E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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E.1.1.1 | Medical condition in easily understood language |
CD is an inflamatory bowel disease affects the lining of the digestive tract, often spreads into the layers of affected bowel tissue, can lead to abdominal pain, severe diarrhea, fatigue, weight loss. |
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E.1.1.2 | Therapeutic area | Diseases [C] - Digestive System Diseases [C06] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10011401 |
E.1.2 | Term | Crohn's disease |
E.1.2 | System Organ Class | 10017947 - Gastrointestinal 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 |
Substudy 1 (randomized, double-blind, placebo-controlled maintenance): To evaluate the efficacy and safety of two doses of upadacitinib versus placebo as maintenance therapy in subjects with moderately to severely active Crohn's disease (CD) who responded to upadacitinib induction treatment in Studies M14-431 or M14-433. Substudy 2 (long-term extension [LTE]): To evaluate safety and efficacy of long-term administration of upadacitinib in subjects with moderately to severely active CD who participated in the Phase 3 upadacitinib induction and maintenance studies. |
Subestudio 1 (de mantenimiento, aleatorizado, doble ciego y controlado con placebo): evaluar la eficacia y seguridad de dos dosis de upadacitinib frente a placebo como terapia de mantenimiento en sujetos con Enfermedad de Crohn de moderada a severamente activa (CD) que respondieron al tratamiento de inducción con upadacitinib en los estudios M14-431 o M14-433. Subestudio 2 (extensión a largo plazo [LTE]): evaluar la seguridad y eficacia de la administración de upadacitinib a largo plazo en sujetos con EC de moderada a severamente activa que participaron en los estudios de inducción y mantenimiento de upadacitinib de fase 3. |
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E.2.2 | Secondary objectives of the trial |
To evaluate improvements in several efficacy parameters, including steroid discontinuation, laboratory parameters and quality of life questionnaires. |
Evaluar las mejoras en varios parámetros de eficacia, incluidos la interrupción de esteroides, los parámetros de laboratorio y los cuestionarios de calidad de vida. |
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E.2.3 | Trial contains a sub-study | Yes |
E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
Substudy 1 - 52-Week, Randomized, Double-Blind, Maintenance Substudy 2 - 240-Week Long-Term-Extension |
Subestudio 1 - 52 semanas, aleatorizado, doble ciego, de mantenimiento Subestudio 2 - Extensión a largo plazo de 240 semanas |
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E.3 | Principal inclusion criteria |
For Substudy 1: - Participant who receive double-blind treatment in Study M14- 431 or Study M14-433 and achieve clinical response. - Participant completes Week 12 or Week 24 study procedures For Substudy 2: - Participant completes Substudy 2 - Participant who receive open-label upadacitinib Dose B in Study M14-431 and achieve clinical response. - Participant completes study procedures in the parent study/substudy. |
Para el Subestudio 1: - Participante que recibe tratamiento doble ciego en el Estudio M14-431 o Estudio M14-433 y alcanza respuesta clínica. - Participante que completa los procedimientos del estudio de la semana 12 o la semana 24 Para el Subestudio 2: - Participante que completa el Subestudio 2 - Participante que recibe de forma abierta la dosis B de upadacitinib en el Estudio M14-431 y alcanza respuesta clínica. - Participante que completa los procedimientos del estudio en el estudio/subestudio principal. |
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E.4 | Principal exclusion criteria |
For Sub-studies 1 and 2: - Participant is considered by the investigator, for any reason, to be an unsuitable candidate for the study. - Participant who has a known hypersensitivity to upadacitinib or its excipients, or had an adverse event during Study M14-431 or Substudy 1 of Study M14-430 that in the investigator's judgment makes the subject unsuitable for this study. - Participant with any active or chronic recurring infections based on the investigator's assessment that makes the subject an unsuitable candidate for the study. Subjects with ongoing infections undergoing treatment may be enrolled BUT NOT dosed until the infection treatment has been completed and the infection is cured, based on the investigator's assessment. - Participants with high grade colonic dysplasia or malignancy diagnosed at the endoscopy performed at the final visit of Study M14-431 (Week 24) or Substudy 1 of Study M14-430 (Week 40). |
Para los estudios secundarios 1 y 2: - Participante que, por cualquier motivo, es considerado un candidato inadecuado para el estudio por parte del investigador. - Participante que presenta una hipersensibilidad conocida a upadacitinib o sus excipientes, o que tuvo un evento adverso durante el Estudio M14-431 o Subestudio 1 del Estudio M14-430 que, a juicio del investigador, hace que el sujeto no sea apto para este estudio. - Participante con cualquier infección recurrente activa o crónica, basada en el criterio del investigador, que hace que el sujeto sea un candidato inadecuado para el estudio. Los sujetos con infecciones en curso que se someten a tratamiento pueden inscribirse PERO NO medicarse hasta que el tratamiento de la infección se haya completado y la infección esté curada, según la evaluación del investigador. - Participantes con displasia o malignidad colónica de alto grado diagnosticada en la endoscopia realizada en la visita final del Estudio M14-431 (Semana 24) o Estudio secundario 1 del Estudio M14-430 (Semana 40). |
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E.5 End points |
E.5.1 | Primary end point(s) |
Substudy 1, Cohort 1 (Upadacitinib vs Placebo) Co-Primary Endpoints: Proportion of subjects with clinical remission at Week 52, AND Proportion of subjects with endoscopic response at Week 52
Substudy 2 Primary Endpoint: Incidence of AEs over time |
Subestudio 1, Cohorte 1 (Upadacitinib vs Placebo) Criterios de valoración principales: • Proporción de sujetos con remisión clínica en la semana 52, y • Proporción de sujetos con respuesta endoscópica en la semana 52 Subestudio 2 Criterio de valoración principal: Incidencia de EAs en el tiempo |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
Substudy 1 1. Proportion of subjects with clinical remission per CDAI (CDAI < 150) at Week 52 in subjects with CDAI of 220 to 450 at Baseline of induction study 2. Proportion of subjects with clinical remission at Week 0 and Week 52 3. Proportion of subjects with endoscopic remission at Week 52 4. Proportion of subjects who discontinue corticosteroid use for CD and achieve clinical remission at Week 52 in subjects taking corticosteroids for CD at Baseline of induction 5. Proportion of subjects who discontinued corticosteroid use for CD at Week 52 in subjects taking corticosteroids for CD at Baseline of induction 6. Proportion of subjects with enhanced clinical response at Week 52 7. Proportion of subjects with clinical remission and endoscopic remission at Week 0 and Week 52 8. Proportion of subjects with ≥ 50% reduction in draining fistulas at Week 12 in subjects with fistulas at Baseline 9. Proportion of subjects with draining fistulas at Week 52 in subjects with draining fistulas at Baseline of induction study 10. Change from Week 0 in Crohn's Symptoms Severity (CSS) Questionnaire at Week 52 11. Proportion of subjects with CD-related hospitalizations during the 52-Week double blind maintenance period. 12. Change from Baseline in Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) at Week 52 13. Change from Baseline in Short Form-36 (SF-36) at Week 52 Substudy 2 Proportion of subjects with clinical remission over time with enhanced clinical response over time with endoscopic remission at Week 0, and every 48 weeks thereafter with endoscopic response at Week 0, and every 48 weeks thereafter who discontinue corticosteroid use and achieve clinical remission over time among subjects taking steroids at Baseline (of induction) with clinical remission over time who were in clinical remission at Week 0 achieving Inflammatory Bowel Disease Questionnaire (IBDQ) response (increase of IBDQ ≥ 16 over time) Time loss of enhanced clinical response clinical remission |
Subestudio 1 1. Proporción de sujetos con remisión clínica por CDAI (CDAI <150) en la semana 52, en sujetos con CDAI de 220 a 450 al inicio del estudio de inducción 2. Proporción de sujetos con remisión clínica en la semana 0 y semana 52 3. Proporción de sujetos con remisión endoscópica en la semana 52 4. Proporción de sujetos que interrumpen el uso de corticosteroides para la EC y logran la remisión clínica en la semana 52, en sujetos que toman corticosteroides para la EC al inicio del estudio de inducción 5. Proporción de sujetos que suspendieron el uso de corticosteroides para la EC en la semana 52, en sujetos que tomaron corticosteroides para la EC al inicio del estudio de inducción 6. Proporción de sujetos con respuesta clínica mejorada en la semana 52 7. Proporción de sujetos con remisión clínica y remisión endoscópica en la semana 0 y la semana 52 8. Proporción de sujetos con una reducción ≥ 50% en las fístulas de drenaje en la semana 12, en sujetos con fístulas al inicio del estudio 9. Proporción de sujetos con fístulas de drenaje en la semana 52, en sujetos con fístulas de drenaje al inicio del estudio de inducción 10. Cambios en el Cuestionario de Severidad de los Síntomas de Crohn (CSS) desde la semana 0 a la Semana 52 11. Proporción de sujetos con hospitalizaciones relacionadas con EC durante el período de mantenimiento doble ciego de 52 semanas 12. Cambios, desde la visita inicial, en la evaluación funcional de la terapia de enfermedades crónicas: fatiga (FACIT-F) en la semana 52 13. Cambios, desde la visita inicial, en el Short Form-36 (SF-36) en la semana 52 Subestudio 2 Proporción de sujetos: • con remisión clínica a lo largo del tiempo • con una respuesta clínica mejorada en el tiempo • con remisión endoscópica en la semana 0, y cada 48 semanas a partir de entonces • con respuesta endoscópica en la semana 0, y cada 48 semanas a partir de entonces • que interrumpen el uso de corticosteroides y logran remisión clínica a lo largo del tiempo entre los sujetos que toman esteroides al inicio del estudio (de inducción) • con remisión clínica en el tiempo, que estaban en remisión clínica en la semana 0 • que logran una respuesta al Cuestionario de Enfermedad Inflamatoria Intestinal (IBDQ) (aumento de IBDQ ≥ 16 a lo largo del tiempo) Pérdida de tiempo de • respuesta clínica mejorada • remisión clínica |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Substudy 1 1. week 52 2. week 52 3. week 52 4. week 52 5. week 52 6. week 52 7. week 52 8. week 12 9. week 52 10. week 52 11. week 52 12. week 52 13. week 52 Substudy 2 Over study duration |
Subestudio 1 1. semana 52 2. semana 52 3. semana 52 4. semana 52 5. semana 52 6. semana 52 7. semana 52 8. semana 12 9. semana 52 10. semana 52 |
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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 | No |
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 | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | Yes |
E.8.1.7.1 | Other trial design description |
Substudy 1 Randomized, double-blind. Substudy 2 Both open-label and double-blind |
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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 | 3 |
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.8.4.1 | Number of sites anticipated in Member State concerned | 6 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 146 |
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 |
Belarus |
Bosnia and Herzegovina |
Brazil |
Canada |
Chile |
China |
Colombia |
Egypt |
Hong Kong |
Israel |
Japan |
Korea, Republic of |
Malaysia |
Mexico |
New Zealand |
Russian Federation |
Serbia |
Singapore |
South Africa |
Switzerland |
Taiwan |
Turkey |
Ukraine |
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
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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 | 5 |
E.8.9.1 | In the Member State concerned months | 2 |
E.8.9.1 | In the Member State concerned days | 12 |
E.8.9.2 | In all countries concerned by the trial years | 5 |
E.8.9.2 | In all countries concerned by the trial months | 2 |
E.8.9.2 | In all countries concerned by the trial days | 12 |