus Low Disease Activity State (LLDAS) at Week 24Baseline, Week 24

LLDAS is a state of low disease activity based on Systemic Lupus Erythematosus Disease Activity Index 2000 score (SLEDAI-2K score ≤4 excluding SLEDAI-2K activity in major organ systems), absence of SLE disease activity in major organ systems and new disease activity, Physician's Global Assessment (PhGA ≤1), and concomitant medication usage (steroid dose ≤7.5 mg QD and toleration of immunosuppressive drugs at standard maintenance doses).

Change From Baseline in Daily Prednisone Dose at Week 24From Baseline to Week 24

Participants' current use of steroid therapy was assessed at each study visit, and the amount of daily prednisone was documented.

Number of Flares Per Patient-year by Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA) SLEDAI Flare Index Through Week 24From Baseline to Week 24

The SELENA SLEDAI flare index defines mild/moderate or severe SLE flares using the SLEDAI score, definitions of worsening signs and symptoms, treatment changes, and Physician's Global Assessment of Disease Activity.

Trial Locations

Locations (160)

Arizona Arthritis & Rheumatology Research, PLLC /ID# 214522

🇺🇸

Mesa, Arizona, United States

AZ Arthritis and Rheumotology Research, PLLC /ID# 211329

🇺🇸

Phoenix, Arizona, United States

AZ Arthritis and Rheumotology Research, PLLC /ID# 214267

🇺🇸

Phoenix, Arizona, United States

Arthritis and Rheumatism Associates /ID# 211411

🇺🇸

Jonesboro, Arkansas, United States

Wallace Rheumatic Studies Center, LLC /ID# 211600

🇺🇸

Beverly Hills, California, United States

Arthritis & Osteo Medical Ctr /ID# 228235

🇺🇸

La Palma, California, United States

Valerius Medical Group & Research Center /ID# 211599

🇺🇸

Los Alamitos, California, United States

East Bay Rheumatology Medical /ID# 211638

🇺🇸

San Leandro, California, United States

The Lundquist Institute at Harbor-UCLA Medical Center /ID# 213402

🇺🇸

Torrance, California, United States

Medvin Clinical Research /ID# 211996

🇺🇸

Tujunga, California, United States

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Arizona Arthritis & Rheumatology Research, PLLC /ID# 214522
🇺🇸Mesa, Arizona, United States

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