E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Axial Spondyloarthritis |
Espondiloartritis axial |
|
E.1.1.1 | Medical condition in easily understood language |
Axial Spondyloarthritis |
Espondiloartritis axial |
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E.1.1.2 | Therapeutic area | Diseases [C] - Immune System Diseases [C20] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10071400 |
E.1.2 | Term | Axial spondyloarthritis |
E.1.2 | System Organ Class | 10028395 - Musculoskeletal and connective tissue disorders |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10076297 |
E.1.2 | Term | Non-radiographic axial spondyloarthritis |
E.1.2 | System Organ Class | 10028395 - Musculoskeletal and connective tissue disorders |
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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 | 10002556 |
E.1.2 | Term | Ankylosing spondylitis |
E.1.2 | System Organ Class | 10028395 - Musculoskeletal and connective tissue disorders |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
• To evaluate the efficacy of upadacitinib compared with placebo on reduction of signs and symptoms in adult subjects with active axSpA including AS who had an inadequate response to a biologic disease-modifying antirheumatic drug (bDMARD) therapy (Study 1) and nr axSpA (Study 2); • To assess the safety and tolerability of upadacitinib in subjects with active axSpA including bDMARD-IR AS (Study 1) and with nr axSpA (Study 2). |
- Para evaluar la eficacia del upacitinib se comparará con placebo la reducción de signos y síntomas en sujetos adultos con axSpa incluyendo AS quien ha tenido una inadecuada respuesta a terapia biológica antirreumática modificadora de la enfermedad (bDMARD) (Estudio 1) y nr-axSpA (Estudio 2). - Evaluar la seguridad y tolerabilidad del upadacitinib en sujetos con axSpA activo, incluido bDMARD-IR AS (Estudio 1) y con nr-axSpA (Estudio 2). |
|
E.2.2 | Secondary objectives of the trial |
• To evaluate the safety and tolerability of upadacitinib in extended treatment in adult subjects with active axSpA including bDMARD-IR AS who have completed the Double Blind Period (Study 1) and with nr-axSpA who have completed the Double Blind Period (Study 2). |
- Para evaluar la seguridad y tolerabilidad a upacitinib en tratamiento prolongado en sujetos adultos con axSpA activo, incluyendo bDMARD-IR AS que han completado el Período Doble Ciego (Estudio 1) y con nr-axSpA que han completado el Período Doble Ciego (Estudio 2). |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
• adult females and males who are at least 18 years of age • clinical diagnosis of AS who meet the modified New York Criteria for AS (Study 1); OR • clinical diagnosis of nr-axSpA fulfilling the 2009 ASAS classification criteria for axSpA but not meeting the radiologic criterion of the modified New York criteria for AS and have objective signs of active inflammation on MRI of sacroiliac joints or based on high sensitivity CRP > ULN (Study 2). • must have a BASDAI score ≥ 4 and a Patient's Assessment of Total Back Pain score ≥ 4 based on a 0 – 10 numerical rating scale at the Screening and Baseline Visits. • For Study 1, subjects must have discontinued 1 bDMARD (either 1 tumor necrosis factor (TNF) inhibitor or 1 interleukin [IL]-17 inhibitor) due to either intolerance or lack of efficacy. • For Study 2, prior treatment with at most 1 bDMARD (either 1 TNF inhibitor or 1 IL-17 inhibitor) is allowed in at least 25%, but not exceeding 35% of subjects |
- Los adultos de ambos sexos que tengan al menos 18 años de edad - Diagnóstico clínico de EA que cumplen con los Criterios de Nueva York modificados para AS (Estudio 1); O - Diagnóstico clínico de nr-axSpA que cumple los criterios de clasificación ASAS 2009 para axSpA pero que no cumple el criterio radiológico de los criterios modificados de Nueva York para AS y tiene signos objetivos de inflamación activa en la IRM de las articulaciones sacroilíacas o basados en la CRP de alta sensibilidad > ULN (Estudio 2). - Debe tener un puntaje de BASDAI ≥ 4 y un puntaje de Evaluación del Dolor Total de Espalda del Paciente ≥ 4 basado en una escala numérica de calificación de 0 - 10 en las Visitas de Revisión y visita basal. - Para el Estudio 1, los sujetos deben haber descontinuado 1 bDMARD (ya sea 1 inhibidor del factor de necrosis tumoral (TNF) o 1 inhibidor de interleucina[IL]-17) debido a intolerancia o falta de eficacia. - Para el Estudio 2, se permite el tratamiento previo con un máximo de 1 bDMARD (1 inhibidor del TNF o 1 inhibidor de la IL-17) en al menos el 25%, pero sin exceder el 35% de los sujetos. |
|
E.4 | Principal exclusion criteria |
• Subject must not have total spinal ankylosis • Subjects who have had an inadequate response to both a TNF inhibitor and IL-17 inhibitor are not eligible. |
- Los sujetos no deben tener la médula espinal totalmente anquilosada - Los sujetos quienes hayan tenido una respuesta inadecuada a los inhibidores TNf y a los inhibidores del IL-17 no son elegibles. |
|
E.5 End points |
E.5.1 | Primary end point(s) |
Study 1 - proportion of subjects achieving an ASAS 40 response Study 2 - proportion of subjects achieving an ASAS 40 response |
Estudio 1- proporción de sujetos que han desarrollado una respuesta de 40 ASAS Estudio 2- proporción de sujetos que han desarrollado una respuesta de 40 ASAS |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Study 1 - Week 14 Study 2 - Week 14 (EU/EMA regulatory purposes); Week 52 (US/FDA regulatory purposes). |
Estudio 1 - Semana 14 Estudio 2 - Semana 14 (Fines regulatorios de UE / EMA ); Semana 52 (Fines regulatorios de EE.UU/ FDA). |
|
E.5.2 | Secondary end point(s) |
Study 1: 1. Change from Baseline in Ankylosing Spondylitis Disease Activity Score (ASDAS); 2. Change from Baseline in magnetic resonance imaging (MRI) Spondyloarthritis Research Consortium of Canada (SPARCC) score (spine); 3. Proportion of subjects with ASAS partial remission (PR) (an absolute score of ≤ 2 units for each of the 4 domains identified in ASAS 40); 4. Proportion of subjects with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) 50 response; 5. Change from Baseline in Bath Ankylosing Spondylitis Functional Index (BASFI); 6. Change from Baseline in Ankylosing Spondylitis Quality of Life (ASQoL); 7. Change from Baseline in ASAS Health Index (HI); 8. Change from Baseline in Maastricht Ankylosing Spondylitis Enthesitis Score (MASES); 9. Change from Baseline in Linear Bath Ankylosing Spondylitis Metrology Index (BASMIlin).
Study 2: 1. Change from Baseline in ASDAS; 2. Change from Baseline in MRI SPARCC score (SI joints); 3. Proportion of subjects with BASDAI 50 response; 4. Proportion of subjects with ASAS PR (an absolute score of ≤ 2 units for each of the 4 domains identified in ASAS 40); 5. Change from Baseline in BASFI; 6. Change from Baseline in ASQoL; 7. Change from Baseline in ASAS HI; 8. Change from Baseline in MASES; 9. Change from Baseline in BASMIlin. |
Estudio 1. Cambio desde la visita basal en la puntuación de actividad de la espondilitis anquilosante (ASDAS); 2. Cambio con respecto a la visita basal en imágenes por resonancia magnética (IRM) Puntaje del Spondyloarthritis Research Consortium of Canada (SPARCC) (columna vertebral); 3. Proporción de sujetos con remisión parcial (RP) de la ASAS (en términos absolutos) de ≤ 2 unidades para cada uno de los 4 dominios identificados en ASAS 40); 4. Proporción de sujetos con espondilitis anquilosante de baño Índice de actividad (BASDAI) 50 respuestas; 5. Cambio desde la visita basal en el índice funcional de la espondilitis anquilosante en el Índice funcional de la espondilitis anquilosante de baño (BASFI); 6. Cambio desde la visita basal en la calidad de vida de la espondilitis anquilosante (ASQoL); 7. Variación con respecto a la visita basal del Índice de Salud ASAS (HI); 8. Cambio con respecto a la visita basal en la entesitis por espondilitis anquilosante de Maastricht Puntuación (MASES); 9. Cambio desde la visita basal en la metrología de la espondilitis anquilosante en baño lineal Índice (BASMIlin).
Estudio 2. 1. Cambio desde la visita basal en ASDAS; 2. Cambio desde la visita basal en la puntuación de MRI SPARCC (articulaciones SI); 3. Proporción de sujetos con respuesta BASDAI 50; 4. Proporción de sujetos con ASAS PR (una puntuación absoluta de ≤ 2 unidades para cada uno de los 4 dominios identificados en ASAS 40); 5. Cambio desde la visita basal en BASFI; 6. Cambio desde la visita basal en ASQoL; 7. Cambio desde la visita basal en ASAS HI; 8. Cambio desde la visita basal en MASES; 9. Cambio desde la visita basal en BASMIlin. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Study 1 and Study 2 - Week 14 |
Estudio 1 y Estudio 2 - Semana 14 |
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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 | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Yes |
E.6.11 | Pharmacogenomic | Yes |
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 | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 7 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 92 |
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 |
Brazil |
Canada |
China |
Japan |
Korea, Republic of |
Mexico |
New Zealand |
Russian Federation |
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 | 4 |
E.8.9.1 | In the Member State concerned months | 2 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 4 |
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 | 0 |