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    Clinical Trial Results:
    A Phase 2, Multicenter, Randomized, Placebo-Controlled, Double-Blind Study to Evaluate the Safety and Efficacy of Risankizumab in Adult Subjects With Moderate to Severe Hidradenitis Suppurativa

    Summary
    EudraCT number
    2019-000122-21
    Trial protocol
    DE   NL   FR   ES  
    Global end of trial date
    02 Aug 2021

    Results information
    Results version number
    v1(current)
    This version publication date
    28 Jul 2022
    First version publication date
    28 Jul 2022
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    M16-833
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT03926169
    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, AbbVie Deutschland GmbH & Co. KG, 001 8006339110, abbvieclinicaltrials@abbvie.com
    Scientific contact
    Global Medical Services, AbbVie, AbbVie Deutschland GmbH & Co. KG, 001 8006339110, abbvieclinicaltrials@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
    02 Aug 2021
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    02 Aug 2021
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    The primary objective of this study is to assess the safety and efficacy of risankizumab 180 mg and 360 mg versus placebo for the treatment of signs and symptoms of moderate to severe hidradenitis suppurativa (HS) in adult participants diagnosed for at least one year before the Baseline visit.
    Protection of trial subjects
    Subject and/or legal guardian read and understood the information provided about the study and gave written permission.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    03 Jun 2019
    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
    Australia: 14
    Country: Number of subjects enrolled
    Canada: 39
    Country: Number of subjects enrolled
    France: 30
    Country: Number of subjects enrolled
    Germany: 26
    Country: Number of subjects enrolled
    Japan: 12
    Country: Number of subjects enrolled
    Netherlands: 15
    Country: Number of subjects enrolled
    Spain: 23
    Country: Number of subjects enrolled
    United States: 84
    Worldwide total number of subjects
    243
    EEA total number of subjects
    94
    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)
    240
    From 65 to 84 years
    3
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    Participants who met the study's eligibility criteria were randomized at the Baseline Visit, in a 1:1:1 ratio, to receive either placebo, risankizumab 180 mg or 360 mg via a subcutaneous (SC) injection.

    Period 1
    Period 1 title
    Period A
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Assessor
    Blinding implementation details
    All AbbVie personnel with direct oversight of the conduct and management of the study (with the exception of AbbVie Drug Supply Management Team) remained blinded until the Primary Analysis at Week 16 was available.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Placebo
    Arm description
    In Period A, participants received blinded placebo via SC injection at Weeks 0 (Baseline), 1, 2, 4, and 12.
    Arm type
    Placebo

    Investigational medicinal product name
    placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection in pre-filled syringe
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    All SC doses of placebo were administered by designated and qualified study site personnel under the direction of the investigator.

    Arm title
    Risankizumab 180 mg
    Arm description
    In Period A, participants received blinded risankizumab 180 mg via SC injection at Weeks 0 (Baseline), 1, 2, 4, and 12.
    Arm type
    Experimental

    Investigational medicinal product name
    risankizumab
    Investigational medicinal product code
    ABBV-066
    Other name
    SKYRIZI
    Pharmaceutical forms
    Solution for injection in pre-filled syringe
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    All SC doses of risankizumab were administered by designated and qualified study site personnel under the direction of the investigator.

    Arm title
    Risankizumab 360 mg
    Arm description
    In Period A, participants received blinded risankizumab 360 mg via SC injection at Weeks 0 (Baseline), 1, 2, 4, and 12.
    Arm type
    Experimental

    Investigational medicinal product name
    risankizumab
    Investigational medicinal product code
    ABBV-066
    Other name
    SKYRIZI
    Pharmaceutical forms
    Solution for injection in pre-filled syringe
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    All SC doses of risankizumab were administered by designated and qualified study site personnel under the direction of the investigator.

    Number of subjects in period 1
    Placebo Risankizumab 180 mg Risankizumab 360 mg
    Started
    82
    80
    81
    Never Received Study Drug
    0 [1]
    0 [2]
    1 [3]
    Completed
    74
    70
    75
    Not completed
    8
    10
    6
         Consent withdrawn by subject
    2
    2
    2
         COVID-19 Logistical Restrictions
    -
    2
    1
         Other, not specified
    1
    -
    -
         Adverse event
    2
    2
    1
         COVID-19 Infection
    -
    1
    -
         Lost to follow-up
    3
    1
    -
         Lack of efficacy
    -
    2
    2
    Notes
    [1] - The number of subjects at this milestone seems inconsistent with the number of subjects in the arm. It is expected that the number of subjects will be greater than, or equal to the number that completed, minus those who left.
    Justification: Number consists of those participants who never received study drug.
    [2] - The number of subjects at this milestone seems inconsistent with the number of subjects in the arm. It is expected that the number of subjects will be greater than, or equal to the number that completed, minus those who left.
    Justification: Number consists of those participants who never received study drug.
    [3] - The number of subjects at this milestone seems inconsistent with the number of subjects in the arm. It is expected that the number of subjects will be greater than, or equal to the number that completed, minus those who left.
    Justification: Number consists of those participants who never received study drug.
    Period 2
    Period 2 title
    Period B
    Is this the baseline period?
    No
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator
    Blinding implementation details
    The investigator, study site personnel, and the participant remained blinded to each participant's initial treatment throughout the study.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Placebo / Risankizumab 360 mg
    Arm description
    In Period A, participants received blinded placebo via SC injection at Weeks 0 (Baseline), 1, 2, 4, and 12. In Period B, participants received blinded risankizumab 360 mg at Weeks 16, 17, and 18. Starting at Week 20, participants received open-label risankizumab 360 mg every 8 weeks (q8w) at Weeks 20, 28, 36, 44, 52, and 60.
    Arm type
    Placebo

    Investigational medicinal product name
    placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection in pre-filled syringe
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    All SC doses of placebo were administered by designated and qualified study site personnel under the direction of the investigator.

    Investigational medicinal product name
    risankizumab
    Investigational medicinal product code
    ABBV-066
    Other name
    SKYRIZI
    Pharmaceutical forms
    Solution for injection in pre-filled syringe
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    All SC doses of risankizumab were administered by designated and qualified study site personnel under the direction of the investigator.

    Arm title
    Risankizumab 180 mg / Risankizumab 360 mg
    Arm description
    In Period A, participants received blinded risankizumab 180 mg via SC injection at Weeks 0 (Baseline), 1, 2, 4, and 12. In Period B, participants received blinded placebo at Weeks 16, 17, and 18. Starting at Week 20, participants received open-label risankizumab 360 mg q8w at Weeks 20, 28, 36, 44, 52, and 60.
    Arm type
    Experimental

    Investigational medicinal product name
    risankizumab
    Investigational medicinal product code
    ABBV-066
    Other name
    SKYRIZI
    Pharmaceutical forms
    Solution for injection in pre-filled syringe
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    All SC doses of risankizumab were administered by designated and qualified study site personnel under the direction of the investigator.

    Investigational medicinal product name
    placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection in pre-filled syringe
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    All SC doses of placebo were administered by designated and qualified study site personnel under the direction of the investigator.

    Arm title
    Risankizumab 360 mg / Risankizumab 360 mg
    Arm description
    In Period A, participants received blinded risankizumab 360 mg via SC injection at Weeks 0 (Baseline), 1, 2, 4, and 12. In Period B, participants received blinded placebo at Weeks 16, 17, and 18. Starting at Week 20, participants received open-label risankizumab 360 mg q8w at Weeks 20, 28, 36, 44, 52, and 60.
    Arm type
    Experimental

    Investigational medicinal product name
    risankizumab
    Investigational medicinal product code
    ABBV-066
    Other name
    SKYRIZI
    Pharmaceutical forms
    Solution for injection in pre-filled syringe
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    All SC doses of risankizumab were administered by designated and qualified study site personnel under the direction of the investigator.

    Investigational medicinal product name
    placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection in pre-filled syringe
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    All SC doses of placebo were administered by designated and qualified study site personnel under the direction of the investigator.

    Number of subjects in period 2
    Placebo / Risankizumab 360 mg Risankizumab 180 mg / Risankizumab 360 mg Risankizumab 360 mg / Risankizumab 360 mg
    Started
    74
    70
    75
    Entered Period B and Received Study Drug
    74
    70
    74
    Completed
    4
    7
    4
    Not completed
    70
    63
    71
         Consent withdrawn by subject
    1
    3
    -
         Other, not specified
    62
    57
    65
         Adverse event
    3
    1
    1
         Lost to follow-up
    1
    1
    4
         Lack of efficacy
    3
    1
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Placebo
    Reporting group description
    In Period A, participants received blinded placebo via SC injection at Weeks 0 (Baseline), 1, 2, 4, and 12.

    Reporting group title
    Risankizumab 180 mg
    Reporting group description
    In Period A, participants received blinded risankizumab 180 mg via SC injection at Weeks 0 (Baseline), 1, 2, 4, and 12.

    Reporting group title
    Risankizumab 360 mg
    Reporting group description
    In Period A, participants received blinded risankizumab 360 mg via SC injection at Weeks 0 (Baseline), 1, 2, 4, and 12.

    Reporting group values
    Placebo Risankizumab 180 mg Risankizumab 360 mg Total
    Number of subjects
    82 80 81 243
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    37.2 ± 11.97 38.9 ± 11.45 38.2 ± 11.99 -
    Gender categorical
    Units: Subjects
        Female
    48 53 51 152
        Male
    34 27 30 91
    Ethnicity
    Units: Subjects
        Hispanic or Latino
    9 10 7 26
        Not Hispanic or Latino
    73 70 74 217
    Race
    Units: Subjects
        White
    68 63 62 193
        Black or African American
    4 12 9 25
        Asian
    8 4 9 21
        American Indian or Alaska Native
    0 1 0 1
        Multiple Races
    2 0 1 3
    Abscess and Inflammatory Nodule (AN) Count
    Units: abscess and inflammatory nodules
        arithmetic mean (standard deviation)
    15.7 ± 28.42 13.7 ± 11.42 12.5 ± 8.24 -

    End points

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    End points reporting groups
    Reporting group title
    Placebo
    Reporting group description
    In Period A, participants received blinded placebo via SC injection at Weeks 0 (Baseline), 1, 2, 4, and 12.

    Reporting group title
    Risankizumab 180 mg
    Reporting group description
    In Period A, participants received blinded risankizumab 180 mg via SC injection at Weeks 0 (Baseline), 1, 2, 4, and 12.

    Reporting group title
    Risankizumab 360 mg
    Reporting group description
    In Period A, participants received blinded risankizumab 360 mg via SC injection at Weeks 0 (Baseline), 1, 2, 4, and 12.
    Reporting group title
    Placebo / Risankizumab 360 mg
    Reporting group description
    In Period A, participants received blinded placebo via SC injection at Weeks 0 (Baseline), 1, 2, 4, and 12. In Period B, participants received blinded risankizumab 360 mg at Weeks 16, 17, and 18. Starting at Week 20, participants received open-label risankizumab 360 mg every 8 weeks (q8w) at Weeks 20, 28, 36, 44, 52, and 60.

    Reporting group title
    Risankizumab 180 mg / Risankizumab 360 mg
    Reporting group description
    In Period A, participants received blinded risankizumab 180 mg via SC injection at Weeks 0 (Baseline), 1, 2, 4, and 12. In Period B, participants received blinded placebo at Weeks 16, 17, and 18. Starting at Week 20, participants received open-label risankizumab 360 mg q8w at Weeks 20, 28, 36, 44, 52, and 60.

    Reporting group title
    Risankizumab 360 mg / Risankizumab 360 mg
    Reporting group description
    In Period A, participants received blinded risankizumab 360 mg via SC injection at Weeks 0 (Baseline), 1, 2, 4, and 12. In Period B, participants received blinded placebo at Weeks 16, 17, and 18. Starting at Week 20, participants received open-label risankizumab 360 mg q8w at Weeks 20, 28, 36, 44, 52, and 60.

    Primary: Percentage of Participants Achieving Hidradenitis Suppurativa Clinical Response (HiSCR) at Week 16

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    End point title
    Percentage of Participants Achieving Hidradenitis Suppurativa Clinical Response (HiSCR) at Week 16
    End point description
    HiSCR is defined as at least a 50% reduction from Baseline in the total abscess and inflammatory nodule (AN) count, with no increase in abscess or draining fistula counts. Intent-to-Treat Population: all randomized participants. Non-responder imputation with multiple imputation to handle missing data due to COVID-19 (NRI-C).
    End point type
    Primary
    End point timeframe
    Baseline (Week 0), Week 16
    End point values
    Placebo Risankizumab 180 mg Risankizumab 360 mg
    Number of subjects analysed
    82
    80
    81
    Units: percentage of participants
        number (confidence interval 97.5%)
    41.5 (29.3 to 53.7)
    46.8 (34.2 to 59.4)
    43.4 (31.0 to 55.8)
    Statistical analysis title
    Statistical Analysis 1
    Comparison groups
    Placebo v Risankizumab 180 mg
    Number of subjects included in analysis
    162
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.422 [1]
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Adjusted response rate difference (%)
    Point estimate
    6
    Confidence interval
         level
    97.5%
         sides
    2-sided
         lower limit
    -10.8
         upper limit
    22.8
    Notes
    [1] - Across the strata, 97.5% confidence interval for adjusted difference and P-value were calculated according to the Cochran-Mantel-Haenszel test adjusted for the actual values stratification factors under a two-sided alpha level 0.025 for each dose.
    Statistical analysis title
    Statistical Analysis 2
    Comparison groups
    Placebo v Risankizumab 360 mg
    Number of subjects included in analysis
    163
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.858 [2]
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Adjusted response rate difference (%)
    Point estimate
    1.3
    Confidence interval
         level
    97.5%
         sides
    2-sided
         lower limit
    -15.4
         upper limit
    18.1
    Notes
    [2] - Across the strata, 97.5% confidence interval for adjusted difference and P-value were calculated according to the Cochran-Mantel-Haenszel test adjusted for the actual values stratification factors under a two-sided alpha level 0.025 for each dose.

    Secondary: Percentage of Participants Achieving ≥ 30% Reduction and ≥ 1 Unit Reduction From Baseline in Patient's Global Assessment (PGA) of Skin Pain Numerical Rating Scale (NRS30) at Week 8 Among Participants With Baseline Numerical Rating Scale (NRS) ≥ 3

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    End point title
    Percentage of Participants Achieving ≥ 30% Reduction and ≥ 1 Unit Reduction From Baseline in Patient's Global Assessment (PGA) of Skin Pain Numerical Rating Scale (NRS30) at Week 8 Among Participants With Baseline Numerical Rating Scale (NRS) ≥ 3
    End point description
    NRS30 is evaluated based on worst skin pain in a 24-hour recall period (maximal daily pain), ranging from 0 (no skin pain) to 10 (skin pain as bad as you can imagine). The percentage of participants who achieved at least 30% reduction and at least 1 unit reduction from Baseline at Week 8 in the PGA of Skin Pain (NRS30) - at worst, among participants with Baseline NRS ≥ 3, is presented. Intent-to-Treat Population: all randomized participants. Participants with Baseline NRS ≥ 3. Non-responder imputation with multiple imputation to handle missing data due to COVID-19.
    End point type
    Secondary
    End point timeframe
    Baseline (Week 0) to Week 8
    End point values
    Placebo Risankizumab 180 mg Risankizumab 360 mg
    Number of subjects analysed
    61
    61
    60
    Units: percentage of participants
        number (confidence interval 97.5%)
    33.0 (19.4 to 46.5)
    29.2 (15.9 to 42.6)
    40.0 (25.8 to 54.2)
    Statistical analysis title
    Statistical Analysis 1
    Comparison groups
    Placebo v Risankizumab 180 mg
    Number of subjects included in analysis
    122
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.725 [3]
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Adjusted response rate difference (%)
    Point estimate
    -3
    Confidence interval
         level
    97.5%
         sides
    2-sided
         lower limit
    -21.8
         upper limit
    15.9
    Notes
    [3] - Across the strata, 97.5% confidence interval for adjusted difference and P-value were calculated according to the Cochran-Mantel-Haenszel test adjusted for the actual values stratification factors under a two-sided alpha level 0.025 for each dose.
    Statistical analysis title
    Statistical Analysis 2
    Comparison groups
    Placebo v Risankizumab 360 mg
    Number of subjects included in analysis
    121
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.301 [4]
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Adjusted response rate difference (%)
    Point estimate
    8.8
    Confidence interval
         level
    97.5%
         sides
    2-sided
         lower limit
    -10.3
         upper limit
    27.8
    Notes
    [4] - Across the strata, 97.5% confidence interval for adjusted difference and P-value were calculated according to the Cochran-Mantel-Haenszel test adjusted for the actual values stratification factors under a two-sided alpha level 0.025 for each dose.

    Secondary: Percentage of Participants Achieving ≥ 30% Reduction and ≥ 1 Unit Reduction From Baseline in PGA of Skin Pain Numerical Rating Scale (NRS30) at Week 16 Among Participants With Baseline Numerical Rating Scale (NRS) ≥ 3

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    End point title
    Percentage of Participants Achieving ≥ 30% Reduction and ≥ 1 Unit Reduction From Baseline in PGA of Skin Pain Numerical Rating Scale (NRS30) at Week 16 Among Participants With Baseline Numerical Rating Scale (NRS) ≥ 3
    End point description
    NRS30 is evaluated based on worst skin pain in a 24-hour recall period (maximal daily pain), ranging from 0 (no skin pain) to 10 (skin pain as bad as you can imagine). The percentage of participants who achieved at least 30% reduction and at least 1 unit reduction from Baseline at Week 16 in the PGA of Skin Pain (NRS30) - at worst, among participants with Baseline NRS ≥ 3, is presented. Intent-to-Treat Population: all randomized participants. Participants with Baseline NRS ≥ 3. Non-responder imputation with multiple imputation to handle missing data due to COVID-19.
    End point type
    Secondary
    End point timeframe
    Baseline (Week 0) to Week 16
    End point values
    Placebo Risankizumab 180 mg Risankizumab 360 mg
    Number of subjects analysed
    61
    61
    60
    Units: percentage of participants
        number (confidence interval 97.5%)
    27.9 (15.0 to 40.7)
    31.1 (17.5 to 44.7)
    38.6 (24.4 to 52.7)
    Statistical analysis title
    Statistical Analysis 1
    Comparison groups
    Placebo v Risankizumab 180 mg
    Number of subjects included in analysis
    122
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.65 [5]
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Adjusted response rate difference (%)
    Point estimate
    3.7
    Confidence interval
         level
    97.5%
         sides
    2-sided
         lower limit
    -14.5
         upper limit
    21.8
    Notes
    [5] - Across the strata, 97.5% confidence interval for adjusted difference and P-value were calculated according to the Cochran-Mantel-Haenszel test adjusted for the actual values stratification factors under a two-sided alpha level 0.025 for each dose.
    Statistical analysis title
    Statistical Analysis 2
    Comparison groups
    Placebo v Risankizumab 360 mg
    Number of subjects included in analysis
    121
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.147
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Adjusted response rate difference (%)
    Point estimate
    12.3
    Confidence interval
         level
    97.5%
         sides
    2-sided
         lower limit
    -6.7
         upper limit
    31.3

    Secondary: Percentage of Participants Who Experienced ≥ 25% Increase in Abscess and Inflammatory Nodule (AN) Counts in Period A With a Minimum Increase of 2 Relative to Baseline

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    End point title
    Percentage of Participants Who Experienced ≥ 25% Increase in Abscess and Inflammatory Nodule (AN) Counts in Period A With a Minimum Increase of 2 Relative to Baseline
    End point description
    Intent-to-Treat Population: all randomized participants. Participants with Baseline NRS ≥ 3. Non-responder imputation.
    End point type
    Secondary
    End point timeframe
    Baseline (Week 0) to Week 16
    End point values
    Placebo Risankizumab 180 mg Risankizumab 360 mg
    Number of subjects analysed
    82
    80
    81
    Units: percentage of participants
        number (confidence interval 97.5%)
    29.3 (18.0 to 40.5)
    22.5 (12.0 to 33.0)
    18.5 (8.8 to 28.2)
    Statistical analysis title
    Statistical Analysis 1
    Comparison groups
    Placebo v Risankizumab 180 mg
    Number of subjects included in analysis
    162
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.342 [6]
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Adjusted response rate difference (%)
    Point estimate
    -6.5
    Confidence interval
         level
    97.5%
         sides
    2-sided
         lower limit
    -21.8
         upper limit
    8.8
    Notes
    [6] - Across the strata, 97.5% confidence interval for adjusted difference and P-value were calculated according to the Cochran-Mantel-Haenszel test adjusted for the actual values stratification factors under a two-sided alpha level 0.025 for each dose.
    Statistical analysis title
    Statistical Analysis 2
    Comparison groups
    Placebo v Risankizumab 360 mg
    Number of subjects included in analysis
    163
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.108 [7]
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Adjusted response rate difference (%)
    Point estimate
    -10.6
    Confidence interval
         level
    97.5%
         sides
    2-sided
         lower limit
    -25.3
         upper limit
    4.2
    Notes
    [7] - Across the strata, 97.5% confidence interval for adjusted difference and P-value were calculated according to the Cochran-Mantel-Haenszel test adjusted for the actual values stratification factors under a two-sided alpha level 0.025 for each dose.

    Secondary: Change From Baseline in Dermatology Life Quality Index (DLQI) Score at Week 16

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    End point title
    Change From Baseline in Dermatology Life Quality Index (DLQI) Score at Week 16
    End point description
    The DLQI is a 10-item validated questionnaire used to assess the impact of HS disease symptoms and treatment on quality of life (QoL). It consists of 10 questions evaluating impact of skin diseases on different aspects of a participant's QoL over the prior week, including symptoms and feelings, daily activities, leisure, work or school, personal relationships, and the side effects of treatment. DLQI scores range from 0 to 30, with a higher score indicating a more impaired QoL. Intent-to-Treat Population: all randomized participants. Participants with an assessment at given time point.
    End point type
    Secondary
    End point timeframe
    Baseline (Week 0) to Week 16
    End point values
    Placebo Risankizumab 180 mg Risankizumab 360 mg
    Number of subjects analysed
    62
    66
    63
    Units: score on a scale
        least squares mean (confidence interval 97.5%)
    -2.1 (-3.9 to -0.4)
    -3.5 (-5.2 to -1.8)
    -3.7 (-5.5 to -2.0)
    Statistical analysis title
    Statistical Analysis 1
    Comparison groups
    Placebo v Risankizumab 180 mg
    Number of subjects included in analysis
    128
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.179 [8]
    Method
    mixed-effect model repeat measures
    Parameter type
    Least Squares (LS) Mean Difference
    Point estimate
    -1.3
    Confidence interval
         level
    97.5%
         sides
    2-sided
         lower limit
    -3.5
         upper limit
    0.9
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.97
    Notes
    [8] - Mixed-effect model repeat measures analysis with treatment, visit, treatment by visit interaction, stratification factor and baseline measurement in the model. An unstructured variance covariance matrix is used.
    Statistical analysis title
    Statistical Analysis 2
    Comparison groups
    Placebo v Risankizumab 360 mg
    Number of subjects included in analysis
    125
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.105 [9]
    Method
    mixed-effect model repeat measures
    Parameter type
    LS Mean Difference
    Point estimate
    -1.6
    Confidence interval
         level
    97.5%
         sides
    2-sided
         lower limit
    -3.8
         upper limit
    0.6
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.98
    Notes
    [9] - Mixed-effect model repeat measures analysis with treatment, visit, treatment by visit interaction, stratification factor and baseline measurement in the model. An unstructured variance covariance matrix is used.

    Secondary: Change From Baseline in HS-Related Swelling Based on the Hidradenitis Suppurativa Symptom Assessment (HSSA) Swollen Skin Score at Week 16

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    End point title
    Change From Baseline in HS-Related Swelling Based on the Hidradenitis Suppurativa Symptom Assessment (HSSA) Swollen Skin Score at Week 16
    End point description
    HSSA is a 9-item participant-reported outcome (PRO) questionnaire developed to assess the symptoms of HS. HS-related swelling is scored on an 11-point NRS, where 0 represents no symptoms and 10 represents extreme symptom experience. Intent-to-Treat Population: all randomized participants. Participants with an assessment at given time point.
    End point type
    Secondary
    End point timeframe
    Baseline (Week 0) to Week 16
    End point values
    Placebo Risankizumab 180 mg Risankizumab 360 mg
    Number of subjects analysed
    65
    53
    63
    Units: score on a scale
        least squares mean (confidence interval 97.5%)
    -0.870 (-1.416 to -0.324)
    -0.751 (-1.338 to -0.165)
    -0.885 (-1.436 to -0.334)
    Statistical analysis title
    Statistical Analysis 1
    Comparison groups
    Placebo v Risankizumab 180 mg
    Number of subjects included in analysis
    118
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.727 [10]
    Method
    mixed-effect model repeat measures
    Parameter type
    LS Mean Difference
    Point estimate
    0.118
    Confidence interval
         level
    97.5%
         sides
    2-sided
         lower limit
    -0.646
         upper limit
    0.883
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.3385
    Notes
    [10] - Mixed-effect model repeat measures analysis with treatment, visit, treatment by visit interaction, stratification factor and baseline measurement in the model. An unstructured variance covariance matrix is used.
    Statistical analysis title
    Statistical Analysis 2
    Comparison groups
    Placebo v Risankizumab 360 mg
    Number of subjects included in analysis
    128
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.963 [11]
    Method
    mixed-effect model repeat measures
    Parameter type
    LS Mean Difference
    Point estimate
    -0.015
    Confidence interval
         level
    97.5%
         sides
    2-sided
         lower limit
    -0.755
         upper limit
    0.724
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.3273
    Notes
    [11] - Mixed-effect model repeat measures analysis with treatment, visit, treatment by visit interaction, stratification factor and baseline measurement in the model. An unstructured variance covariance matrix is used.

    Secondary: Change From Baseline in HS-Related Odor Based on the HSSA Bad Smell Score at Week 16

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    End point title
    Change From Baseline in HS-Related Odor Based on the HSSA Bad Smell Score at Week 16
    End point description
    HSSA is a 9-item PRO questionnaire developed to assess the symptoms of HS. HS-related odor is scored on an 11-point NRS, where 0 represents no symptoms and 10 represents extreme symptom experience. Intent-to-Treat Population: all randomized participants. Participants with an assessment at given time point.
    End point type
    Secondary
    End point timeframe
    Baseline (Week 0) to Week 16
    End point values
    Placebo Risankizumab 180 mg Risankizumab 360 mg
    Number of subjects analysed
    65
    53
    63
    Units: score on a scale
        least squares mean (confidence interval 97.5%)
    -0.677 (-1.160 to -0.195)
    -0.635 (-1.149 to -0.120)
    -0.442 (-0.928 to 0.044)
    Statistical analysis title
    Statistical Analysis 1
    Comparison groups
    Risankizumab 180 mg v Placebo
    Number of subjects included in analysis
    118
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.886 [12]
    Method
    mixed-effect model repeat measures
    Parameter type
    LS Mean Difference
    Point estimate
    0.042
    Confidence interval
         level
    97.5%
         sides
    2-sided
         lower limit
    -0.622
         upper limit
    0.706
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.2941
    Notes
    [12] - Mixed-effect model repeat measures analysis with treatment, visit, treatment by visit interaction, stratification factor and baseline measurement in the model. An unstructured variance covariance matrix is used.
    Statistical analysis title
    Statistical Analysis 2
    Comparison groups
    Placebo v Risankizumab 360 mg
    Number of subjects included in analysis
    128
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.409 [13]
    Method
    mixed-effect model repeat measures
    Parameter type
    LS Mean Difference
    Point estimate
    0.236
    Confidence interval
         level
    97.5%
         sides
    2-sided
         lower limit
    -0.408
         upper limit
    0.879
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.2851
    Notes
    [13] - Mixed-effect model repeat measures analysis with treatment, visit, treatment by visit interaction, stratification factor and baseline measurement in the model. An unstructured variance covariance matrix is used.

    Secondary: Change From Baseline in HS-Related Worst Drainage Based on the HSSA Worst Drainage Score at Week 16

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    End point title
    Change From Baseline in HS-Related Worst Drainage Based on the HSSA Worst Drainage Score at Week 16
    End point description
    HSSA is a 9-item PRO questionnaire developed to assess the symptoms of HS. HS-related worst drainage is scored on an 11-point NRS, where 0 represents no symptoms and 10 represents extreme symptom experience. Intent-to-Treat Population: all randomized participants. Participants with an assessment at given time point.
    End point type
    Secondary
    End point timeframe
    Baseline (Week 0) to Week 16
    End point values
    Placebo Risankizumab 180 mg Risankizumab 360 mg
    Number of subjects analysed
    65
    53
    63
    Units: score on a scale
        least squares mean (confidence interval 97.5%)
    -0.630 (-1.154 to -0.107)
    -0.882 (-1.440 to -0.324)
    -0.705 (-1.233 to -0.176)
    Statistical analysis title
    Statistical Analysis 1
    Comparison groups
    Placebo v Risankizumab 180 mg
    Number of subjects included in analysis
    118
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.434 [14]
    Method
    mixed-effect model repeat measures
    Parameter type
    LS Mean Difference
    Point estimate
    -0.252
    Confidence interval
         level
    97.5%
         sides
    2-sided
         lower limit
    -0.977
         upper limit
    0.473
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.3212
    Notes
    [14] - Mixed-effect model repeat measures analysis with treatment, visit, treatment by visit interaction, stratification factor and baseline measurement in the model. An unstructured variance covariance matrix is used.
    Statistical analysis title
    Statistical Analysis 2
    Comparison groups
    Placebo v Risankizumab 360 mg
    Number of subjects included in analysis
    128
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.813 [15]
    Method
    mixed-effect model repeat measures
    Parameter type
    LS Mean Difference
    Point estimate
    -0.074
    Confidence interval
         level
    97.5%
         sides
    2-sided
         lower limit
    -0.779
         upper limit
    0.631
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.3123
    Notes
    [15] - Mixed-effect model repeat measures analysis with treatment, visit, treatment by visit interaction, stratification factor and baseline measurement in the model. An unstructured variance covariance matrix is used.

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    From the first dose of study medication until 20 weeks after the last dose. Part A overall mean duration on study drug was 108.5 days. Part B overall mean duration on study drug was 179.9 days.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    24.0
    Reporting groups
    Reporting group title
    Placebo
    Reporting group description
    In Period A, participants received blinded placebo via a SC injection at Weeks 0 (Baseline), 1, 2, 4, and 12.

    Reporting group title
    Risankizumab 180 mg
    Reporting group description
    In Period A, participants received blinded risankizumab 180 mg via a SC injection at Weeks 0 (Baseline), 1, 2, 4, and 12.

    Reporting group title
    Risankizumab 360 mg
    Reporting group description
    In Period A, participants received blinded risankizumab 360 mg via a SC injection at Weeks 0 (Baseline), 1, 2, 4, and 12.

    Reporting group title
    Placebo / Risankizumab 360 mg
    Reporting group description
    In Period A, participants received blinded placebo via a SC injection at Weeks 0 (Baseline), 1, 2, 4, and 12. In Period B, participants received blinded risankizumab 360 mg at Weeks 16, 17, and 18. Starting at Week 20, participants received open-label risankizumab 360 mg every 8 weeks (q8w) at Weeks 20, 28, 36, 44, 52, and 60.

    Reporting group title
    Risankizumab 180 mg / Risankizumab 360 mg
    Reporting group description
    In Period A, participants received blinded risankizumab 180 mg via a SC injection at Weeks 0 (Baseline), 1, 2, 4, and 12. In Period B, participants received blinded placebo at Weeks 16, 17, and 18. Starting at Week 20, participants received open-label risankizumab 360 mg q8w at Weeks 20, 28, 36, 44, 52, and 60.

    Reporting group title
    Risankizumab 360 mg / Risankizumab 360 mg
    Reporting group description
    In Period A, participants received blinded risankizumab 360 mg via a SC injection at Weeks 0 (Baseline), 1, 2, 4, and 12. In Period B, participants received blinded placebo at Weeks 16, 17, and 18. Starting at Week 20, participants received open-label risankizumab 360 mg q8w at Weeks 20, 28, 36, 44, 52, and 60.

    Serious adverse events
    Placebo Risankizumab 180 mg Risankizumab 360 mg Placebo / Risankizumab 360 mg Risankizumab 180 mg / Risankizumab 360 mg Risankizumab 360 mg / Risankizumab 360 mg
    Total subjects affected by serious adverse events
         subjects affected / exposed
    2 / 82 (2.44%)
    3 / 80 (3.75%)
    2 / 80 (2.50%)
    3 / 74 (4.05%)
    4 / 70 (5.71%)
    0 / 74 (0.00%)
         number of deaths (all causes)
    0
    0
    0
    0
    0
    0
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    BREAST CANCER
         subjects affected / exposed
    0 / 82 (0.00%)
    0 / 80 (0.00%)
    0 / 80 (0.00%)
    1 / 74 (1.35%)
    0 / 70 (0.00%)
    0 / 74 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Vascular disorders
    DEEP VEIN THROMBOSIS
         subjects affected / exposed
    0 / 82 (0.00%)
    0 / 80 (0.00%)
    0 / 80 (0.00%)
    0 / 74 (0.00%)
    1 / 70 (1.43%)
    0 / 74 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiac disorders
    ANGINA UNSTABLE
         subjects affected / exposed
    1 / 82 (1.22%)
    0 / 80 (0.00%)
    0 / 80 (0.00%)
    0 / 74 (0.00%)
    0 / 70 (0.00%)
    0 / 74 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Surgical and medical procedures
    ABORTION INDUCED
         subjects affected / exposed
    0 / 82 (0.00%)
    1 / 80 (1.25%)
    0 / 80 (0.00%)
    0 / 74 (0.00%)
    0 / 70 (0.00%)
    0 / 74 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    SMALL INTESTINAL OBSTRUCTION
         subjects affected / exposed
    0 / 82 (0.00%)
    0 / 80 (0.00%)
    1 / 80 (1.25%)
    0 / 74 (0.00%)
    1 / 70 (1.43%)
    0 / 74 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Reproductive system and breast disorders
    ENDOMETRIOSIS
         subjects affected / exposed
    0 / 82 (0.00%)
    0 / 80 (0.00%)
    0 / 80 (0.00%)
    1 / 74 (1.35%)
    0 / 70 (0.00%)
    0 / 74 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    OVARIAN CYST
         subjects affected / exposed
    0 / 82 (0.00%)
    0 / 80 (0.00%)
    0 / 80 (0.00%)
    1 / 74 (1.35%)
    0 / 70 (0.00%)
    0 / 74 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    HIDRADENITIS
         subjects affected / exposed
    1 / 82 (1.22%)
    0 / 80 (0.00%)
    0 / 80 (0.00%)
    0 / 74 (0.00%)
    0 / 70 (0.00%)
    0 / 74 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Psychiatric disorders
    AFFECTIVE DISORDER
         subjects affected / exposed
    0 / 82 (0.00%)
    0 / 80 (0.00%)
    1 / 80 (1.25%)
    0 / 74 (0.00%)
    0 / 70 (0.00%)
    0 / 74 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    INTENTIONAL SELF-INJURY
         subjects affected / exposed
    0 / 82 (0.00%)
    0 / 80 (0.00%)
    1 / 80 (1.25%)
    0 / 74 (0.00%)
    0 / 70 (0.00%)
    0 / 74 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    MAJOR DEPRESSION
         subjects affected / exposed
    0 / 82 (0.00%)
    0 / 80 (0.00%)
    1 / 80 (1.25%)
    0 / 74 (0.00%)
    0 / 70 (0.00%)
    0 / 74 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    SUICIDAL IDEATION
         subjects affected / exposed
    0 / 82 (0.00%)
    0 / 80 (0.00%)
    1 / 80 (1.25%)
    0 / 74 (0.00%)
    0 / 70 (0.00%)
    0 / 74 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    INTERVERTEBRAL DISC PROTRUSION
         subjects affected / exposed
    0 / 82 (0.00%)
    0 / 80 (0.00%)
    0 / 80 (0.00%)
    0 / 74 (0.00%)
    1 / 70 (1.43%)
    0 / 74 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    APPENDICITIS
         subjects affected / exposed
    0 / 82 (0.00%)
    0 / 80 (0.00%)
    0 / 80 (0.00%)
    1 / 74 (1.35%)
    0 / 70 (0.00%)
    0 / 74 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    CELLULITIS
         subjects affected / exposed
    0 / 82 (0.00%)
    0 / 80 (0.00%)
    0 / 80 (0.00%)
    1 / 74 (1.35%)
    0 / 70 (0.00%)
    0 / 74 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    COVID-19 PNEUMONIA
         subjects affected / exposed
    0 / 82 (0.00%)
    1 / 80 (1.25%)
    0 / 80 (0.00%)
    0 / 74 (0.00%)
    0 / 70 (0.00%)
    0 / 74 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    SUBCUTANEOUS ABSCESS
         subjects affected / exposed
    0 / 82 (0.00%)
    1 / 80 (1.25%)
    0 / 80 (0.00%)
    0 / 74 (0.00%)
    0 / 70 (0.00%)
    0 / 74 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    TONSILLITIS
         subjects affected / exposed
    0 / 82 (0.00%)
    0 / 80 (0.00%)
    0 / 80 (0.00%)
    0 / 74 (0.00%)
    1 / 70 (1.43%)
    0 / 74 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    URINARY TRACT INFECTION
         subjects affected / exposed
    0 / 82 (0.00%)
    0 / 80 (0.00%)
    0 / 80 (0.00%)
    0 / 74 (0.00%)
    1 / 70 (1.43%)
    0 / 74 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Placebo Risankizumab 180 mg Risankizumab 360 mg Placebo / Risankizumab 360 mg Risankizumab 180 mg / Risankizumab 360 mg Risankizumab 360 mg / Risankizumab 360 mg
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    19 / 82 (23.17%)
    21 / 80 (26.25%)
    26 / 80 (32.50%)
    26 / 74 (35.14%)
    12 / 70 (17.14%)
    19 / 74 (25.68%)
    Nervous system disorders
    HEADACHE
         subjects affected / exposed
    9 / 82 (10.98%)
    6 / 80 (7.50%)
    11 / 80 (13.75%)
    7 / 74 (9.46%)
    1 / 70 (1.43%)
    4 / 74 (5.41%)
         occurrences all number
    16
    6
    15
    10
    1
    5
    Gastrointestinal disorders
    DIARRHOEA
         subjects affected / exposed
    4 / 82 (4.88%)
    2 / 80 (2.50%)
    2 / 80 (2.50%)
    5 / 74 (6.76%)
    1 / 70 (1.43%)
    2 / 74 (2.70%)
         occurrences all number
    4
    2
    4
    5
    1
    2
    Skin and subcutaneous tissue disorders
    ECZEMA
         subjects affected / exposed
    0 / 82 (0.00%)
    0 / 80 (0.00%)
    2 / 80 (2.50%)
    1 / 74 (1.35%)
    0 / 70 (0.00%)
    4 / 74 (5.41%)
         occurrences all number
    0
    0
    2
    1
    0
    4
    HIDRADENITIS
         subjects affected / exposed
    7 / 82 (8.54%)
    3 / 80 (3.75%)
    2 / 80 (2.50%)
    6 / 74 (8.11%)
    8 / 70 (11.43%)
    10 / 74 (13.51%)
         occurrences all number
    7
    3
    3
    6
    8
    10
    Musculoskeletal and connective tissue disorders
    BACK PAIN
         subjects affected / exposed
    2 / 82 (2.44%)
    3 / 80 (3.75%)
    4 / 80 (5.00%)
    2 / 74 (2.70%)
    0 / 70 (0.00%)
    1 / 74 (1.35%)
         occurrences all number
    2
    3
    4
    2
    0
    1
    Infections and infestations
    NASOPHARYNGITIS
         subjects affected / exposed
    3 / 82 (3.66%)
    6 / 80 (7.50%)
    7 / 80 (8.75%)
    1 / 74 (1.35%)
    4 / 70 (5.71%)
    1 / 74 (1.35%)
         occurrences all number
    3
    6
    8
    1
    5
    1
    UPPER RESPIRATORY TRACT INFECTION
         subjects affected / exposed
    1 / 82 (1.22%)
    1 / 80 (1.25%)
    4 / 80 (5.00%)
    2 / 74 (2.70%)
    0 / 70 (0.00%)
    0 / 74 (0.00%)
         occurrences all number
    1
    1
    4
    2
    0
    0
    URINARY TRACT INFECTION
         subjects affected / exposed
    1 / 82 (1.22%)
    4 / 80 (5.00%)
    3 / 80 (3.75%)
    4 / 74 (5.41%)
    0 / 70 (0.00%)
    0 / 74 (0.00%)
         occurrences all number
    1
    4
    3
    4
    0
    0

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    19 Aug 2019
    The purpose of this version is to: - Modify eligibility criterion #35 to allow subjects to continue on non-opioid analgesics provided that the dose and dosing regimen have been stable for at least 14 days preceding the Baseline visit and are expected to remain stable at least until Week 16 visit. - Add a statement regarding dose/regimen adjustments for subjects who are on a documented stable dose and dosing regimen of a non-opioid analgesic treatment prior to entering the study. - Clarify eligibility criteria #24, 25, and 36 and relevant text in Section 5.2 and Section 5.3 to indicate duration of contraception use and expectation for live vaccines to be 20 weeks after the last dose of study drug or as guided by the local risankizumab label if approved, whichever is longer. - Clarify in Section 5.3 that ibuprofen is an allowed medication for pain management during study conduct. - Delete over the counter soap as a prohibited medication to treat HS in Section 5.3 - Clarify in Section 5.4, Allowed Concomitant Medications/Therapies that subjects will document their HS-related analgesic pain. - Increase the number of approximate enrollment sites from 50 to 60 sites. - Clarify in criterion #27 that for subjects who have had prior exposure to anti-TNF therapy, the last anti-TNF treatment administration must have occurred at least 3 months or 5 half-lives (whichever is longer) prior to Baseline. - Clarify data collection procedures in Section 3.4 and Section 3.11 of the Operations Manual. - Add requirement for collection of PK and ADA/nAb samples in the context of a suspected anaphylactic reaction in Section 3.13 of the Operations Manual. - Reduce duration of post-dose safety surveillance to 1 hour in Section 3.13 of the Operations Manual.
    26 Mar 2020
    The purpose of this version is to: - Clarify the wording describing Hidradenitis Suppurativa Clinical Response (HiSCR) throughout the protocol. This clarification has no impact on the overall HiSCR analysis. - Clarify the wording describing the definition of NRS30 throughout the protocol. This clarification has no impact on the overall NRS30. - In Section 5.1, eligibility criterion #27, removed the cap of no more than 15% TNF-IR subjects from eligibility and changed the last anti-TNF treatment administration to having occurred at least 2 months prior to Baseline. - Clarify in Section 5.3 that metformin (except for continuous treatment of pre-existing diabetes) is a prohibited systemic therapy for HS during study conduct. - Clarify in Section 5.3, criterion #6, the prohibited treatments for HS-related pain during study conduct. - Clarify in Section 5.4, any lesion that undergoes an intervention as a rescue treatment will be counted as permanently present from the date of intervention. - Clarify in Section 5.5, the withdrawal criteria. - In Section 5.8, removed the cap of no more than 15% TNF-IR subjects. - Clarify in Section 5.8, the 4 strata in the study. - Update the description of analgesic therapy relative to subject pain in Section 5.4, Allowed Concomitant Medications/Therapies. - Remove Response Adaptive Randomization (RAR) in Section 5.8 and throughout protocol. - Remove Internal Executive Review Committee (IERC) in Section 5.8 and throughout protocol. - In Section 5.5, update wording on study withdrawal. - In Section 6.1, update safety considerations pertaining to adverse events and use of drug. - In Section 6.1, update the details about how to handle subjects who do not continue into Period B from the ITT Population. - In Section 7.3, update the statistical analysis for efficacy and the control for overall type-I error.
    26 Mar 2020
    (continued) - In Section 7.3, update the power and sample size evaluation using adjusted assumptions. - Modify list of protocol signatories.
    09 Jun 2020
    The purpose of this version is to revert the following text in Section 5.4 and Section 5.5 as introduced in Protocol Version 1.0 based upon Agency feedback on Protocol Version 3.0: - Remove the provision in Section 5.4, that the investigator should consult with the TA MD to determine whether discontinuation from the study would be in the best interest of the subject if the subject requires more than 2 protocol-allowed interventions after the Week 16 visit. - Add to Section 5.5, the discontinuation criterion if a subject requires > 2 protocol-allowed HS interventions.
    15 Dec 2020
    The purpose of Protocol Version 5.0 is to update the following sections below and incorporate necessary protocol modifications due to the COVID-19 pandemic and per revised Risankizumab Safety Standards (v7.0) as follows: Modifications to the Protocol and Operations Manual due to State-of Emergency or Pandemic Situations One of the purposes of this version is to provide flexibility during state-of emergency or pandemic situations so subjects may safely enroll and continue study participation as follows: - Included information in Section 2.2 on the re-evaluation of the benefit and risk to subjects participating in the study. The benefit-risk profile of various immunomodulatory therapies is being evaluated. -Modify the following sections to account for state-emergency or pandemic situations: Update Section 5.5 to permit mitigation strategies for withdrawal/interruption/discontinuation of study drug. Update Section 5.9 to define protocol deviations to include those due to the COVID-19 pandemic. Update Section 7.3 to clarify that in the efficacy analysis, Non-Responder Imputation incorporating multiple imputation will be utilized to handle missing data due to COVID-19. Update Section 8.2 with a reference to the Operations Manual to permit modifications to the study protocol as necessary due to state-of emergency or pandemic situations and note investigators should also notify AbbVie if any urgent safety measures are taken. Update Section 9 to note that remote monitoring may be employed as needed. Update Appendix D to add reference to Operations Manual for allowed modifications.
    15 Dec 2020
    (continued) Protocol - In the Synopsis and Section 2.1, replaced the term/abbreviation "inflammatory nodule (AN)" with "abscess and inflammatory nodule (AN)." - In the Section 2.2, updated that subjects with active systemic infection or clinically important infection will not be included in the study. - In the Section 2.2, removed text stating that there are no cases of active TB, including no reactivation of TB in subjects diagnosed with latent TB, across the entire risankizumab development program to date. - In the Section 2.2, updated that subjects with positive QuantiFERON-TB testing/TB skin test who have latent TB and are considered at low risk for reactivation are not required to be treated with TB prophylaxis. - Clarified in Section 3.3 that the additional endpoint with respect to the proportion of subjects achieving at least 1 grade improvement from Baseline in PGIS scale is among subjects with Baseline PGIS of at least "minimal." - In Section 5.3, removed text for new topical therapies and clarified the use of non-antibiotic topical therapies or changes in the concentration/frequency of such treatments for the treatment of HS. - In Section 5.3, added in addition to systemic antibiotic use, "and/or topical" antibiotic use is only allowed for the treatment of acute, non-HS related infections. - In Section 5.3, added Dengue (Dengvaxia®) to the list of examples of live attenuated vaccines that are not permitted during study participation and including up to 140 days after the last dose of study drug. - In Section 5.5, added hepatic test abnormalities confirmed by a second sample should be at least 48 hours apart. - In Section 6.1 for product complaints and pregnancies, replaced the reporting period from '1 business day' or '1 working day' (respectively) to '24 hours.'
    15 Dec 2020
    (continued) - In Section 6.1, update the text 'areas of safety interest' to 'areas of safety interest/safety topics of interest' and rename Table 2 'Areas of Safety Interest' to 'Supplemental Adverse Events eCRFs.' - In Section 6.1, removed text that infections, especially opportunistic infections, are a potential risk with immunomodulators. - In Appendix C, updated protocol signatories and titles. - In Appendix D, removed "PGA Skin Pain and Analgesic Use" as an assessment performed at the Week 36 visit.

    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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