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    Clinical Trial Results:
    A Phase 2 Single-Arm Open-Label Extension Study to Investigate Safety With Risankizumab in Psoriatic Arthritis Subjects Who Have Completed Week 24 Visit of Study M16¬002 (1311.5)

    Summary
    EudraCT number
    2016-003113-94
    Trial protocol
    CZ   DE   FI   ES   BE   FR  
    Global end of trial date
    30 Jul 2018

    Results information
    Results version number
    v1(current)
    This version publication date
    13 Jul 2019
    First version publication date
    13 Jul 2019
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    M16-244
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02986373
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    AbbVie Deutschland GmbH & Co. KG
    Sponsor organisation address
    AbbVie House, Vanwall Business Park, Vanwall Road, Maidenhead, Berkshire, United Kingdom, SL6-4UB
    Public contact
    Global Medical Services, AbbVie, 001 800-633-9110,
    Scientific contact
    Maureen Kelly, MD, AbbVie, maureen.kelly@abbvie.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    30 Jul 2018
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    30 Jul 2018
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    This is an open-label extension (OLE) study to assess the efficacy, safety and tolerability of risankizumab in participants with psoriatic arthritis (PsA). Participants who had completed all doses of study drug and the Week 24 visit of M16-002 (1311.5; the lead-in study) were eligible to enroll in M16-244 (this study). Participants were allowed to either finish the Week 24 visit of the lead-in study and take the first dose of study drug for this study on the same day, or delay the start of this study up to 8 weeks if needed.
    Protection of trial subjects
    Subject or his or her representative read and understood the information provided about the study and gave written permission.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    15 Dec 2016
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Belgium: 5
    Country: Number of subjects enrolled
    Canada: 6
    Country: Number of subjects enrolled
    Czech Republic: 13
    Country: Number of subjects enrolled
    Finland: 15
    Country: Number of subjects enrolled
    France: 4
    Country: Number of subjects enrolled
    Japan: 14
    Country: Number of subjects enrolled
    Poland: 38
    Country: Number of subjects enrolled
    Spain: 9
    Country: Number of subjects enrolled
    Taiwan: 5
    Country: Number of subjects enrolled
    United States: 36
    Worldwide total number of subjects
    145
    EEA total number of subjects
    84
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    121
    From 65 to 84 years
    24
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    Participants who had completed all doses of study drug and the Week 24 visit of M16-002 (NCT02719171; lead-in study) were eligible to enroll in M16-244 (this study).

    Period 1
    Period 1 title
    Overall Trial (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Risankizumab
    Arm description
    Participants received open-label risankizumab 150 mg by subcutaneous injection at Weeks 0, 12, 24, and 36.
    Arm type
    Experimental

    Investigational medicinal product name
    Risankizumab
    Investigational medicinal product code
    Other name
    ABBV-066, BI 655066
    Pharmaceutical forms
    Injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Risankizumab administered by subcutaneous injection.

    Number of subjects in period 1
    Risankizumab
    Started
    145
    Completed
    106
    Not completed
    39
         Adverse Event
    4
         Not specified
    24
         Withdrawal by Subject
    10
         Lost to follow-up
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Overall Trial (overall period)
    Reporting group description
    -

    Reporting group values
    Overall Trial (overall period) Total
    Number of subjects
    145 145
    Age categorical
    Units: Subjects
        In utero
    0
        Preterm newborn infants (gestational age < 37 wks)
    0
        Newborns (0-27 days)
    0
        Infants and toddlers (28 days-23 months)
    0
        Children (2-11 years)
    0
        Adolescents (12-17 years)
    0
        Adults (18-64 years)
    0
        From 65-84 years
    0
        85 years and over
    0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    50.4 ( 12.52 ) -
    Gender categorical
    Units: Subjects
        Female
    61 61
        Male
    84 84
    Ethnicity (NIH/OMB)
    Units: Subjects
        Hispanic or Latino
    3 3
        Not Hispanic or Latino
    138 138
        Unknown or Not Reported
    4 4
    Race (NIH/OMB)
    Units: Subjects
        American Indian or Alaska Native
    1 1
        Asian
    21 21
        Native Hawaiian or Other Pacific Islander
    0 0
        Black or African American
    0 0
        White
    119 119
        More than one race
    0 0
        Unknown or Not Reported
    4 4

    End points

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    End points reporting groups
    Reporting group title
    Risankizumab
    Reporting group description
    Participants received open-label risankizumab 150 mg by subcutaneous injection at Weeks 0, 12, 24, and 36.

    Primary: Number of Participants With Adverse Events

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    End point title
    Number of Participants With Adverse Events [1]
    End point description
    An adverse event (AE) is defined as any untoward medical occurrence in a patient or clinical investigation subject administered a pharmaceutical product and which does not necessarily have a causal relationship with this treatment. The investigator assessed the relationship of each event to the use of study drug as either probably related, possibly related, probably not related or not related. A serious adverse event (SAE) is an event that results in death, is life-threatening, requires or prolongs hospitalization, results in a congenital anomaly, persistent or significant disability/incapacity or is an important medical event that, based on medical judgment, may jeopardize the subject and may require medical or surgical intervention to prevent any of the outcomes listed above. Treatment-emergent events (TEAEs) are defined as an AE that began or worsened in severity after initiation of study drug and 20 weeks (140 days) after last dose. Abbreviations: NMSC=non-melanoma skin cancer.
    End point type
    Primary
    End point timeframe
    From the first dose of study drug in this study until 20 weeks after the last dose of study drug (up to 56 weeks).
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Descriptive data are summarized for this end point per protocol.
    End point values
    Risankizumab
    Number of subjects analysed
    145 [2]
    Units: Participants
        Any AE
    87
        Any AE possibly drug related
    22
        Any SAE at least possibly drug related
    1
        Any severe AE
    7
        Any SAE
    5
        Any AE leading to discontinuation of study drug
    5
        Any major adverse cardiac events (adjudicated)
    2
        Any serious infections events
    2
        Any tuberculosis events
    2
        Any malignant tumor events
    1
        Any malignancies excluding NMSC events
    1
    Notes
    [2] - Safety Analysis Set: all participants that received at least 1 dose of study drug in this study.
    No statistical analyses for this end point

    Secondary: Modified Total Sharp Score (mTSS): Change From Baseline (in the Lead-in Study) to Week 24 in the Lead-in Study

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    End point title
    Modified Total Sharp Score (mTSS): Change From Baseline (in the Lead-in Study) to Week 24 in the Lead-in Study
    End point description
    The mTSS is a measure of change in joint health. X-rays of hands, wrists, and feet (including distal interphalangeal joints) were obtained at Week 24 and Week 48. Totals for hands and feet for erosion scores (range 0 to 320) and joint space narrowing scores (range 0 to 208) were calculated and added to obtain the mTSS (range = 0 [normal] to 528 [maximal disease]). An increase in mTSS from Baseline represents disease progression and/or joint worsening; no progression was defined as a change of ≤0.5. Analysis based on derivation method #1 per the lead-in study. Baseline is defined as baseline in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Baseline (Lead-in Study), Week 24 (Lead-in Study)
    End point values
    Risankizumab
    Number of subjects analysed
    118 [3]
    Units: units on a scale
        arithmetic mean (confidence interval 95%)
    0.12 (-0.16 to 0.40)
    Notes
    [3] - Safety Analysis Set
    No statistical analyses for this end point

    Secondary: mTSS: Change From Baseline (in the Lead-in Study) to Week 24

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    End point title
    mTSS: Change From Baseline (in the Lead-in Study) to Week 24
    End point description
    The mTSS is a measure of change in joint health. X-rays of hands, wrists, and feet (including distal interphalangeal joints) were obtained at Week 24 and Week 48. Totals for hands and feet for erosion scores (range 0 to 320) and joint space narrowing scores (range 0 to 208) were calculated and added to obtain the mTSS (range = 0 [normal] to 528 [maximal disease]). An increase in mTSS from Baseline represents disease progression and/or joint worsening; no progression was defined as a change of ≤0.5. Analysis based on derivation method #1 per the lead-in study. Baseline is defined as baseline in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Baseline (Lead-in Study), Week 24
    End point values
    Risankizumab
    Number of subjects analysed
    118 [4]
    Units: units on a scale
        arithmetic mean (confidence interval 95%)
    0.38 (0.06 to 0.71)
    Notes
    [4] - Safety Analysis Set
    No statistical analyses for this end point

    Secondary: mTSS: Change From Baseline (in the Lead-in Study) to Week 48

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    End point title
    mTSS: Change From Baseline (in the Lead-in Study) to Week 48
    End point description
    The mTSS is a measure of change in joint health. X-rays of hands, wrists, and feet (including distal interphalangeal joints) were obtained at Week 24 and Week 48. Totals for hands and feet for erosion scores (range 0 to 320) and joint space narrowing scores (range 0 to 208) were calculated and added to obtain the mTSS (range = 0 [normal] to 528 [maximal disease]). An increase in mTSS from Baseline represents disease progression and/or joint worsening; no progression was defined as a change of ≤0.5. Analysis based on derivation method #1 per the lead-in study. Baseline is defined as baseline in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Baseline (Lead-in Study), Week 48
    End point values
    Risankizumab
    Number of subjects analysed
    102 [5]
    Units: units on a scale
        arithmetic mean (confidence interval 95%)
    0.34 (-0.07 to 0.75)
    Notes
    [5] - Safety Analysis Set
    No statistical analyses for this end point

    Secondary: Percentage of Participants Achieving American College of Rheumatology 20% (ACR20) Response at Week 0

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    End point title
    Percentage of Participants Achieving American College of Rheumatology 20% (ACR20) Response at Week 0
    End point description
    Response defined by ACR20 criteria (improvement from baseline) at Week 0: ≥20% improvement in tender joint count; ≥20% improvement in swollen joint count; and ≥20% improvement in at least 3 out of the following 5 parameters: Patient's Assessment of Pain Intensity visual analog scale (VAS), Patient's Global Assessment of Disease Activity, Investigator's Global Assessment of Disease Activity, Health Assessment Questionnaire Disability Index (HAQ-DI), and acute phase reactant value (C-reactive protein). Baseline is defined as the last non missing pre-treatment observation prior to first dose in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Week 0
    End point values
    Risankizumab
    Number of subjects analysed
    145 [6]
    Units: Percentage of Participants
        number (confidence interval 95%)
    43.4 (35.2 to 51.9)
    Notes
    [6] - Safety Analysis Set
    No statistical analyses for this end point

    Secondary: Percentage of Participants Achieving ACR20 Response at Week 4

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    End point title
    Percentage of Participants Achieving ACR20 Response at Week 4
    End point description
    Response defined by ACR20 criteria (improvement from baseline) at Week 4: ≥20% improvement in tender joint count; ≥20% improvement in swollen joint count; and ≥20% improvement in at least 3 out of the following 5 parameters: Patient's Assessment of Pain Intensity VAS, Patient's Global Assessment of Disease Activity, Investigator's Global Assessment of Disease Activity, HAQ-DI, and acute phase reactant value (C-reactive protein). Baseline is defined as the last non missing pre-treatment observation prior to first dose in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Week 4
    End point values
    Risankizumab
    Number of subjects analysed
    144 [7]
    Units: percentage of participants
        number (confidence interval 95%)
    55.6 (47.1 to 63.8)
    Notes
    [7] - Safety Analysis Set
    No statistical analyses for this end point

    Secondary: Percentage of Participants Achieving ACR20 Response at Week 12

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    End point title
    Percentage of Participants Achieving ACR20 Response at Week 12
    End point description
    Response defined by ACR20 criteria (improvement from baseline) at Week 12: ≥20% improvement in tender joint count; ≥20% improvement in swollen joint count; and ≥20% improvement in at least 3 out of the following 5 parameters: Patient's Assessment of Pain Intensity VAS, Patient's Global Assessment of Disease Activity, Investigator's Global Assessment of Disease Activity, HAQ-DI, and acute phase reactant value (C-reactive protein). Baseline is defined as baseline in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Week 12
    End point values
    Risankizumab
    Number of subjects analysed
    142 [8]
    Units: percentage of participants
        number (confidence interval 95%)
    57.0 (48.5 to 65.3)
    Notes
    [8] - Safety Analysis Set
    No statistical analyses for this end point

    Secondary: Percentage of Participants Achieving ACR20 Response at Week 24

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    End point title
    Percentage of Participants Achieving ACR20 Response at Week 24
    End point description
    Response defined by ACR20 criteria (improvement from baseline) at Week 24: ≥20% improvement in tender joint count; ≥20% improvement in swollen joint count; and ≥20% improvement in at least 3 out of the following 5 parameters: Patient's Assessment of Pain Intensity VAS, Patient's Global Assessment of Disease Activity, Investigator's Global Assessment of Disease Activity, HAQ-DI, and acute phase reactant value (C-reactive protein). Baseline is defined as the last non missing pre-treatment observation prior to first dose in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Week 24
    End point values
    Risankizumab
    Number of subjects analysed
    134 [9]
    Units: percentage of participants
        number (confidence interval 95%)
    62.7 (53.9 to 70.9)
    Notes
    [9] - Safety Analysis Set
    No statistical analyses for this end point

    Secondary: Percentage of Participants Achieving ACR20 Response at Week 36

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    End point title
    Percentage of Participants Achieving ACR20 Response at Week 36
    End point description
    Response defined by ACR20 criteria (improvement from baseline) at Week 36: ≥20% improvement in tender joint count; ≥20% improvement in swollen joint count; and ≥20% improvement in at least 3 out of the following 5 parameters: Patient's Assessment of Pain Intensity VAS, Patient's Global Assessment of Disease Activity, Investigator's Global Assessment of Disease Activity, HAQ-DI, and acute phase reactant value (C-reactive protein). Baseline is defined as the last non missing pre-treatment observation prior to first dose in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Week 36
    End point values
    Risankizumab
    Number of subjects analysed
    115 [10]
    Units: percentage of participants
        number (confidence interval 95%)
    68.7 (59.4 to 77.0)
    Notes
    [10] - Safety Analysis Set
    No statistical analyses for this end point

    Secondary: Percentage of Participants Achieving ACR20 Response at Week 48

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    End point title
    Percentage of Participants Achieving ACR20 Response at Week 48
    End point description
    Response defined by ACR20 criteria (improvement from baseline) at Week 48: ≥20% improvement in tender joint count; ≥20% improvement in swollen joint count; and ≥20% improvement in at least 3 out of the following 5 parameters: Patient's Assessment of Pain Intensity VAS, Patient's Global Assessment of Disease Activity, Investigator's Global Assessment of Disease Activity, HAQ-DI, and acute phase reactant value (C-reactive protein). Baseline is defined as the last non missing pre-treatment observation prior to first dose in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Week 48
    End point values
    Risankizumab
    Number of subjects analysed
    109 [11]
    Units: percentage of participants
        number (confidence interval 95%)
    69.7 (60.2 to 78.2)
    Notes
    [11] - Safety Analysis Set
    No statistical analyses for this end point

    Secondary: Percentage of Participants Achieving ACR20 Response at Week 52

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    End point title
    Percentage of Participants Achieving ACR20 Response at Week 52
    End point description
    Response defined by ACR20 criteria (improvement from baseline) at Week 52: ≥20% improvement in tender joint count; ≥20% improvement in swollen joint count; and ≥20% improvement in at least 3 out of the following 5 parameters: Patient's Assessment of Pain Intensity VAS, Patient's Global Assessment of Disease Activity, Investigator's Global Assessment of Disease Activity, HAQ-DI, and acute phase reactant value (C-reactive protein). Baseline is defined as the last non missing pre-treatment observation prior to first dose in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Week 52
    End point values
    Risankizumab
    Number of subjects analysed
    101 [12]
    Units: percentage of participants
        number (confidence interval 95%)
    75.2 (65.7 to 83.3)
    Notes
    [12] - Safety Analysis Set
    No statistical analyses for this end point

    Secondary: Health Assessment Questionnaire Disability Index (HAQ-Dl): Change From Baseline (in the Lead-in Study) to Week 0

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    End point title
    Health Assessment Questionnaire Disability Index (HAQ-Dl): Change From Baseline (in the Lead-in Study) to Week 0
    End point description
    The HAQ-DI is a patient-reported questionnaire specific for rheumatoid arthritis that consists of 20 questions referring to 8 domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and daily activities. Participants assessed their ability to do each task over the past week using the following response categories: without any difficulty (0); with some difficulty (1); with much difficulty (2); and unable to do (3). Scores on each task were summed and averaged to provide an overall score ranging from 0 to 3, where 0 represents no disability and 3 very severe, high-dependency disability. HAQ remission indicating normal physical function is defined by HAQ-DI score of < 0.5. Negative change from Baseline indicates improvement. Baseline is defined as baseline in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Baseline (Lead-in Study), Week 0
    End point values
    Risankizumab
    Number of subjects analysed
    143 [13]
    Units: units on a scale
        arithmetic mean (confidence interval 95%)
    -0.176 (-0.249 to -0.102)
    Notes
    [13] - Safety Analysis Set
    No statistical analyses for this end point

    Secondary: HAQ-DI: Change From Baseline (in the Lead-in Study) to Week 4

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    End point title
    HAQ-DI: Change From Baseline (in the Lead-in Study) to Week 4
    End point description
    The HAQ-DI is a patient-reported questionnaire specific for rheumatoid arthritis that consists of 20 questions referring to 8 domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and daily activities. Participants assessed their ability to do each task over the past week using the following response categories: without any difficulty (0); with some difficulty (1); with much difficulty (2); and unable to do (3). Scores on each task were summed and averaged to provide an overall score ranging from 0 to 3, where 0 represents no disability and 3 very severe, high-dependency disability. HAQ remission indicating normal physical function is defined by HAQ-DI score of < 0.5. Negative change from Baseline indicates improvement. Baseline is defined as baseline in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Baseline (Lead-in Study), Week 4
    End point values
    Risankizumab
    Number of subjects analysed
    143 [14]
    Units: units on a scale
        arithmetic mean (confidence interval 95%)
    -0.258 (-0.332 to -0.183)
    Notes
    [14] - Safety Analysis Set
    No statistical analyses for this end point

    Secondary: HAQ-DI: Change From Baseline (in the Lead-in Study) to Week 12

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    End point title
    HAQ-DI: Change From Baseline (in the Lead-in Study) to Week 12
    End point description
    The HAQ-DI is a patient-reported questionnaire specific for rheumatoid arthritis that consists of 20 questions referring to 8 domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and daily activities. Participants assessed their ability to do each task over the past week using the following response categories: without any difficulty (0); with some difficulty (1); with much difficulty (2); and unable to do (3). Scores on each task were summed and averaged to provide an overall score ranging from 0 to 3, where 0 represents no disability and 3 very severe, high-dependency disability. HAQ remission indicating normal physical function is defined by HAQ-DI score of < 0.5. Negative change from Baseline indicates improvement. Baseline is defined as the last non missing pre-treatment observation prior to first dose in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Baseline (Lead-in Study), Week 12
    End point values
    Risankizumab
    Number of subjects analysed
    140 [15]
    Units: units on a scale
        arithmetic mean (confidence interval 95%)
    -0.261 (-0.336 to -0.186)
    Notes
    [15] - Safety Analysis Set
    No statistical analyses for this end point

    Secondary: HAQ-DI: Change From Baseline (in the Lead-in Study) to Week 24

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    End point title
    HAQ-DI: Change From Baseline (in the Lead-in Study) to Week 24
    End point description
    The HAQ-DI is a patient-reported questionnaire specific for rheumatoid arthritis that consists of 20 questions referring to 8 domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and daily activities. Participants assessed their ability to do each task over the past week using the following response categories: without any difficulty (0); with some difficulty (1); with much difficulty (2); and unable to do (3). Scores on each task were summed and averaged to provide an overall score ranging from 0 to 3, where 0 represents no disability and 3 very severe, high-dependency disability. HAQ remission indicating normal physical function is defined by HAQ-DI score of < 0.5. Negative change from Baseline indicates improvement. Baseline is defined as baseline in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Baseline (Lead-in Study), Week 24
    End point values
    Risankizumab
    Number of subjects analysed
    133 [16]
    Units: units on a scale
        arithmetic mean (confidence interval 95%)
    -0.296 (-0.374 to -0.217)
    Notes
    [16] - Safety Analysis Set
    No statistical analyses for this end point

    Secondary: HAQ-DI: Change From Baseline (in the Lead-in Study) to Week 36

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    End point title
    HAQ-DI: Change From Baseline (in the Lead-in Study) to Week 36
    End point description
    The HAQ-DI is a patient-reported questionnaire specific for rheumatoid arthritis that consists of 20 questions referring to 8 domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and daily activities. Participants assessed their ability to do each task over the past week using the following response categories: without any difficulty (0); with some difficulty (1); with much difficulty (2); and unable to do (3). Scores on each task were summed and averaged to provide an overall score ranging from 0 to 3, where 0 represents no disability and 3 very severe, high-dependency disability. HAQ remission indicating normal physical function is defined by HAQ-DI score of < 0.5. Negative change from Baseline indicates improvement. Baseline is defined as baseline in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Baseline (Lead-in Study), Week 36
    End point values
    Risankizumab
    Number of subjects analysed
    114 [17]
    Units: units on a scale
        arithmetic mean (confidence interval 95%)
    -0.294 (-0.384 to -0.204)
    Notes
    [17] - Safety Analysis Set
    No statistical analyses for this end point

    Secondary: HAQ-DI: Change From Baseline (in the Lead-in Study) to Week 48

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    End point title
    HAQ-DI: Change From Baseline (in the Lead-in Study) to Week 48
    End point description
    The HAQ-DI is a patient-reported questionnaire specific for rheumatoid arthritis that consists of 20 questions referring to 8 domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and daily activities. Participants assessed their ability to do each task over the past week using the following response categories: without any difficulty (0); with some difficulty (1); with much difficulty (2); and unable to do (3). Scores on each task were summed and averaged to provide an overall score ranging from 0 to 3, where 0 represents no disability and 3 very severe, high-dependency disability. HAQ remission indicating normal physical function is defined by HAQ-DI score of < 0.5. Negative change from Baseline indicates improvement. Baseline is defined as baseline in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Baseline (Lead-in Study), Week 48
    End point values
    Risankizumab
    Number of subjects analysed
    107 [18]
    Units: units on a scale
        arithmetic mean (confidence interval 95%)
    -0.298 (-0.381 to -0.215)
    Notes
    [18] - Safety Analysis Set
    No statistical analyses for this end point

    Secondary: HAQ-DI: Change From Baseline (in the Lead-in Study) to Week 52

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    End point title
    HAQ-DI: Change From Baseline (in the Lead-in Study) to Week 52
    End point description
    The HAQ-DI is a patient-reported questionnaire specific for rheumatoid arthritis that consists of 20 questions referring to 8 domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and daily activities. Participants assessed their ability to do each task over the past week using the following response categories: without any difficulty (0); with some difficulty (1); with much difficulty (2); and unable to do (3). Scores on each task were summed and averaged to provide an overall score ranging from 0 to 3, where 0 represents no disability and 3 very severe, high-dependency disability. HAQ remission indicating normal physical function is defined by HAQ-DI score of < 0.5. Negative change from Baseline indicates improvement. Baseline is defined as baseline in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Baseline (Lead-in Study), Week 52
    End point values
    Risankizumab
    Number of subjects analysed
    99 [19]
    Units: units on a scale
        arithmetic mean (confidence interval 95%)
    -0.318 (-0.405 to -0.231)
    Notes
    [19] - Safety Analysis Set
    No statistical analyses for this end point

    Secondary: Short Form Health Survey 36 (SF-36) Physical Component Summary (PCS) Score: Change From Baseline (in the Lead-in Study) to Week 0

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    End point title
    Short Form Health Survey 36 (SF-36) Physical Component Summary (PCS) Score: Change From Baseline (in the Lead-in Study) to Week 0
    End point description
    The SF-36 Health determined participants' overall quality of life by assessing 1) limitations in physical functioning due to health problems; 2) limitations in usual role because of physical health problems; 3) bodily pain; 4) general health perceptions; 5) vitality; 6) limitations in social functioning because of physical or emotional problems; 7) limitations in usual role due to emotional problems; and 8) general mental health. Items 1-4 comprise the physical component of the SF-36. Scores on each item were summed and averaged (range = 0-100); a positive change from Baseline indicates improvement. Baseline is defined as baseline in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Baseline (Lead-in Study), Week 0
    End point values
    Risankizumab
    Number of subjects analysed
    144 [20]
    Units: units on a scale
        median (confidence interval 95%)
    2.11 (0.89 to 3.34)
    Notes
    [20] - Safety Analysis Set
    No statistical analyses for this end point

    Secondary: SF-36 PCS Score: Change From Baseline (in the Lead-in Study) to Week 4

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    End point title
    SF-36 PCS Score: Change From Baseline (in the Lead-in Study) to Week 4
    End point description
    The SF-36 Health determined participants' overall quality of life by assessing 1) limitations in physical functioning due to health problems; 2) limitations in usual role because of physical health problems; 3) bodily pain; 4) general health perceptions; 5) vitality; 6) limitations in social functioning because of physical or emotional problems; 7) limitations in usual role due to emotional problems; and 8) general mental health. Items 1-4 comprise the physical component of the SF-36. Scores on each item were summed and averaged (range = 0-100); a positive change from Baseline indicates improvement. Baseline is defined as baseline in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Baseline (Lead-in Study), Week 4
    End point values
    Risankizumab
    Number of subjects analysed
    143 [21]
    Units: units on a scale
        median (confidence interval 95%)
    3.63 (2.41 to 4.85)
    Notes
    [21] - Safety Analysis Set
    No statistical analyses for this end point

    Secondary: SF-36 PCS Score: Change From Baseline (in the Lead-in Study) to Week 12

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    End point title
    SF-36 PCS Score: Change From Baseline (in the Lead-in Study) to Week 12
    End point description
    The SF-36 Health determined participants' overall quality of life by assessing 1) limitations in physical functioning due to health problems; 2) limitations in usual role because of physical health problems; 3) bodily pain; 4) general health perceptions; 5) vitality; 6) limitations in social functioning because of physical or emotional problems; 7) limitations in usual role due to emotional problems; and 8) general mental health. Items 1-4 comprise the physical component of the SF-36. Scores on each item were summed and averaged (range = 0-100); a positive change from Baseline indicates improvement. Baseline is defined as baseline in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Baseline (Lead-in Study), Week 12
    End point values
    Risankizumab
    Number of subjects analysed
    140 [22]
    Units: units on a scale
        median (confidence interval 95%)
    3.63 (2.32 to 4.94)
    Notes
    [22] - Safety Analysis Set
    No statistical analyses for this end point

    Secondary: SF-36 PCS Score: Change From Baseline (in the Lead-in Study) to Week 24

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    End point title
    SF-36 PCS Score: Change From Baseline (in the Lead-in Study) to Week 24
    End point description
    The SF-36 Health determined participants' overall quality of life by assessing 1) limitations in physical functioning due to health problems; 2) limitations in usual role because of physical health problems; 3) bodily pain; 4) general health perceptions; 5) vitality; 6) limitations in social functioning because of physical or emotional problems; 7) limitations in usual role due to emotional problems; and 8) general mental health. Items 1-4 comprise the physical component of the SF-36. Scores on each item were summed and averaged (range = 0-100); a positive change from Baseline indicates improvement. Baseline is defined as baseline in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Baseline (Lead-in Study), Week 24
    End point values
    Risankizumab
    Number of subjects analysed
    134 [23]
    Units: units on a scale
        median (confidence interval 95%)
    3.76 (2.50 to 5.02)
    Notes
    [23] - Safety Analysis Set
    No statistical analyses for this end point

    Secondary: SF-36 PCS Score: Change From Baseline (in the Lead-in Study) to Week 36

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    End point title
    SF-36 PCS Score: Change From Baseline (in the Lead-in Study) to Week 36
    End point description
    The SF-36 Health determined participants' overall quality of life by assessing 1) limitations in physical functioning due to health problems; 2) limitations in usual role because of physical health problems; 3) bodily pain; 4) general health perceptions; 5) vitality; 6) limitations in social functioning because of physical or emotional problems; 7) limitations in usual role due to emotional problems; and 8) general mental health. Items 1-4 comprise the physical component of the SF-36. Scores on each item were summed and averaged (range = 0-100); a positive change from Baseline indicates improvement. Baseline is defined as baseline in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Baseline (Lead-in Study), Week 36
    End point values
    Risankizumab
    Number of subjects analysed
    115 [24]
    Units: units on a scale
        median (confidence interval 95%)
    4.27 (2.97 to 5.57)
    Notes
    [24] - Safety Analysis Set
    No statistical analyses for this end point

    Secondary: SF-36 PCS Score: Change From Baseline (in the Lead-in Study) to Week 48

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    End point title
    SF-36 PCS Score: Change From Baseline (in the Lead-in Study) to Week 48
    End point description
    The SF-36 Health determined participants' overall quality of life by assessing 1) limitations in physical functioning due to health problems; 2) limitations in usual role because of physical health problems; 3) bodily pain; 4) general health perceptions; 5) vitality; 6) limitations in social functioning because of physical or emotional problems; 7) limitations in usual role due to emotional problems; and 8) general mental health. Items 1-4 comprise the physical component of the SF-36. Scores on each item were summed and averaged (range = 0-100); a positive change from Baseline indicates improvement. Baseline is defined as baseline in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Baseline (Lead-in Study), Week 48
    End point values
    Risankizumab
    Number of subjects analysed
    108 [25]
    Units: units on a scale
        median (confidence interval 95%)
    5.08 (3.66 to 6.50)
    Notes
    [25] - Safety Analysis Set
    No statistical analyses for this end point

    Secondary: SF-36 PCS Score: Change From Baseline (in the Lead-in Study) to Week 52

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    End point title
    SF-36 PCS Score: Change From Baseline (in the Lead-in Study) to Week 52
    End point description
    The SF-36 Health determined participants' overall quality of life by assessing 1) limitations in physical functioning due to health problems; 2) limitations in usual role because of physical health problems; 3) bodily pain; 4) general health perceptions; 5) vitality; 6) limitations in social functioning because of physical or emotional problems; 7) limitations in usual role due to emotional problems; and 8) general mental health. Items 1-4 comprise the physical component of the SF-36. Scores on each item were summed and averaged (range = 0-100); a positive change from Baseline indicates improvement. Baseline is defined as baseline in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Baseline (Lead-in Study), Week 52
    End point values
    Risankizumab
    Number of subjects analysed
    100 [26]
    Units: units on a scale
        median (confidence interval 95%)
    4.47 (3.11 to 5.84)
    Notes
    [26] - Safety Analysis Set
    No statistical analyses for this end point

    Secondary: SF-36 Mental Component Summary (MCS) Score: Change From Baseline (in the Lead-in Study) to Week 0

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    End point title
    SF-36 Mental Component Summary (MCS) Score: Change From Baseline (in the Lead-in Study) to Week 0
    End point description
    The SF-36 determined participants' overall quality of life by assessing 1) limitations in physical functioning due to health problems; 2) limitations in usual role because of physical health problems; 3) bodily pain; 4) general health perceptions; 5) vitality; 6) limitations in social functioning because of physical or emotional problems; 7) limitations in usual role due to emotional problems; and 8) general mental health. Items 5-8 comprise the mental component of the SF-36. Scores on each item were summed and averaged (range = 0-100); a positive change from Baseline indicates improvement. Baseline is defined as baseline in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Baseline (Lead-in Study), Week 0
    End point values
    Risankizumab
    Number of subjects analysed
    144 [27]
    Units: units on a scale
        median (confidence interval 95%)
    0.86 (-0.64 to 2.35)
    Notes
    [27] - Safety Analysis Set
    No statistical analyses for this end point

    Secondary: SF-36 MCS Score: Change From Baseline (in the Lead-in Study) to Week 4

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    End point title
    SF-36 MCS Score: Change From Baseline (in the Lead-in Study) to Week 4
    End point description
    The SF-36 determined participants' overall quality of life by assessing 1) limitations in physical functioning due to health problems; 2) limitations in usual role because of physical health problems; 3) bodily pain; 4) general health perceptions; 5) vitality; 6) limitations in social functioning because of physical or emotional problems; 7) limitations in usual role due to emotional problems; and 8) general mental health. Items 5-8 comprise the mental component of the SF-36. Scores on each item were summed and averaged (range = 0-100); a positive change from Baseline indicates improvement. Baseline is defined as baseline in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Baseline (Lead-in Study), Week 4
    End point values
    Risankizumab
    Number of subjects analysed
    143 [28]
    Units: units on a scale
        median (confidence interval 95%)
    2.79 (1.27 to 4.31)
    Notes
    [28] - Safety Analysis Set
    No statistical analyses for this end point

    Secondary: SF-36 MCS Score: Change From Baseline (in the Lead-in Study) to Week 12

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    End point title
    SF-36 MCS Score: Change From Baseline (in the Lead-in Study) to Week 12
    End point description
    The SF-36 determined participants' overall quality of life by assessing 1) limitations in physical functioning due to health problems; 2) limitations in usual role because of physical health problems; 3) bodily pain; 4) general health perceptions; 5) vitality; 6) limitations in social functioning because of physical or emotional problems; 7) limitations in usual role due to emotional problems; and 8) general mental health. Items 5-8 comprise the mental component of the SF-36. Scores on each item were summed and averaged (range = 0-100); a positive change from Baseline indicates improvement. Baseline is defined as baseline in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Baseline (Lead-in Study), Week 12
    End point values
    Risankizumab
    Number of subjects analysed
    140 [29]
    Units: units on a scale
        median (confidence interval 95%)
    2.22 (0.49 to 3.96)
    Notes
    [29] - Safety Analysis Set
    No statistical analyses for this end point

    Secondary: SF-36 MCS Score: Change From Baseline (in the Lead-in Study) to Week 24

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    End point title
    SF-36 MCS Score: Change From Baseline (in the Lead-in Study) to Week 24
    End point description
    The SF-36 determined participants' overall quality of life by assessing 1) limitations in physical functioning due to health problems; 2) limitations in usual role because of physical health problems; 3) bodily pain; 4) general health perceptions; 5) vitality; 6) limitations in social functioning because of physical or emotional problems; 7) limitations in usual role due to emotional problems; and 8) general mental health. Items 5-8 comprise the mental component of the SF-36. Scores on each item were summed and averaged (range = 0-100); a positive change from Baseline indicates improvement. Baseline is defined as baseline in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Baseline (Lead-in Study), Week 24
    End point values
    Risankizumab
    Number of subjects analysed
    134 [30]
    Units: units on a scale
        median (confidence interval 95%)
    4.08 (2.39 to 5.77)
    Notes
    [30] - Safety Analysis Set
    No statistical analyses for this end point

    Secondary: SF-36 MCS Score: Change From Baseline (in the Lead-in Study) to Week 36

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    End point title
    SF-36 MCS Score: Change From Baseline (in the Lead-in Study) to Week 36
    End point description
    The SF-36 determined participants' overall quality of life by assessing 1) limitations in physical functioning due to health problems; 2) limitations in usual role because of physical health problems; 3) bodily pain; 4) general health perceptions; 5) vitality; 6) limitations in social functioning because of physical or emotional problems; 7) limitations in usual role due to emotional problems; and 8) general mental health. Items 5-8 comprise the mental component of the SF-36. Scores on each item were summed and averaged (range = 0-100); a positive change from Baseline indicates improvement. Baseline is defined as baseline in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Baseline (Lead-in Study), Week 36
    End point values
    Risankizumab
    Number of subjects analysed
    115 [31]
    Units: units on a scale
        median (confidence interval 95%)
    3.44 (1.60 to 5.28)
    Notes
    [31] - Safety Analysis Set
    No statistical analyses for this end point

    Secondary: SF-36 MCS Score: Change From Baseline (in the Lead-in Study) to Week 48

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    End point title
    SF-36 MCS Score: Change From Baseline (in the Lead-in Study) to Week 48
    End point description
    The SF-36 determined participants' overall quality of life by assessing 1) limitations in physical functioning due to health problems; 2) limitations in usual role because of physical health problems; 3) bodily pain; 4) general health perceptions; 5) vitality; 6) limitations in social functioning because of physical or emotional problems; 7) limitations in usual role due to emotional problems; and 8) general mental health. Items 5-8 comprise the mental component of the SF-36. Scores on each item were summed and averaged (range = 0-100); a positive change from Baseline indicates improvement. Baseline is defined as baseline in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Baseline (Lead-in Study), Week 48
    End point values
    Risankizumab
    Number of subjects analysed
    108 [32]
    Units: units on a scale
        median (confidence interval 95%)
    3.36 (1.40 to 5.31)
    Notes
    [32] - Safety Analysis Set
    No statistical analyses for this end point

    Secondary: SF-36 MCS Score: Change From Baseline (in the Lead-in Study) to Week 52

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    End point title
    SF-36 MCS Score: Change From Baseline (in the Lead-in Study) to Week 52
    End point description
    The SF-36 determined participants' overall quality of life by assessing 1) limitations in physical functioning due to health problems; 2) limitations in usual role because of physical health problems; 3) bodily pain; 4) general health perceptions; 5) vitality; 6) limitations in social functioning because of physical or emotional problems; 7) limitations in usual role due to emotional problems; and 8) general mental health. Items 5-8 comprise the mental component of the SF-36. Scores on each item were summed and averaged (range = 0-100); a positive change from Baseline indicates improvement. Baseline is defined as baseline in the lead-in study.
    End point type
    Secondary
    End point timeframe
    Baseline (Lead-in Study), Week 52
    End point values
    Risankizumab
    Number of subjects analysed
    100 [33]
    Units: units on a scale
        median (confidence interval 95%)
    4.33 (2.56 to 6.10)
    Notes
    [33] - Safety Analysis Set
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Treatment-emergent adverse events (TEAEs) and serious adverse events (TESAEs) were collected from the first dose of study drug in this study until 20 weeks after the last dose of study drug (up to 56 weeks).
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    20.0
    Reporting groups
    Reporting group title
    RISANKIZUMAB
    Reporting group description
    -

    Serious adverse events
    RISANKIZUMAB
    Total subjects affected by serious adverse events
         subjects affected / exposed
    5 / 145 (3.45%)
         number of deaths (all causes)
    0
         number of deaths resulting from adverse events
    0
    Investigations
    GLOMERULAR FILTRATION RATE ABNORMAL
         subjects affected / exposed
    1 / 145 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    COLORECTAL CANCER
         subjects affected / exposed
    1 / 145 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    ACUTE CORONARY SYNDROME
         subjects affected / exposed
    1 / 145 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    ANGINA PECTORIS
         subjects affected / exposed
    1 / 145 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    ISCHAEMIC CARDIOMYOPATHY
         subjects affected / exposed
    1 / 145 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    ISCHAEMIC STROKE
         subjects affected / exposed
    1 / 145 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    ACUTE RESPIRATORY DISTRESS SYNDROME
         subjects affected / exposed
    1 / 145 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    PNEUMONIA HAEMOPHILUS
         subjects affected / exposed
    1 / 145 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    PNEUMONIA PSEUDOMONAL
         subjects affected / exposed
    1 / 145 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    STAPHYLOCOCCAL INFECTION
         subjects affected / exposed
    1 / 145 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    UROSEPSIS
         subjects affected / exposed
    1 / 145 (0.69%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    RISANKIZUMAB
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    16 / 145 (11.03%)
    Infections and infestations
    VIRAL UPPER RESPIRATORY TRACT INFECTION
         subjects affected / exposed
    16 / 145 (11.03%)
         occurrences all number
    21

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    23 May 2018
    Revisions to the protocol included extending the adverse event collection period and contraception requirement duration from 16 weeks after the last dose of study drug to 20 weeks after the last dose of study drug and adding a follow-up phone call 20 weeks after the last dose of study drug. These changes were made based on the availability of additional data clarifying the risankizumab terminal half-life (t1/2) from 16 weeks to 20 weeks in Investigator's Brochure Edition 3.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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