| E.1 Medical condition or disease under investigation | 
| E.1.1 | Medical condition(s) being investigated  | 
| Polyarticular-course juvenile idiopathic arthritis | 
 
 
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| E.1.1.1 | Medical condition in easily understood language  | 
| Childhood arthritis in several joints | 
 
 
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| E.1.1.2 | Therapeutic area  | Diseases [C] - Musculoskeletal Diseases [C05] | 
| MedDRA Classification | 
| E.1.2 Medical condition or disease under investigation | 
| E.1.2 | Version  | 13.1 | 
 
| E.1.2 | Level  | LLT | 
 
| E.1.2 | Classification code  | 10059176 | 
 
| E.1.2 | Term  | Juvenile idiopathic arthritis | 
 
| E.1.2 | System Organ Class  | 10028395 - Musculoskeletal and connective tissue disorders | 
 
 
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| E.1.3 | Condition being studied is a rare disease  |  No  | 
| E.2 Objective of the trial | 
| E.2.1 | Main objective of the trial  | 
Primary Objective (from Part II)
 To compare the proportion of patients on tocilizumab versus placebo who develop a JIA ACR30 flare (compared to week 16) by week 40. | 
 
 
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| E.2.2 | Secondary objectives of the trial  | 
• To evaluate the efficacy of open-label tocilizumab therapy (Part I), 
 • To evaluate the long-term effect of tocilizumab on the maintenance of clinical response and safety in patients with pcJIA (Part III)
 • To evaluate the efficacy and safety of 8 mg/kg vs 10 mg/kg in patients < 30 kg (Parts I, II and III) | 
 
 
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| E.2.3 | Trial contains a sub-study  |  No  | 
| E.3 | Principal inclusion criteria  | 
children/juveniles, 2-17 years of age 
 polyarticular-course juvenile idiopathic arthritis (pcJIA) >/=6 months duration 
 active disease (>/=5 active joints, >/=3 with limitation of motion) 
 inadequate response to or inability to tolerate methotrexate 
 methotrexate, oral corticosteroids and NSAIDs at stable dose (at least 8, 4 and 2 weeks, respectively) prior to and including baseline 
 biologics discontinued, between at least 1 and 20 weeks prior to and including baseline, depending on biologic  | 
 
 
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| E.4 | Principal exclusion criteria | 
auto-immune, rheumatic disease or overlap syndrome other than polyarticular-course JIA 
 wheelchair bound or bedridden 
 intraarticular, intramuscular, intravenous or long-acting corticosteroids within 4 weeks prior to and including baseline 
 DMARDs (other than methotrexate) within 4 weeks prior to and including baseline 
 previous treatment with tocilizumab 
 
 | 
 
 
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| E.5 End points | 
| E.5.1 | Primary end point(s) | 
Part II 
 Proportion of patients who develop a JIA ACR30 flare (relative to week 16) in the period from week 16 up to and including week 40. | 
 
 
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| E.5.1.1 | Timepoint(s) of evaluation of this end point | 
| First JIA ACR30 flare between visit weeks 16 and 40.  | 
 
 
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| E.5.2 | Secondary end point(s) | 
• Proportion of patients with JIA ACR30/50/70/90 responses at week 40. 
 • Mean absolute change from baseline in each component of the JIA core set at week 40. 
 • Mean absolute change from baseline in pain VAS at week 40.
 • Proportion of patients with inactive disease at week 40. 
 
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| E.5.2.1 | Timepoint(s) of evaluation of this end point | 
 | 
| E.6 and E.7 Scope of the trial | 
| E.6 | Scope of the trial | 
| E.6.1 | Diagnosis |  No  | 
| E.6.2 | Prophylaxis |  No  | 
| E.6.3 | Therapy |  Yes  | 
| E.6.4 | Safety |  Yes  | 
| E.6.5 | Efficacy |  Yes  | 
| E.6.6 | Pharmacokinetic |  Yes  | 
| E.6.7 | Pharmacodynamic |  Yes  | 
| E.6.8 | Bioequivalence |  No  | 
| E.6.9 | Dose response |  No  | 
| E.6.10 | Pharmacogenetic |  No  | 
| E.6.11 | Pharmacogenomic |  No  | 
| E.6.12 | Pharmacoeconomic |  No  | 
| E.6.13 | Others |  Yes  | 
| E.6.13.1 | Other scope of the trial description | 
| Immunogenicity, QoL Assessments | 
 
 
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| E.7 | Trial type and phase | 
| E.7.1 | Human pharmacology (Phase I) |  No  | 
| E.7.1.1 | First administration to humans |  No  | 
| E.7.1.2 | Bioequivalence study |  No  | 
| E.7.1.3 | Other |  No  | 
| E.7.1.3.1 | Other trial type description |  | 
| E.7.2 | Therapeutic exploratory (Phase II) |  No  | 
| E.7.3 | Therapeutic confirmatory (Phase III) |  Yes  | 
| E.7.4 | Therapeutic use (Phase IV) |  No  | 
| E.8 Design of the trial | 
| E.8.1 | Controlled |  Yes  | 
| E.8.1.1 | Randomised |  Yes  | 
| E.8.1.2 | Open |  Yes  | 
| E.8.1.3 | Single blind |  No  | 
| E.8.1.4 | Double blind  |  Yes  | 
| E.8.1.5 | Parallel group |  Yes  | 
| E.8.1.6 | Cross over  |  No  | 
| E.8.1.7 | Other |  Yes  | 
| E.8.1.7.1 | Other trial design description | 
| Part I: lead in period; Part II: randomized double blind; Part III: open-label | 
 
 
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| E.8.2 |  Comparator of controlled trial | 
| E.8.2.1 | Other medicinal product(s) |  No  | 
| E.8.2.2 | Placebo  |  Yes  | 
| E.8.2.3 | Other |  No  | 
| E.8.2.4 | Number of treatment arms in the trial | 2 | 
| E.8.3 | 
                                The trial involves single site in the Member State concerned
                             |  No  | 
| E.8.4 |  The trial involves multiple sites in the Member State concerned  |  Yes  | 
| E.8.5 | The trial involves multiple Member States |  Yes  | 
| E.8.5.1 | Number of sites anticipated in the EEA | 31 | 
| E.8.6 Trial involving sites outside the EEA | 
| E.8.6.1 | Trial being conducted both within and outside the EEA |  Yes  | 
| E.8.6.2 | Trial being conducted completely outside of the EEA |  No  | 
| E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned | 
| Argentina | 
 
| Australia | 
 
| Belgium | 
 
| Brazil | 
 
| Canada | 
 
| France | 
 
| Germany | 
 
| Italy | 
 
| Mexico | 
 
| Peru | 
 
| Poland | 
 
| Russian Federation | 
 
| Spain | 
 
| United Kingdom | 
 
| United States | 
 
 
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| E.8.7 | Trial has a data monitoring committee |  Yes  | 
| E.8.8 | 
                        Definition of the end of the trial and justification where it is not the last
                        visit of the last subject undergoing the trial
                     | 
| The study will end when the last participating patient completes the last scheduled visit of Part III, or when the sponsor decides to discontinue the development program. | 
 
 
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| E.8.9 Initial estimate of the duration of the trial | 
| E.8.9.1 | In the Member State concerned years | 3 | 
| E.8.9.1 | In the Member State concerned months | 6 | 
| E.8.9.1 | In the Member State concerned days | 0 | 
| E.8.9.2 | In all countries concerned by the trial years | 3 | 
| E.8.9.2 | In all countries concerned by the trial months | 6 | 
| E.8.9.2 | In all countries concerned by the trial days | 0 |