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    Clinical Trial Results:
    Moderate to Severe Atopic Dermatitis: Evaluation of Upadacitinib in Combination with Topical Corticosteroids in Adolescent and Adult Subjects in Japan

    Summary
    EudraCT number
    2022-002777-29
    Trial protocol
    Outside EU/EEA  
    Global end of trial date
    19 Aug 2022

    Results information
    Results version number
    v1(current)
    This version publication date
    23 Feb 2023
    First version publication date
    23 Feb 2023
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    M17-377
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT03661138
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    AbbVie
    Sponsor organisation address
    1 North Waukegan Road, North Chicago, IL, United States, 60064
    Public contact
    Global Medical Services, AbbVie, 001 8006339110, abbvieclinicaltrials@abbvie.com
    Scientific contact
    Global Medical Services, AbbVie, 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?
    Yes
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    19 Aug 2022
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    19 Aug 2022
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The objective of this study is to assess the safety of upadacitinib combined with topical corticosteroids (TCS) in adolescent and adult subjects in Japan with moderate to severe atopic dermatitis (AD) who are candidates for systemic therapy.
    Protection of trial subjects
    The study was conducted in accordance with the protocol, International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines, applicable regulations and guidelines governing clinical study conduct and ethical principles that have their origin in the Declaration of Helsinki. Prior to the initiation of any screening or study-specific procedures, the investigator or his or her representative explained the nature of the study to the subject or his or her representative and answered all questions regarding this study. The informed consent statement was reviewed and signed and dated by the subject and/or the subject's parent or legal guardian and the person who administered the informed consent.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    27 Oct 2018
    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
    Japan: 272
    Worldwide total number of subjects
    272
    EEA total number of subjects
    0
    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)
    25
    Adults (18-64 years)
    245
    From 65 to 84 years
    2
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    The study included a 35-day screening period.

    Period 1
    Period 1 title
    Double Blind (DB) Period
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator
    Blinding implementation details
    Study sites and subjects remained blinded for the duration of the study. To maintain integrity of the trial and avoid introduction of bias, the study team only had access to unblinded subject level data for adverse events adverse events of special interest (AESIs) and serious adverse events (SAEs) for regulatory submissions. In order to maintain the blind, the upadacitinib tablets and placebo tablets provided for the study were identical in appearance.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Placebo + TCS
    Arm description
    Placebo administered once daily (QD) along with TCS for 16 weeks.
    Arm type
    Placebo

    Investigational medicinal product name
    placebo for upadacitinib (ABT-494)
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Film-coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Study drug was taken QD beginning on Day 1 (Baseline) at approximately the same time each day, with or without food.

    Investigational medicinal product name
    topical corticosteroids
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Ointment, Cream
    Routes of administration
    Topical use
    Dosage and administration details
    A TCS regimen in combination with study drug was mandatory until Week 16. After Week 16, the use of any concomitant topical medication for AD could be administered per investigator discretion and was no longer required.

    Arm title
    Upadacitinib 15 mg + TCS
    Arm description
    Upadacitinib 15 mg administered QD along with TCS for 16 weeks.
    Arm type
    Experimental

    Investigational medicinal product name
    upadacitinib
    Investigational medicinal product code
    ABT-494
    Other name
    Pharmaceutical forms
    Film-coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Study drug was taken QD beginning on Day 1 (Baseline) at approximately the same time each day, with or without food.

    Investigational medicinal product name
    topical corticosteroids
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Cream, Ointment
    Routes of administration
    Topical use
    Dosage and administration details
    A TCS regimen in combination with study drug was mandatory until Week 16. After Week 16, the use of any concomitant topical medication for AD could be administered per investigator discretion and was no longer required.

    Arm title
    Upadacitinib 30 mg + TCS
    Arm description
    Upadacitinib 30 mg administered QD along with TCS for 16 weeks.
    Arm type
    Experimental

    Investigational medicinal product name
    upadacitinib
    Investigational medicinal product code
    ABT-494
    Other name
    Pharmaceutical forms
    Film-coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Study drug was taken QD beginning on Day 1 (Baseline) at approximately the same time each day, with or without food.

    Investigational medicinal product name
    topical corticosteroids
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Cream, Ointment
    Routes of administration
    Topical use
    Dosage and administration details
    A TCS regimen in combination with study drug was mandatory until Week 16. After Week 16, the use of any concomitant topical medication for AD could be administered per investigator discretion and was no longer required.

    Number of subjects in period 1
    Placebo + TCS Upadacitinib 15 mg + TCS Upadacitinib 30 mg + TCS
    Started
    90
    91
    91
    Completed
    87
    89
    88
    Not completed
    3
    2
    3
         Consent withdrawn by subject
    2
    -
    2
         Other, not specified
    1
    -
    1
         Adverse event
    -
    2
    -
    Period 2
    Period 2 title
    Blind Extension/Open Label Period
    Is this the baseline period?
    No
    Allocation method
    Randomised - controlled
    Blinding used
    Single blind [1]
    Roles blinded
    Subject, Investigator
    Blinding implementation details
    Single-blinded and then open label after Week 52. Study sites and subjects will remain blinded for the duration of the study. To maintain integrity of the trial and avoid introduction of bias, the study team will only have access to unblinded subject level data for AESIs and SAEs for regulatory submissions.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Placebo + TCS / Upadacitinib 15 mg +TCS
    Arm description
    Subjects in the double blind Placebo + TCS arm (Week 1 to 16) received upadacitinib 15 mg QD in the 36-week blind extension period (Week 16 to 52), and the open label long-term extension Period (Week 52 to Week 160 or permanent withdrawal of the marketing application).
    Arm type
    Experimental

    Investigational medicinal product name
    upadacitinib
    Investigational medicinal product code
    ABT-494
    Other name
    Pharmaceutical forms
    Film-coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Study drug was taken QD beginning on Day 1 (Baseline) at approximately the same time each day, with or without food.

    Arm title
    Placebo + TCS / Upadacitinib 30 mg +TCS
    Arm description
    Subjects in the double blind Placebo + TCS arm (Week 1 to 16) received upadacitinib 30 mg QD in the 36-week blind extension period (Week 16 to 52), and the open label long-term extension Period (Week 52 to Week 160 or permanent withdrawal of the marketing application).
    Arm type
    Experimental

    Investigational medicinal product name
    upadacitinib
    Investigational medicinal product code
    ABT-494
    Other name
    Pharmaceutical forms
    Film-coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Study drug was taken QD beginning on Day 1 (Baseline) at approximately the same time each day, with or without food.

    Arm title
    Upadacitinib 15 mg +TCS / Upadacitinib 15 mg +TCS
    Arm description
    Subjects in the double blind Upadacitinib 15 mg + TCS arm (Week 1 to 16) received upadacitinib 15 mg QD in the 36-week blind extension period (Week 16 to 52), and the open label long-term extension Period (Week 52 to Week 160 or permanent withdrawal of the marketing application).
    Arm type
    Experimental

    Investigational medicinal product name
    upadacitinib
    Investigational medicinal product code
    ABT-494
    Other name
    Pharmaceutical forms
    Film-coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Study drug was taken QD beginning on Day 1 (Baseline) at approximately the same time each day, with or without food.

    Arm title
    Upadacitinib 30 mg +TCS / Upadacitinib 30 mg +TCS
    Arm description
    Subjects in the double blind Upadacitinib 30 mg + TCS arm (Week 1 to 16) received upadacitinib 30 mg QD in the 36-week blind extension period (Week 16 to 52), and the open label long-term extension Period (Week 52 to Week 160 or permanent withdrawal of the marketing application).
    Arm type
    Experimental

    Investigational medicinal product name
    upadacitinib
    Investigational medicinal product code
    ABT-494
    Other name
    Pharmaceutical forms
    Film-coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Study drug was taken QD beginning on Day 1 (Baseline) at approximately the same time each day, with or without food.

    Notes
    [1] - The number of roles blinded appears inconsistent with a single blinded trial. It is expected that there will be one role blinded in a single blind trial.
    Justification: Study sites and subjects will remain blinded for the duration of the study. To maintain integrity of the trial and avoid introduction of bias, the study team will only have access to unblinded subject level data for AESIs and SAEs for regulatory submissions.
    Number of subjects in period 2
    Placebo + TCS / Upadacitinib 15 mg +TCS Placebo + TCS / Upadacitinib 30 mg +TCS Upadacitinib 15 mg +TCS / Upadacitinib 15 mg +TCS Upadacitinib 30 mg +TCS / Upadacitinib 30 mg +TCS
    Started
    42
    45
    89
    88
    Completed
    36
    40
    80
    74
    Not completed
    6
    5
    9
    14
         Consent withdrawn by subject
    6
    3
    5
    8
         Other, not specified
    -
    1
    2
    3
         Adverse event
    -
    -
    1
    2
         Lost to follow-up
    -
    1
    1
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Placebo + TCS
    Reporting group description
    Placebo administered once daily (QD) along with TCS for 16 weeks.

    Reporting group title
    Upadacitinib 15 mg + TCS
    Reporting group description
    Upadacitinib 15 mg administered QD along with TCS for 16 weeks.

    Reporting group title
    Upadacitinib 30 mg + TCS
    Reporting group description
    Upadacitinib 30 mg administered QD along with TCS for 16 weeks.

    Reporting group values
    Placebo + TCS Upadacitinib 15 mg + TCS Upadacitinib 30 mg + TCS Total
    Number of subjects
    90 91 91 272
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    36.3 ( 12.64 ) 35.9 ( 13.22 ) 34.7 ( 12.74 ) -
    Gender categorical
    Units: Subjects
        Female
    16 23 22 61
        Male
    74 68 69 211
    Race
    Units: Subjects
        Asian
    90 91 91 272
    Ethnicity
    Units: Subjects
        Not Hispanic or Latino
    90 91 91 272

    End points

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    End points reporting groups
    Reporting group title
    Placebo + TCS
    Reporting group description
    Placebo administered once daily (QD) along with TCS for 16 weeks.

    Reporting group title
    Upadacitinib 15 mg + TCS
    Reporting group description
    Upadacitinib 15 mg administered QD along with TCS for 16 weeks.

    Reporting group title
    Upadacitinib 30 mg + TCS
    Reporting group description
    Upadacitinib 30 mg administered QD along with TCS for 16 weeks.
    Reporting group title
    Placebo + TCS / Upadacitinib 15 mg +TCS
    Reporting group description
    Subjects in the double blind Placebo + TCS arm (Week 1 to 16) received upadacitinib 15 mg QD in the 36-week blind extension period (Week 16 to 52), and the open label long-term extension Period (Week 52 to Week 160 or permanent withdrawal of the marketing application).

    Reporting group title
    Placebo + TCS / Upadacitinib 30 mg +TCS
    Reporting group description
    Subjects in the double blind Placebo + TCS arm (Week 1 to 16) received upadacitinib 30 mg QD in the 36-week blind extension period (Week 16 to 52), and the open label long-term extension Period (Week 52 to Week 160 or permanent withdrawal of the marketing application).

    Reporting group title
    Upadacitinib 15 mg +TCS / Upadacitinib 15 mg +TCS
    Reporting group description
    Subjects in the double blind Upadacitinib 15 mg + TCS arm (Week 1 to 16) received upadacitinib 15 mg QD in the 36-week blind extension period (Week 16 to 52), and the open label long-term extension Period (Week 52 to Week 160 or permanent withdrawal of the marketing application).

    Reporting group title
    Upadacitinib 30 mg +TCS / Upadacitinib 30 mg +TCS
    Reporting group description
    Subjects in the double blind Upadacitinib 30 mg + TCS arm (Week 1 to 16) received upadacitinib 30 mg QD in the 36-week blind extension period (Week 16 to 52), and the open label long-term extension Period (Week 52 to Week 160 or permanent withdrawal of the marketing application).

    Subject analysis set title
    Safety Double Blind Population: Placebo + TCS
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    Subjects who were randomized to placebo + TCS at baseline and received at least one dose of study drug in the double blind period.

    Subject analysis set title
    Safety Double Blind Population: Upadacitinib 15 mg + TCS
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    Subjects who were randomized to upadacitinib 15 mg + TCS at baseline and received at least one dose of study drug in the double blind period.

    Subject analysis set title
    Safety Double Blind Population: Upadacitinib 30 mg + TCS
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    Subjects who were randomized to upadacitinib 30 mg + TCS at baseline and received at least one dose of study drug in the double blind period.

    Subject analysis set title
    All Upadacitinib Treated Population: Upadacitinib 15 mg
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    Subjects randomized to upadacitinib 15 mg who received at least one dose of upadacitinib in the study.

    Subject analysis set title
    All Upadacitinib Treated Population: Upadacitinib 30 mg
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    Subjects randomized to upadacitinib 30 mg who received at least one dose of upadacitinib in the study.

    Primary: Number of Subjects With TEAEs, SAEs, and Discontinuations Due to AEs in the Double Blind Treatment Period

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    End point title
    Number of Subjects With TEAEs, SAEs, and Discontinuations Due to AEs in the Double Blind Treatment Period [1]
    End point description
    An AE is defined as any untoward medical occurrence which does not necessarily have a causal relationship with treatment. An SAE is any event that results in the death of a subject, is life-threatening, results in hospitalization or prolongation of hospitalization, is a congenital anomaly, results in persistent or significant disability/incapacity, is an important medical event requiring medical or surgical intervention to prevent a serious outcome. The severity of each AE was rated according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.03. IP=investigational product
    End point type
    Primary
    End point timeframe
    From 1st dose of study drug and before the 1st dose of study drug in extension (Week 16), or after the last dose of double blind study drug + 30 days (for subjects not entering the blind extension period). Median treatment duration was 112 days.
    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 statistics are presented per protocol.
    End point values
    Safety Double Blind Population: Placebo + TCS Safety Double Blind Population: Upadacitinib 15 mg + TCS Safety Double Blind Population: Upadacitinib 30 mg + TCS
    Number of subjects analysed
    90
    91
    91
    Units: subjects
        TEAE
    38
    51
    58
        TEAE with reasonably possible relationship to IP
    11
    12
    25
        Severe TEAE
    0
    2
    4
        Serious TEAE (STEAE)
    1
    1
    1
        STEAE with reasonably possible relationship to IP
    0
    1
    1
        TEAE leading to discontinuation of study drug
    1
    2
    1
        TEAE leading to death
    0
    0
    0
    No statistical analyses for this end point

    Primary: Number of Subjects With TEAEs, SAEs, and Discontinuations Due to AEs During Administration of Upadacitinib

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    End point title
    Number of Subjects With TEAEs, SAEs, and Discontinuations Due to AEs During Administration of Upadacitinib [2]
    End point description
    An AE is defined as any untoward medical occurrence which does not necessarily have a causal relationship with treatment. An SAE is any event that results in the death of a subject, is life-threatening, results in hospitalization or prolongation of hospitalization, is a congenital anomaly, results in persistent or significant disability/incapacity, is an important medical event requiring medical or surgical intervention to prevent a serious outcome. The severity of each AE was rated according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.03. IP=investigational product
    End point type
    Primary
    End point timeframe
    From first dose of upadacitinib up to the last dose of upadacitinib + 30 days. Median treatment duration was 1114 days.
    Notes
    [2] - 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 statistics are presented per protocol.
    End point values
    All Upadacitinib Treated Population: Upadacitinib 15 mg All Upadacitinib Treated Population: Upadacitinib 30 mg
    Number of subjects analysed
    133
    136
    Units: subjects
        TEAE
    121
    124
        TEAE with reasonably possible relationship to IP
    70
    74
        Severe TEAE
    18
    19
        Serious TEAE (STEAE)
    15
    13
        STEAE with reasonably possible relationship to IP
    6
    6
        TEAE leading to discontinuation of study drug
    8
    7
        TEAE leading to death
    0
    0
    No statistical analyses for this end point

    Primary: Number of Subjects With TEAEs of Special Interest in the Double Blind Period

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    End point title
    Number of Subjects With TEAEs of Special Interest in the Double Blind Period [3]
    End point description
    "Opportunistic Infection" excludes tuberculosis and herpes zoster. "Major Adverse Cardiovascular Events" are defined as cardiovascular (CV) death, non-fatal myocardial infarction and non-fatal stroke. CV death includes acute myocardial Infarction, sudden cardiac death, death due to heart failure, CV Procedure-Related death, death due to CV hemorrhage, fatal stroke, pulmonary embolism and other CV causes. "Venous Thromboembolic Events" include deep vein thrombosis (DVT) and pulmonary embolism (PE).
    End point type
    Primary
    End point timeframe
    From 1st dose of study drug and before the 1st dose of study drug in extension (Week 16), or after the last dose of double blind study drug + 30 days (for subjects not entering the blind extension period). Median treatment duration was 112 days.
    Notes
    [3] - 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 statistics are presented per protocol.
    End point values
    Safety Double Blind Population: Placebo + TCS Safety Double Blind Population: Upadacitinib 15 mg + TCS Safety Double Blind Population: Upadacitinib 30 mg + TCS
    Number of subjects analysed
    90
    91
    91
    Units: subjects
        Serious Infections
    0
    0
    1
        Opportunistic Infection
    0
    3
    1
        Possible Malignancy
    0
    0
    0
        Malignancy
    0
    0
    0
        Non-Melanoma Skin Cancer (NMSC)
    0
    0
    0
        Malignancy excluding NMSC
    0
    0
    0
        Lymphoma
    0
    0
    0
        Hepatic Disorder
    0
    1
    1
        Gastrointestinal Perforations
    0
    0
    0
        Anemia
    0
    0
    1
        Neutropenia
    0
    1
    4
        Lymphopenia
    0
    0
    0
        Herpes Zoster
    0
    0
    4
        Creatine Phosphokinase (CPK) Elevation
    0
    1
    3
        Renal Dysfunction
    0
    0
    0
        Active Tuberculosis
    0
    0
    0
        Adjudicated Major Adverse Cardiovascular Events
    0
    1
    0
        Adjudicated Venous Thromboembolic Events
    0
    0
    0
    No statistical analyses for this end point

    Primary: Number of Subjects With TEAEs of Special Interest During Administration of Upadacitinib

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    End point title
    Number of Subjects With TEAEs of Special Interest During Administration of Upadacitinib [4]
    End point description
    "Opportunistic Infection" excludes tuberculosis and herpes zoster. "Major Adverse Cardiovascular Events" are defined as CV death, non-fatal myocardial infarction and non-fatal stroke. CV death includes acute myocardial Infarction, sudden cardiac death, death due to heart failure, CV Procedure-Related death, death due to CV hemorrhage, fatal stroke, pulmonary embolism and other CV causes. "Venous Thromboembolic Events" include DVT and PE.
    End point type
    Primary
    End point timeframe
    From first dose of upadacitinib up to the last dose of upadacitinib + 30 days. Median treatment duration was 1114 days.
    Notes
    [4] - 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 statistics are presented per protocol.
    End point values
    All Upadacitinib Treated Population: Upadacitinib 15 mg All Upadacitinib Treated Population: Upadacitinib 30 mg
    Number of subjects analysed
    133
    136
    Units: subjects
        Serious Infections
    7
    9
        Opportunistic Infection
    13
    6
        Possible Malignancy
    1
    0
        Malignancy
    1
    0
        Non-Melanoma Skin Cancer (NMSC)
    0
    0
        Malignancy excluding NMSC
    1
    0
        Lymphoma
    0
    1
        Hepatic Disorder
    14
    16
        Gastrointestinal Perforations
    0
    0
        Anemia
    4
    8
        Neutropenia
    3
    8
        Lymphopenia
    0
    4
        Herpes Zoster
    29
    39
        Creatine Phosphokinase (CPK) Elevation
    8
    15
        Renal Dysfunction
    0
    0
        Active Tuberculosis
    0
    0
        Adjudicated Major Adverse Cardiovascular Events
    1
    0
        Adjudicated Venous Thromboembolic Events
    0
    0
    No statistical analyses for this end point

    Primary: Number of Subjects With Potentially Clinically Important Hematology During the Double Blind Period

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    End point title
    Number of Subjects With Potentially Clinically Important Hematology During the Double Blind Period [5]
    End point description
    End point type
    Primary
    End point timeframe
    From 1st dose of study drug and before the 1st dose of study drug in extension (Week 16), or after the last dose of double blind study drug + 30 days (for subjects not entering the blind extension period). Median treatment duration was 112 days.
    Notes
    [5] - 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 statistics are presented per protocol.
    End point values
    Safety Double Blind Population: Placebo + TCS Safety Double Blind Population: Upadacitinib 15 mg + TCS Safety Double Blind Population: Upadacitinib 30 mg + TCS
    Number of subjects analysed
    90
    91
    91
    Units: subjects
        Hemoglobin < 80 g/L
    0
    0
    0
        Leukocytes < 2.0 10^9/L
    0
    0
    0
        Lymphocytes < 0.5 10^9/L
    0
    1
    0
        Neutrophils < 1.0 10^9/L
    0
    2
    0
        Platelets < 50 10^9/L
    0
    0
    0
    No statistical analyses for this end point

    Primary: Number of Subjects With Potentially Clinically Important Hematology During Administration of Upadacitinib

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    End point title
    Number of Subjects With Potentially Clinically Important Hematology During Administration of Upadacitinib [6]
    End point description
    End point type
    Primary
    End point timeframe
    From first dose of upadacitinib up to the last dose of upadacitinib + 30 days. Median treatment duration was 1114 days.
    Notes
    [6] - 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 statistics are presented per protocol.
    End point values
    All Upadacitinib Treated Population: Upadacitinib 15 mg All Upadacitinib Treated Population: Upadacitinib 30 mg
    Number of subjects analysed
    133
    136
    Units: subjects
        Hemoglobin < 80 g/L
    0
    0
        Leukocytes < 2.0 10^9/L
    0
    0
        Lymphocytes < 0.5 10^9/L
    1
    6
        Neutrophils < 1.0 10^9/L
    2
    3
        Platelets < 50 10^9/L
    0
    0
    No statistical analyses for this end point

    Primary: Number of Subjects With Potentially Clinically Important Chemistry During the Double Blind Period

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    End point title
    Number of Subjects With Potentially Clinically Important Chemistry During the Double Blind Period [7]
    End point description
    ULN=upper limit of normal
    End point type
    Primary
    End point timeframe
    From 1st dose of study drug and before the 1st dose of study drug in extension (Week 16), or after the last dose of double blind study drug + 30 days (for subjects not entering the blind extension period). Median treatment duration was 112 days.
    Notes
    [7] - 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 statistics are presented per protocol.
    End point values
    Safety Double Blind Population: Placebo + TCS Safety Double Blind Population: Upadacitinib 15 mg + TCS Safety Double Blind Population: Upadacitinib 30 mg + TCS
    Number of subjects analysed
    90
    91
    91
    Units: subjects
        Alanine Aminotransferase > 5.0 x ULN
    1
    0
    0
        Albumin < 20 g/L
    0
    0
    0
        Alkaline Phosphatase > 5.0 x ULN
    0
    0
    0
        Aspartate Aminotransferase > 5.0 x ULN
    0
    0
    0
        Calcium Hyper > 3.1 mmol/L
    0
    0
    0
        Calcium Hypo < 1.75 mmol/L
    0
    0
    0
        Cholesterol > 10.34 mmol/L
    0
    0
    2
        Creatine Kinase >5.0 x ULN
    0
    0
    2
        Creatinine > 3.0 x ULN
    0
    0
    0
        Glucose Hyper > 13.9 mmol/L
    0
    0
    0
        Glucose Hypo < 2.2 mmol/L
    0
    0
    0
        Phosphate < 0.6 mmol/L
    0
    0
    0
        Potassium Hyper > 6.0 mmol/L
    0
    0
    0
        Potassium Hypo < 3.0 mmol/L
    0
    0
    0
        Sodium Hyper > 155 mmol/L
    0
    0
    0
        Sodium Hypo < 130 mmol/L
    0
    0
    0
        Triglycerides > 5.7 mmol/L
    3
    1
    2
    No statistical analyses for this end point

    Primary: Number of Subjects With Potentially Clinically Important Chemistry During Administration of Upadacitinib

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    End point title
    Number of Subjects With Potentially Clinically Important Chemistry During Administration of Upadacitinib [8]
    End point description
    ULN=upper limit of normal
    End point type
    Primary
    End point timeframe
    From first dose of upadacitinib up to the last dose of upadacitinib + 30 days. Median treatment duration was 1114 days.
    Notes
    [8] - 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 statistics are presented per protocol.
    End point values
    All Upadacitinib Treated Population: Upadacitinib 15 mg All Upadacitinib Treated Population: Upadacitinib 30 mg
    Number of subjects analysed
    133
    136
    Units: subjects
        Alanine Aminotransferase > 5.0 x ULN
    3
    1
        Albumin < 20 g/L
    0
    0
        Alkaline Phosphatase > 5.0 x ULN
    0
    0
        Aspartate Aminotransferase > 5.0 x ULN
    2
    0
        Calcium Hyper > 3.1 mmol/L
    0
    0
        Calcium Hypo < 1.75 mmol/L
    0
    0
        Cholesterol > 10.34 mmol/L
    0
    3
        Creatine Kinase >5.0 x ULN
    6
    11
        Creatinine > 3.0 x ULN
    0
    0
        Glucose Hyper > 13.9 mmol/L
    0
    0
        Glucose Hypo < 2.2 mmol/L
    0
    0
        Phosphate < 0.6 mmol/L
    1
    1
        Potassium Hyper > 6.0 mmol/L
    0
    0
        Potassium Hypo < 3.0 mmol/L
    1
    0
        Sodium Hyper > 155 mmol/L
    0
    0
        Sodium Hypo < 130 mmol/L
    0
    0
        Triglycerides > 5.7 mmol/L
    8
    13
    No statistical analyses for this end point

    Primary: Number of Subjects With Potentially Clinically Important Vital Signs During the Double Blind Period

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    End point title
    Number of Subjects With Potentially Clinically Important Vital Signs During the Double Blind Period [9]
    End point description
    Vitals signs included increases (↑) and decreases (↓) from baseline (BL) in sitting systolic blood pressure (SBP), sitting diastolic blood pressure (DBP), and weight (for adult subjects).
    End point type
    Primary
    End point timeframe
    From 1st dose of study drug and before the 1st dose of study drug in extension (Week 16), or after the last dose of double blind study drug + 30 days (for subjects not entering the blind extension period). Median treatment duration was 112 days.
    Notes
    [9] - 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 statistics are presented per protocol.
    End point values
    Safety Double Blind Population: Placebo + TCS Safety Double Blind Population: Upadacitinib 15 mg + TCS Safety Double Blind Population: Upadacitinib 30 mg + TCS
    Number of subjects analysed
    90 [10]
    91 [11]
    91 [12]
    Units: subjects
        SBP ≤ 90 mmHg + ↓ ≥ 20 mmHg from BL; n=90, 91, 91
    1
    2
    2
        SBP ≥ 160 mmHg + ↑ ≥ 20 mmHg from BL; n=90, 91, 91
    1
    2
    0
        DBP ≤ 50 mmHg + ↓ ≥ 10 mmHg from BL; n=90, 91, 91
    2
    3
    2
        DBP ≥ 100 mmHg + ↑ ≥ 10 mmHg from BL; n=90, 91, 91
    3
    4
    2
        Weight (Adults Only) > 7% ↓ from BL; n=80, 80, 81
    2
    1
    0
        Weight (Adults Only) > 7% ↑ from BL; n=80, 80, 81
    2
    6
    13
    Notes
    [10] - n=subjects with an assessment
    [11] - n=subjects with an assessment
    [12] - n=subjects with an assessment
    No statistical analyses for this end point

    Primary: Number of Subjects With Potentially Clinically Important Vital Signs During Administration of Upadacitinib

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    End point title
    Number of Subjects With Potentially Clinically Important Vital Signs During Administration of Upadacitinib [13]
    End point description
    Vitals signs included increases (↑) and decreases (↓) from BL in sitting SBP, sitting DBP, and weight (for adult subjects).
    End point type
    Primary
    End point timeframe
    From first dose of upadacitinib up to the last dose of upadacitinib + 30 days. Median treatment duration was 1114 days.
    Notes
    [13] - 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 statistics are presented per protocol.
    End point values
    All Upadacitinib Treated Population: Upadacitinib 15 mg All Upadacitinib Treated Population: Upadacitinib 30 mg
    Number of subjects analysed
    133 [14]
    136 [15]
    Units: subjects
        SBP ≤ 90 mmHg + ↓ ≥ 20 mmHg from BL; n=133, 136
    3
    3
        SBP ≥ 160 mmHg + ↑ ≥ 20 mmHg from BL; n=133, 136
    8
    4
        DBP ≤ 50 mmHg + ↓ ≥ 10 mmHg from BL; n=133, 136
    6
    4
        DBP ≥ 100 mmHg + ↑ ≥ 10 mmHg from BL; n=133, 136
    18
    12
        Weight (Adults Only) > 7% ↓ from BL; n=117, 121
    21
    17
        Weight (Adults Only) > 7% ↑ from BL; n=117, 121
    57
    57
    Notes
    [14] - n=subjects with an assessment
    [15] - n=subjects with an assessment
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    DB Period: From 1st dose of study drug and before the 1st dose of study drug in extension (Week 16), or after the last dose of double blind study drug + 30 days (for subjects not entering the blind extension period). Median treatment duration = 112 days.
    Adverse event reporting additional description
    All Upadacitinib Groups: From first dose of upadacitinib up to the last dose of upadacitinib + 30 days. Median treatment duration = 1114 days.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    25.0
    Reporting groups
    Reporting group title
    Safety Double Blind Population: Placebo + TCS
    Reporting group description
    Subjects who were randomized to placebo + TCS at baseline and received at least one dose of study drug in the double blind period.

    Reporting group title
    All Upadacitinib Treated Population: Upadacitinib 30 mg + TCS
    Reporting group description
    Randomized subjects who received at least one dose of upadacitinib 30 mg in the study.

    Reporting group title
    All Upadacitinib Treated Population: Upadacitinib 15 mg + TCS
    Reporting group description
    Randomized subjects who received at least one dose of upadacitinib 15 mg in the study.

    Reporting group title
    Safety Double Blind Population: Upadacitinib 15 mg + TCS
    Reporting group description
    Subjects who were randomized to upadacitinib 15 mg + TCS at baseline and received at least one dose of study drug in the double blind period.

    Reporting group title
    Safety Double Blind Population: Upadacitinib 30 mg + TCS
    Reporting group description
    Subjects who were randomized to upadacitinib 30 mg + TCS at baseline and received at least one dose of study drug in the double blind period.

    Serious adverse events
    Safety Double Blind Population: Placebo + TCS All Upadacitinib Treated Population: Upadacitinib 30 mg + TCS All Upadacitinib Treated Population: Upadacitinib 15 mg + TCS Safety Double Blind Population: Upadacitinib 15 mg + TCS Safety Double Blind Population: Upadacitinib 30 mg + TCS
    Total subjects affected by serious adverse events
         subjects affected / exposed
    1 / 90 (1.11%)
    13 / 136 (9.56%)
    15 / 133 (11.28%)
    1 / 91 (1.10%)
    1 / 91 (1.10%)
         number of deaths (all causes)
    0
    0
    0
    0
    0
         number of deaths resulting from adverse events
    0
    0
    0
    0
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    OSTEOMA
         subjects affected / exposed
    0 / 90 (0.00%)
    1 / 136 (0.74%)
    0 / 133 (0.00%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences causally related to treatment / all
    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
    Injury, poisoning and procedural complications
    CONCUSSION
         subjects affected / exposed
    0 / 90 (0.00%)
    0 / 136 (0.00%)
    1 / 133 (0.75%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences causally related to treatment / all
    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
    MENISCUS INJURY
         subjects affected / exposed
    0 / 90 (0.00%)
    1 / 136 (0.74%)
    0 / 133 (0.00%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences causally related to treatment / all
    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
    RADIUS FRACTURE
         subjects affected / exposed
    0 / 90 (0.00%)
    1 / 136 (0.74%)
    0 / 133 (0.00%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences causally related to treatment / all
    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
    SKIN LACERATION
         subjects affected / exposed
    0 / 90 (0.00%)
    0 / 136 (0.00%)
    1 / 133 (0.75%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences causally related to treatment / all
    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
    Congenital, familial and genetic disorders
    HYDROCELE
         subjects affected / exposed
    0 / 90 (0.00%)
    1 / 136 (0.74%)
    0 / 133 (0.00%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences causally related to treatment / all
    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
    Nervous system disorders
    CEREBELLAR HAEMORRHAGE
         subjects affected / exposed
    0 / 90 (0.00%)
    0 / 136 (0.00%)
    1 / 133 (0.75%)
    1 / 91 (1.10%)
    0 / 91 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    General disorders and administration site conditions
    CYST
         subjects affected / exposed
    0 / 90 (0.00%)
    0 / 136 (0.00%)
    1 / 133 (0.75%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences causally related to treatment / all
    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
    Eye disorders
    CATARACT DIABETIC
         subjects affected / exposed
    0 / 90 (0.00%)
    0 / 136 (0.00%)
    1 / 133 (0.75%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences causally related to treatment / all
    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
    RETINAL DETACHMENT
         subjects affected / exposed
    0 / 90 (0.00%)
    0 / 136 (0.00%)
    1 / 133 (0.75%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences causally related to treatment / all
    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
    Gastrointestinal disorders
    ALCOHOLIC PANCREATITIS
         subjects affected / exposed
    0 / 90 (0.00%)
    0 / 136 (0.00%)
    1 / 133 (0.75%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences causally related to treatment / all
    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
    INGUINAL HERNIA
         subjects affected / exposed
    0 / 90 (0.00%)
    0 / 136 (0.00%)
    1 / 133 (0.75%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences causally related to treatment / all
    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
    IRRITABLE BOWEL SYNDROME
         subjects affected / exposed
    0 / 90 (0.00%)
    0 / 136 (0.00%)
    1 / 133 (0.75%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences causally related to treatment / all
    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
    LARGE INTESTINE POLYP
         subjects affected / exposed
    0 / 90 (0.00%)
    1 / 136 (0.74%)
    0 / 133 (0.00%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hepatobiliary disorders
    CHOLELITHIASIS
         subjects affected / exposed
    1 / 90 (1.11%)
    0 / 136 (0.00%)
    0 / 133 (0.00%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences causally related to treatment / all
    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
    Respiratory, thoracic and mediastinal disorders
    PNEUMOTHORAX
         subjects affected / exposed
    0 / 90 (0.00%)
    1 / 136 (0.74%)
    0 / 133 (0.00%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    PNEUMOTHORAX SPONTANEOUS
         subjects affected / exposed
    0 / 90 (0.00%)
    0 / 136 (0.00%)
    1 / 133 (0.75%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences causally related to treatment / all
    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
    Psychiatric disorders
    SOMATIC SYMPTOM DISORDER
         subjects affected / exposed
    0 / 90 (0.00%)
    0 / 136 (0.00%)
    1 / 133 (0.75%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences causally related to treatment / all
    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
    Musculoskeletal and connective tissue disorders
    SPINAL OSTEOARTHRITIS
         subjects affected / exposed
    0 / 90 (0.00%)
    1 / 136 (0.74%)
    0 / 133 (0.00%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences causally related to treatment / all
    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
    Infections and infestations
    APPENDICITIS
         subjects affected / exposed
    0 / 90 (0.00%)
    1 / 136 (0.74%)
    1 / 133 (0.75%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    CELLULITIS
         subjects affected / exposed
    0 / 90 (0.00%)
    0 / 136 (0.00%)
    1 / 133 (0.75%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences causally related to treatment / all
    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
    COVID-19
         subjects affected / exposed
    0 / 90 (0.00%)
    3 / 136 (2.21%)
    0 / 133 (0.00%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    ECZEMA HERPETICUM
         subjects affected / exposed
    0 / 90 (0.00%)
    0 / 136 (0.00%)
    1 / 133 (0.75%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences causally related to treatment / all
    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
    ENTERITIS INFECTIOUS
         subjects affected / exposed
    0 / 90 (0.00%)
    0 / 136 (0.00%)
    1 / 133 (0.75%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences causally related to treatment / all
    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
    HERPES SIMPLEX
         subjects affected / exposed
    0 / 90 (0.00%)
    1 / 136 (0.74%)
    0 / 133 (0.00%)
    0 / 91 (0.00%)
    1 / 91 (1.10%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    HERPES ZOSTER
         subjects affected / exposed
    0 / 90 (0.00%)
    2 / 136 (1.47%)
    1 / 133 (0.75%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    HERPES ZOSTER CUTANEOUS DISSEMINATED
         subjects affected / exposed
    0 / 90 (0.00%)
    1 / 136 (0.74%)
    0 / 133 (0.00%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    HERPES ZOSTER DISSEMINATED
         subjects affected / exposed
    0 / 90 (0.00%)
    1 / 136 (0.74%)
    0 / 133 (0.00%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    PNEUMOCYSTIS JIROVECII PNEUMONIA
         subjects affected / exposed
    0 / 90 (0.00%)
    0 / 136 (0.00%)
    1 / 133 (0.75%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences causally related to treatment / all
    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
    SEPTIC SHOCK
         subjects affected / exposed
    0 / 90 (0.00%)
    0 / 136 (0.00%)
    1 / 133 (0.75%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences causally related to treatment / all
    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
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Safety Double Blind Population: Placebo + TCS All Upadacitinib Treated Population: Upadacitinib 30 mg + TCS All Upadacitinib Treated Population: Upadacitinib 15 mg + TCS Safety Double Blind Population: Upadacitinib 15 mg + TCS Safety Double Blind Population: Upadacitinib 30 mg + TCS
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    29 / 90 (32.22%)
    114 / 136 (83.82%)
    108 / 133 (81.20%)
    40 / 91 (43.96%)
    44 / 91 (48.35%)
    Investigations
    ALANINE AMINOTRANSFERASE INCREASED
         subjects affected / exposed
    0 / 90 (0.00%)
    11 / 136 (8.09%)
    9 / 133 (6.77%)
    1 / 91 (1.10%)
    1 / 91 (1.10%)
         occurrences all number
    0
    13
    13
    1
    1
    BLOOD CREATINE PHOSPHOKINASE INCREASED
         subjects affected / exposed
    0 / 90 (0.00%)
    15 / 136 (11.03%)
    8 / 133 (6.02%)
    1 / 91 (1.10%)
    3 / 91 (3.30%)
         occurrences all number
    0
    16
    8
    1
    3
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    SKIN PAPILLOMA
         subjects affected / exposed
    0 / 90 (0.00%)
    8 / 136 (5.88%)
    14 / 133 (10.53%)
    1 / 91 (1.10%)
    0 / 91 (0.00%)
         occurrences all number
    0
    8
    17
    1
    0
    Nervous system disorders
    HEADACHE
         subjects affected / exposed
    2 / 90 (2.22%)
    12 / 136 (8.82%)
    6 / 133 (4.51%)
    1 / 91 (1.10%)
    1 / 91 (1.10%)
         occurrences all number
    3
    16
    11
    3
    1
    General disorders and administration site conditions
    INJECTION SITE PAIN
         subjects affected / exposed
    0 / 90 (0.00%)
    11 / 136 (8.09%)
    3 / 133 (2.26%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences all number
    0
    19
    4
    0
    0
    PYREXIA
         subjects affected / exposed
    1 / 90 (1.11%)
    28 / 136 (20.59%)
    20 / 133 (15.04%)
    4 / 91 (4.40%)
    3 / 91 (3.30%)
         occurrences all number
    1
    33
    25
    5
    3
    Eye disorders
    CONJUNCTIVITIS ALLERGIC
         subjects affected / exposed
    0 / 90 (0.00%)
    5 / 136 (3.68%)
    8 / 133 (6.02%)
    1 / 91 (1.10%)
    1 / 91 (1.10%)
         occurrences all number
    0
    6
    10
    1
    1
    Gastrointestinal disorders
    DENTAL CARIES
         subjects affected / exposed
    0 / 90 (0.00%)
    4 / 136 (2.94%)
    8 / 133 (6.02%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences all number
    0
    4
    8
    0
    0
    Respiratory, thoracic and mediastinal disorders
    ASTHMA
         subjects affected / exposed
    1 / 90 (1.11%)
    8 / 136 (5.88%)
    1 / 133 (0.75%)
    0 / 91 (0.00%)
    2 / 91 (2.20%)
         occurrences all number
    1
    10
    1
    0
    2
    Skin and subcutaneous tissue disorders
    ACNE
         subjects affected / exposed
    5 / 90 (5.56%)
    53 / 136 (38.97%)
    34 / 133 (25.56%)
    12 / 91 (13.19%)
    18 / 91 (19.78%)
         occurrences all number
    5
    64
    43
    14
    18
    DERMATITIS ATOPIC
         subjects affected / exposed
    3 / 90 (3.33%)
    16 / 136 (11.76%)
    19 / 133 (14.29%)
    3 / 91 (3.30%)
    0 / 91 (0.00%)
         occurrences all number
    3
    18
    20
    3
    0
    Musculoskeletal and connective tissue disorders
    ARTHRALGIA
         subjects affected / exposed
    0 / 90 (0.00%)
    11 / 136 (8.09%)
    2 / 133 (1.50%)
    0 / 91 (0.00%)
    5 / 91 (5.49%)
         occurrences all number
    0
    15
    2
    0
    5
    Infections and infestations
    COVID-19
         subjects affected / exposed
    0 / 90 (0.00%)
    4 / 136 (2.94%)
    8 / 133 (6.02%)
    0 / 91 (0.00%)
    0 / 91 (0.00%)
         occurrences all number
    0
    4
    8
    0
    0
    ECZEMA HERPETICUM
         subjects affected / exposed
    0 / 90 (0.00%)
    5 / 136 (3.68%)
    11 / 133 (8.27%)
    3 / 91 (3.30%)
    1 / 91 (1.10%)
         occurrences all number
    0
    9
    16
    3
    1
    FOLLICULITIS
         subjects affected / exposed
    2 / 90 (2.22%)
    7 / 136 (5.15%)
    13 / 133 (9.77%)
    3 / 91 (3.30%)
    2 / 91 (2.20%)
         occurrences all number
    3
    8
    18
    4
    2
    FURUNCLE
         subjects affected / exposed
    2 / 90 (2.22%)
    3 / 136 (2.21%)
    7 / 133 (5.26%)
    2 / 91 (2.20%)
    0 / 91 (0.00%)
         occurrences all number
    2
    4
    9
    2
    0
    GASTROENTERITIS
         subjects affected / exposed
    1 / 90 (1.11%)
    5 / 136 (3.68%)
    8 / 133 (6.02%)
    0 / 91 (0.00%)
    1 / 91 (1.10%)
         occurrences all number
    1
    5
    9
    0
    1
    HERPES SIMPLEX
         subjects affected / exposed
    2 / 90 (2.22%)
    7 / 136 (5.15%)
    14 / 133 (10.53%)
    2 / 91 (2.20%)
    1 / 91 (1.10%)
         occurrences all number
    2
    12
    32
    2
    1
    HERPES ZOSTER
         subjects affected / exposed
    0 / 90 (0.00%)
    35 / 136 (25.74%)
    26 / 133 (19.55%)
    0 / 91 (0.00%)
    4 / 91 (4.40%)
         occurrences all number
    0
    38
    26
    0
    4
    INFLUENZA
         subjects affected / exposed
    1 / 90 (1.11%)
    11 / 136 (8.09%)
    7 / 133 (5.26%)
    1 / 91 (1.10%)
    2 / 91 (2.20%)
         occurrences all number
    1
    11
    7
    1
    2
    NASOPHARYNGITIS
         subjects affected / exposed
    14 / 90 (15.56%)
    44 / 136 (32.35%)
    36 / 133 (27.07%)
    12 / 91 (13.19%)
    14 / 91 (15.38%)
         occurrences all number
    15
    68
    55
    14
    19
    PARONYCHIA
         subjects affected / exposed
    0 / 90 (0.00%)
    10 / 136 (7.35%)
    1 / 133 (0.75%)
    0 / 91 (0.00%)
    1 / 91 (1.10%)
         occurrences all number
    0
    12
    1
    0
    1
    ORAL HERPES
         subjects affected / exposed
    0 / 90 (0.00%)
    8 / 136 (5.88%)
    12 / 133 (9.02%)
    1 / 91 (1.10%)
    2 / 91 (2.20%)
         occurrences all number
    0
    14
    19
    1
    2
    PHARYNGITIS
         subjects affected / exposed
    1 / 90 (1.11%)
    7 / 136 (5.15%)
    6 / 133 (4.51%)
    0 / 91 (0.00%)
    1 / 91 (1.10%)
         occurrences all number
    1
    8
    6
    0
    1
    TINEA PEDIS
         subjects affected / exposed
    2 / 90 (2.22%)
    13 / 136 (9.56%)
    3 / 133 (2.26%)
    0 / 91 (0.00%)
    1 / 91 (1.10%)
         occurrences all number
    2
    13
    3
    0
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    01 Apr 2019
    ○ Updated to include safety results from the recent Phase 2b atopic dermatitis study and Phase 3 rheumatoid arthritis studies. ○ Updated biomarker sample language for clarification. ○ Added rationale for selection of doses for adolescents and recent efficacy and safety data from the Phase 2b study to justify dose selection. ○ Updated Eligibility Criteria to specify method of glomerular filtration rate estimation for adult and adolescent subjects and to specify that topical corticosteroids (TCS) or topical calcineurin inhibitors (TCIs) are not contraindicated. ○ Updated contraception requirements to clarify age range of postmenopausal subjects and definition of childbearing potential to include female adolescents. ○ Updated to allow prohibited medications and therapy after discontinuation of study drug and to clarify cannabis prohibition duration. ○ Clarified required concomitant medication duration. ○ Clarified the daily use of TCS and/or TCI during the study with step-down regimen, the restriction of wet wraps, and use after premature study drug discontinuation. ○ Clarified that intentional/prospective deviations from withdrawal criteria are not permitted. ○ Incorporated biomarker procedure for subjects after withdrawal from the study. ○ Added clarification of treatment after end of study. ○ Updated details on how the study drug was to be taken, packaged and labelled, stored and disposed of, dose randomization, selection and timing of study drug, treatment compliance, and blinding. ○ Added proper detail of other study procedures originally found in the Operations Manual. ○ Updated pregnancy language, methods and timing of safety assessment, recording data and analyses of safety findings, and reporting of AEs and intercurrent illnesses.
    01 Apr 2019
    (continued) ○ Added clarifications for management of toxicity, serious infections, serious gastrointestinal (GI) events, cardiovascular and embolic/thrombotic events, malignancy, electrocardiogram (ECG) abnormality, and select laboratory abnormalities. ○ Updated detail regarding the Data Monitoring Committee (DMC). ○ Provided additional detail regarding safety data collection and Suspected Unexpected Serious Adverse Reactions (SUSAR) reporting. ○ Clarified timing of population pharmacokinetic (PK) reporting. ○ Provided additional detail regarding subject consent. ○ Updated Activity Schedule to include review of pregnancy avoidance recommendations, additional height measures for adolescents, additional procedures at the 30-Day Follow-Up Visit, additional 12-lead ECGs, chest x-ray clarification, and urine drug screen.
    17 Jan 2020
    ○ Updated the benefits and risks to subjects to include safety language specifying that events of deep vein thrombosis and pulmonary embolism have been report in patients receiving Janus kinase (JAK) inhibitors including upadacitinib, and added text indicating that updating is not genotoxic but is teratogenic based on animal studies and there is no risk associated with administration in male partners of females of childbearing potential. ○ Updated toxicity management instructions to include management of herpes zoster and muscle-related events, added recommendation for periodic skin examination for patients at increased risk for skin cancer. ○ Instructions for the management of cardiovascular and embolic/thrombotic events were revised to make them specific to thrombosis events and included instructions that subjects must be discontinued if deep vein thrombosis, pulmonary embolus or non-cardiac, non-neurologic arterial thrombosis is confirmed. ○ Updated discontinuation criteria to include confirmed diagnosis of deep vein thrombosis, pulmonary embolus or non-cardiac, non-neurologic arterial thrombosis. ○ Added "Active" to tuberculosis (TB) and "adjudicated" to GI perforations in the list of reported AESIs.
    01 Dec 2020
    ○ Stated that study drug shipments could be made from the study site to the subject and that there were no time limits for study drug interruption if no permanent study drug discontinuation criteria had been met. ○ Updated to include details on how to perform specific activities/procedures that may be impacted by changes in global/local regulations due to the pandemic, provide guidance on delayed assessments due to the pandemic, and state which assessments may not be performed remotely. ○ Provided instructions for completing supplemental study case report forms in the case of COVID-19-related missed/virtual visit, study drug discontinuations, or AEs; added instruction to interrupt study drug in subjects with confirmed diagnosis of COVID-19. ○ Changed the last date of the open label (OL) long-term extension from Week 136 to Week 160. ○ Updated the study drug discontinuation criteria for Eczema Area and Severity Index (EASI) worsening of 25% or more to include the following: "For example, permanent study drug discontinuation would apply at Week 8 if EASI score worsening criteria are met at Week 4 and Week 8 without rescue therapy given at Week 4. Permanent study drug discontinuation would apply at Week 12 if EASI score worsening criteria are met at Week 8 and Week 12 with rescue therapy given at Week 4. This rule applies similarly to later timepoints." ○ In the safety section, added the supplemental electronic case report form for eczema herpeticum to the table of events that required a supplemental report, removed management of muscle-related events from toxicity management events, and updated guidelines for abnormal laboratory values for alanine aminotransferase (ALT) and aspartate transaminase (AST) in the toxicity management guidelines table.
    01 Dec 2020
    (continued) ○ In the schedule of events, clarified that chest x-ray will be repeated annually (Weeks 100 and 148) starting at Week 52 if newly positive TB risk factor or results are obtained, added 12-lead ECG at Week 148 to accommodate extension to 160 weeks, clarified that blood samples for PK assay should not be taken at the Premature Discontinuation (PD) Visit if the PD Visit occurs after Week 16, and corrected the assessment time points for body surface area from every visit to only Screening, baseline, and Unscheduled Visits.

    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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