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NCT05609630PHASE3Recruiting

Study of Oral Upadacitinib and Subcutaneous/Intravenous Tocilizumab to Evaluate Change in Disease Activity, Adverse Events and How Drug Moves Through the Body of Pediatric and Adolescent Participants With Active Systemic Juvenile Idiopathic Arthritis.

AbbVie

Start Date

10/2/2023

Completion Date

6/1/2029

Summary

Juvenile Idiopathic Arthritis (JIA) is the most common type of arthritis that affects children. The term "idiopathic" means "of unknown origin". It is a chronic (long-lasting) disease that causes swelling, warmth, and pain of one or more small joints. Systemic JIA ia a rare and serious form of JIA. Systemic" means it may affect not only the joints but other parts of the body, including the liver, lungs and heart. sJIA is more severe and can be more challenging to diagnose and treat than other types of juvenile idiopathic arthritis. It is a lifelong disease for many patients and can continue into adulthood. This study will assess how safe and effective upadacitinib is in treating pediatric and adolescent participants aged 1 to \< 18 with systemic juvenile idiopathic arthritis (sJIA) and will include a tocilizumab treatment arm for reference. Adverse events and change in the disease activity will be assessed. Upadacitinib is an investigational drug being developed for the treatment of sJIA. Participants are assigned to 1 of 2 cohorts. In cohort 1, participants will receive upadacitinib or tocilizumab reference. In cohort 2, participants will receive upadacitinib. Approximately 90 participants with sJIA will be enrolled in approximately 45 sites worldwide. Participants will receive upadacitinib oral tablets once daily or oral solution twice daily or tocilizumab subcutaneous injection or intravenous infusion as per local label for 52 weeks and followed for approximately 30 days. There may be higher treatment burden for participants in this trial compared to their standard of care. Participants will attend regular visits/calls during the study at a hospital or clinic. The effect of the treatment will be checked by medical assessments, checking for side effects and completing questionnaires.

Eligibility Criteria

Age Range: 1 years to 17 years

Inclusion Criteria: \- Baseline with a total body weight of 10 kg or higher at screening and symptoms of systemic juvenile idiopathic arthritis (sJIA) according to International League of Associations for Rheumatology (ILAR) criteria for at least 6 weeks prior to Screening, with onset prior to 16 years old, and meet the following conditions: * Must have active sJIA with at least 2 active joints at Screening and Baseline, fever more than 38°C on at least one day within 14 consecutive days before the Screening Visit, and an erythrocyte sedimentation rate (ESR) or high-sensitivity C-reactive protein (hsCRP) \> upper limit of normal (ULN) at Screening. OR At least 4 active joints at Screening and Baseline and an ESR or hsCRP \> ULN at Screening. * Must have inadequate response to previous treatment with nonsteroidal anti-inflammatory drugs and/or systemic glucocorticoids, as judged by the investigator. * For Cohort 1, participants must not have had previous treatment with any IL-6 inhibitor. For Cohort 2, participants must have an intolerance or inadequate response to an IL-6 inhibitor as judged by the investigator. Note: For Cohort 1, participants must be ages 2 to \< 18 years old in countries where SC tocilizumab is not approved for sJIA. Exclusion Criteria: * Has any type of juvenile idiopathic arthritis (JIA), other than sJIA, as defined by the ILAR criteria, and must not have a history or presence of any other autoimmune inflammatory condition other than sJIA. * Has uncontrolled severe systemic disease and/or impeding or active macrophage activation syndrome within 1 month prior to Baseline.

Interventions

DRUG

Upadacitinib

DRUG

Tocilizumab

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Conditions

Juvenile Idiopathic Arthritis

Locations

Phoenix Children's Hospital /ID# 253403

Phoenix, Arizona 85016-7710

United States

Childrens National Medical Center /ID# 253344

Washington D.C., District of Columbia 20010-2916

United States

New York Medical College /ID# 253437

Valhalla, New York 10595

United States

Levine Children's Hospital /ID# 253491

Charlotte, North Carolina 28203

United States

Cincinnati Childrens Hospital Medical Center /ID# 251827

Cincinnati, Ohio 45229

United States

Randall Children's Hospital /ID# 251829

Portland, Oregon 97227-1654

United States

Instituto CAICI S.R.L /ID# 251448

Rosario, Santa Fe Province 2000

Argentina

Centro de Investigaciones Medicas Tucuman /ID# 251781

San Miguel de Tucumán, Tucumán Province 4000

Argentina

Hospital de Niños de la Santisima Trinidad /ID# 252736

Córdoba, 5014

Argentina

Monash Health - Monash Medical Centre - Clayton /ID# 251691

Clayton, Victoria 3168

Australia

Royal Children's Hospital /ID# 251663

Parkville, Victoria 3052

Australia

Landeskrankenhaus Bregenz /ID# 266317

Bregenz, Vorarlberg 6900

Austria

CMiP - Centro Mineiro de Pesquisa Ltda - ME /ID# 251769

Juiz de Fora, Minas Gerais 36010-570

Brazil

Hospital Sao Paulo /ID# 251765

São Paulo, 04023-062

Brazil

Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao /ID# 251764

São Paulo, 05403-000

Brazil

The Childrens Hospital of Chongqing Medical University /ID# 251539

Chongqing, Chongqing Municipality 400065

China

Children'S Hospital Of Soochow University /ID# 251755

Suzhou, Jiangsu 215025

China

Xi'an Children's Hospital /ID# 251693

Xi'an, Shaanxi 710054

China

Children's Hospital of Fudan University /ID# 251619

Shanghai, Shanghai Municipality 200032

China

The Children's Hospital of Zhejiang University School of Medicine /ID# 251754

Hangzhou, Zhejiang 310003

China

Universitaetsklinikum Freiburg /ID# 253288

Freiburg im Breisgau, Baden-Wurttemberg 79106

Germany

Asklepios Klinik Sankt Augustin /ID# 251565

Sankt Augustin, North Rhine-Westphalia 53757

Germany

St. Josef-Stift Sendenhorst /ID# 268680

Sendenhorst, North Rhine-Westphalia 48324

Germany

Hamburger Zentrum fuer Kinder- und Jugendrheumatologie /ID# 251564

Hamburg, 22081

Germany

Semmelweis Egyetem /ID# 266750

Budapest, 1085

Hungary

Azienda Ospedaliero Universitaria Meyer /ID# 251775

Florence, Firenze 50139

Italy

IRCCS Istituto Giannina Gaslini /ID# 251776

Genoa, Genova 16147

Italy

Hyogo Prefectural Kobe Children'S Hospital - Minatojima /ID# 251649

Kobe, Hyōgo 650-0045

Japan

St Marianna University School Of Medicine /ID# 251623

Kawasaki-shi, Kanagawa 216-8511

Japan

Niigata University Medical and Dental Hospital /ID# 251538

Niigata, Niigata 951-8520

Japan

Osaka Medical and Pharmaceutical University Hospital /ID# 252092

Takatsuki-shi, Osaka 569-8686

Japan

Institute of Science Tokyo Hospital /ID# 251505

Bunkyo-ku, Tokyo 113-8519

Japan

CREA de Guadalajara SC /ID# 252917

Guadalajara, Jalisco 44620

Mexico

Universitair Medisch Centrum Utrecht /ID# 267435

Utrecht, 3584 CX

Netherlands

Hospital Sant Joan de Deu /ID# 251353

Esplugues de Llobregat, Barcelona 08950

Spain

Hospital Universitario y Politecnico La Fe /ID# 251352

Valencia, 46026

Spain

Ostersunds Sjukhus /ID# 281645

Östersund, Jämtland County 831 31

Sweden

Skane University Hospital Lund /ID# 282573

Lund, Skåne County 224 84

Sweden

Akademiska Sjukhuset - Uppsala University Hospital /ID# 282653

Uppsala, Uppsala County 751 85

Sweden

Queen Silvia Children's Hosp /ID# 251318

Gothenburg, Västra Götaland County 416 85

Sweden

National Taiwan University Hospital /ID# 267387

Taipei, 100

Taiwan

Linkou Chang Gung Memorial Hospital /ID# 267390

Taoyuan City, 333

Taiwan

Gazi University Medical Faculty /ID# 253677

Ankara, 06560

Turkey (Türkiye)

Istanbul University Istanbul Medical Faculty /ID# 251652

Istanbul, 34093

Turkey (Türkiye)

Istanbul Universitesi-Cerrahpasa Cerrahpasa Tip Fakultesi /ID# 251651

Istanbul, 34098

Turkey (Türkiye)

Umraniye Training and Res Hosp /ID# 251653

Istanbul, 34764

Turkey (Türkiye)

Great Ormond Street Children's Hospital /ID# 251512

London, Greater London WC1N 3HZ

United Kingdom