A Phase 2b/3, Randomized, Double-Blind Study Comparing Upadacitinib (ABT-494) to Placebo in Japanese Subjects With Moderately to Severely Active Rheumatoid Arthritis Who Are on a Stable Dose of Conventional Synthetic Disease-Modifying Anti-Rheumatic Drugs (csDMARDs) and Have an Inadequate Response to csDMARDs
试验速览
- 阶段
- 2 期
- 状态
- 已完成
- 发起方
- 入组人数
- 197
- 试验地点
- 50
- 主要终点
- Percentage of Participants With an American College of Rheumatology 20% (ACR20) Response at Week 12
研究概览
简要总结
This is a randomized, double-blind study comparing ABT-494 to placebo in Japanese participants with moderately to severely active rheumatoid arthritis who are on a stable dose of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) and have an inadequate response.
Following marketing approval of upadacitinib for rheumatoid arthritis in Japan, this study will become a post-marketing clinical study and include a long-term extension period.
详细描述
This study consisted of a 35-day screening period; a 12-week randomized, double-blind, parallel-group, placebo-controlled treatment period (Period 1); a 248-week blinded long-term extension period (Period 2); and a 30-day follow-up period (call or visit).
Participants who met eligibility criteria were randomized in a 3:3:3:1:1:1 ratio to one of six treatment groups:
- Group 1: Upadacitinib 7.5 mg QD (Period 1) → upadacitinib 7.5 mg QD (Period 2)
- Group 2: Upadacitinib 15 mg QD (Period 1) → upadacitinib 15 mg QD (Period 2)
- Group 3: Upadacitinib 30 mg QD (Period 1) → upadacitinib 30 mg QD (Period 2)
- Group 4: Placebo (Period 1) → upadacitinib 7.5 mg QD (Period 2)
- Group 5: Placebo (Period 1) → upadacitinib 15 mg QD (Period 2)
- Group 6: Placebo (Period 1) → upadacitinib 30 mg QD (Period 2)
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Diagnosis of rheumatoid arthritis (RA) for >= 3 months who also fulfill the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification criteria for RA.
- •Subjects have been receiving conventional synthetic disease-modifying anti-rheumatic drug (csDMARD) therapy >= 3 months and on a stable dose for >= 4 weeks prior to the first dose of study drug.
- •Subject has >= 6 swollen joints (based on 66 joint counts) and >= 6 tender joints (based on 68 joint counts) at Screening and Baseline Visits.
- •Subjects with prior exposure to at most one biological disease-modifying anti-rheumatic drug (bDMARD) may be enrolled (up to 20% of total number of subjects) after the required washout period. Specifically, prior to enrollment:
- •Subjects with limited exposure to bDMARD (< 3 months) OR
- •Subjects who are responding to bDMARD therapy but had to discontinue due to intolerability (regardless of treatment duration).
排除标准
- •Prior exposure to any Janus kinase (JAK) inhibitor
- •Subjects who are considered inadequate responders (lack of efficacy) to bDMARD therapy, after minimum 3 months treatment, as determined by the Investigator.
- •History of any arthritis with onset prior to age 17 years or current diagnosis of inflammatory joint disease other than RA (including but not limited to gout, systemic lupus erythematosus, psoriatic arthritis, axial spondyloarthritis [SpA] including ankylosing spondylitis and non-radiographic axial SpA, reactive arthritis, overlap connective tissue diseases, scleroderma, polymyositis, dermatomyositis, fibromyalgia [currently with active symptoms]). Current diagnosis of secondary Sjogren's Syndrome is permitted.
研究组 & 干预措施
Placebo / Upadacitinib 7.5 mg
Period 1: Participants will receive placebo once daily for 12 weeks.
Period 2: Participants will receive Upadacitinib 7.5 mg once daily for 248 weeks.
干预措施: Placebo (Drug)
Placebo / Upadacitinib 7.5 mg
Period 1: Participants will receive placebo once daily for 12 weeks.
Period 2: Participants will receive Upadacitinib 7.5 mg once daily for 248 weeks.
干预措施: Upadacitinib (Drug)
Placebo / Upadacitinib 15 mg
Period 1: Participants will receive placebo once daily for 12 weeks.
Period 2: Participants will receive upadacitinib 15 mg once daily for 248 weeks.
干预措施: Placebo (Drug)
Placebo / Upadacitinib 15 mg
Period 1: Participants will receive placebo once daily for 12 weeks.
Period 2: Participants will receive upadacitinib 15 mg once daily for 248 weeks.
干预措施: Upadacitinib (Drug)
Placebo / Upadacitinib 30 mg
Period 1: Participants will receive placebo once daily for 12 weeks.
Period 2: Participants will receive upadacitinib 30 mg once daily until regulatory approval of RA indication in Japan at which point they will switch to receive upadacitinib 15 mg once daily. Participants will receive upadacitinib for 248 weeks.
干预措施: Placebo (Drug)
Placebo / Upadacitinib 30 mg
Period 1: Participants will receive placebo once daily for 12 weeks.
Period 2: Participants will receive upadacitinib 30 mg once daily until regulatory approval of RA indication in Japan at which point they will switch to receive upadacitinib 15 mg once daily. Participants will receive upadacitinib for 248 weeks.
干预措施: Upadacitinib (Drug)
Upadacitinib 7.5 mg / Upadacitinib 7.5 mg
Period 1: Participants will receive upadacitinib 7.5 mg once daily for 12 weeks.
Period 2: Participants will receive upadacitinib 7.5 mg once daily for 248 weeks.
干预措施: Upadacitinib (Drug)
Upadacitinib 15 mg / Upadacitinib 15 mg
Period 1: Participants will receive upadacitinib 15 mg once daily for 12 weeks.
Period 2: Participants will receive upadacitinib 15 mg once daily for 248 weeks.
干预措施: Upadacitinib (Drug)
Upadacitinib 30 mg / Upadacitinib 30 mg
Period 1: Participants will receive upadacitinib 30 mg once daily for 12 weeks.
Period 2: Participants will receive upadacitinib 30 mg once daily until regulatory approval of RA indication in Japan at which point they will switch to receive upadacitinib 15 mg once daily. Participants will receive upadacitinib for 248 weeks.
干预措施: Upadacitinib (Drug)
结局指标
主要结局
Percentage of Participants With an American College of Rheumatology 20% (ACR20) Response at Week 12
时间窗: Baseline and Week 12
Participants who met the following 3 conditions for improvement from baseline were classified as meeting the ACR20 response criteria: 1. ≥ 20% improvement in 68-tender joint count; 2. ≥ 20% improvement in 66-swollen joint count; and 3. ≥ 20% improvement in at least 3 of the 5 following parameters: * Physician global assessment of disease activity * Patient global assessment of disease activity * Patient assessment of pain * Health Assessment Questionnaire - Disability Index (HAQ-DI) * High-sensitivity C-reactive protein (hsCRP).
次要结局
- Percentage of Participants With an American College of Rheumatology 50% (ACR50) Response at Week 12(Baseline and Week 12)
- Percentage of Participants With an American College of Rheumatology 70% (ACR70) Response at Week 12(Baseline and Week 12)
- Change From Baseline in Short-Form 36 (SF-36) Physical Component Score (PCS) at Week 12(Baseline and Week 12)
- Change From Baseline in Disease Activity Score 28 (DAS28) (CRP) at Week 12(Baseline and Week 12)
- Change From Baseline in Rheumatoid Arthritis Work Instability Scale (RA-WIS) at Week 12(Baseline and Week 12)
- Percentage of Participants Achieving Low Disease Activity (LDA) Based on DAS28(CRP) at Week 12(Week 12)
- Percentage of Participants Achieving Clinical Remission (CR) Based on DAS28(CRP) at Week 12(Week 12)
- Change From Baseline in in Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F) at Week 12(Baseline and Week 12)
- Change From Baseline in Health Assessment Questionnaire - Disability Index (HAQ-DI) at Week 12(Baseline and Week 12)
- Percentage of Participants With an American College of Rheumatology 20% (ACR20) Response at Week 1(Baseline and Week 1)
- Change From Baseline in the Severity of Morning Stiffness at Week 12(Baseline and Week 12)
