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A Study With Upadacitinib (ABT-494) in Subjects From China and Selected Countries With Moderately to Severely Active Rheumatoid Arthritis Who Have Had an Inadequate Response to Conventional Synthetic Disease-Modifying Anti-Rheumatic Drugs (csDMARDs)

A Phase 3, Randomized, Double-Blind, Placebo-Controlled Study With Upadacitinib (ABT-494) in Subjects From China and Selected Countries With Moderately to Severely Active Rheumatoid Arthritis Who Have Had an Inadequate Response to Conventional Synthetic Disease-Modifying Anti-Rheumatic Drugs (csDMARDs)

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02955212
Enrollment
338
Registered
2016-11-04
Start date
2018-01-03
Completion date
2020-09-03
Last updated
2021-09-27

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Rheumatoid Arthritis (RA)

Keywords

Rheumatoid Arthritis, Conventional Synthetic Disease-Modifying Anti-Rheumatic Drugs (csDMARDs), ABT-494

Brief summary

The study objectives of Period 1 of this study were to compare the efficacy, safety, and tolerability of upadacitinib versus placebo for the treatment of signs and symptoms of subjects from China and selected countries including Brazil and South Korea with moderately to severely active rheumatoid arthritis (RA) who are on a stable dose of csDMARDs and have an inadequate response to csDMARDs. The study objective of Period 2 is to evaluate the long-term safety, tolerability, and efficacy of upadacitinib in subjects with RA who have completed Period 1.

Detailed description

This is a Phase 3 multicenter study that includes two periods. Period 1 is a 12-week, randomized, double-blind, parallel-group, placebo-controlled period designed to compare the safety and efficacy of upadacitinib versus placebo for the treatment of signs and symptoms of participants with moderately to severely active RA who are on a stable dose of csDMARDs and have an inadequate response to csDMARDs. Period 2 is an open label 52 week extension period to evaluate the long-term safety, tolerability, and efficacy of upadacitinib in participants with RA who have completed Period 1.

Interventions

DRUGUpadacitinib

Tablets for oral administration

DRUGPlacebo

Tablets for oral administration

Sponsors

AbbVie
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Diagnosis of RA for ≥ 3 months who also fulfill the 2010 American College of Rheumatology (ACR)/ European League Against Rheumatism (EULAR) classification criteria for RA. * Participants have been receiving csDMARD therapy ≥ 3 months and on a stable dose for ≥ 4 weeks prior to the first dose of study drug. 1. Participants must have failed (lack of efficacy) at least one of the following: methotrexate (MTX), sulfasalazine, or leflunomide. 2. The following csDMARDs are allowed: oral or parenteral MTX, sulfasalazine, hydroxychloroquine, chloroquine, and leflunomide. 3. A combination of up to two background csDMARDs is allowed except the combination of MTX and leflunomide. * Participant meets both of the following disease activity criteria: 1. ≥ 6 swollen joints (based on 66 joint counts) and ≥ 6 tender joints (based on 68 joint counts) at Screening and Baseline Visits; and 2. High-sensitivity C-Reactive Protein (hsCRP) ≥ 3 mg/L at Screening * Participants with prior exposure to at most one biological disease-modifying anti-rheumatic drugs (bDMARD) may be enrolled (up to 20% of total number of subjects). Specifically, prior to enrollment: 1. Participants with limited exposure to bDMARD (\< 3 months) OR 2. Participants who are responding to a bDMARD therapy but had to discontinue due to intolerability (regardless of treatment duration). * Participants must have discontinued bDMARD therapy prior to the first dose of study drug.

Exclusion criteria

* Prior exposure to any Janus kinase (JAK) inhibitor (including but not limited to tofacitinib, baricitinib, and filgotinib). * Participants who are considered inadequate responders (lack of efficacy) to bDMARD therapy as defined by the Investigator. * History of any arthritis with onset prior to age 17 years or current diagnosis of inflammatory joint disease other than RA (including but not limited to gout, systemic lupus erythematosus, psoriatic arthritis, axial spondyloarthritis including ankylosing spondylitis and non-radiographic axial spondyloarthritis, reactive arthritis, overlap connective tissue diseases, scleroderma, polymyositis, dermatomyositis, fibromyalgia \[currently with active symptoms\]. Current diagnosis of secondary Sjogren's Syndrome is permitted.

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants With an American College of Rheumatology 20% (ACR20) Response at Week 12Baseline and Week 12Participants who met the following 3 conditions for improvement from Baseline were classified as meeting the ACR20 response criteria: 1. ≥ 20% improvement in 68-tender joint count; 2. ≥ 20% improvement in 66-swollen joint count; and 3. ≥ 20% improvement in at least 3 of the 5 following parameters: * Physician global assessment of disease activity * Patient global assessment of disease activity * Patient assessment of pain * Health Assessment Questionnaire - Disability Index (HAQ-DI) * High-sensitivity C-reactive protein (hsCRP).

Secondary

MeasureTime frameDescription
Change From Baseline in Health Assessment Questionnaire Disability Index (HAQ-DI) at Week 12Baseline and Week 12The Health Assessment Questionnaire - Disability Index is a patient-reported questionnaire that measures the degree of difficulty a person has in accomplishing tasks in 8 functional areas (dressing, arising, eating, walking, hygiene, reaching, gripping, and errands and chores) over the past week. Participants assessed their ability to do each task on a scale from 0 (without any difficulty) to 3 (unable to do). Scores were averaged to provide an overall score ranging from 0 to 3, where 0 represents no disability and 3 represents very severe, high-dependency disability. A negative change from Baseline in the overall score indicates improvement.
Change From Baseline in Short-Form 36 (SF-36) Physical Component Score (PCS) at Week 12Baseline and Week 12The Short Form 36-Item Health Survey (SF-36) Version 2 is a self-administered questionnaire that measures the impact of disease on overall quality of life during the past 4 weeks. The SF-36 consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). The physical component score is a weighted combination of the 8 subscales with positive weighting for physical functioning, role-physical, bodily pain, and general health. The PCS was calculated using norm-based scoring so that 50 is the average score and the standard deviation equals 10. Higher scores are associated with better functioning/quality of life; a positive change from baseline score indicates an improvement.
Percentage of Participants Achieving Low Disease Activity (LDA) Based on DAS28 (CRP) at Week 12Week 12Low disease activity based on DAS28 (CRP) is defined a DAS28 (CRP) score of ≤ 3.2. The DAS28 is a composite index used to assess rheumatoid arthritis disease activity, calculated based on the tender joint count (out of 28 evaluated joints), swollen joint count (out of 28 evaluated joints), Patient's Global Assessment of Disease Activity (0-100), and hsCRP (in mg/L). Scores on the DAS28 range from 0 to 10, where higher scores indicate more disease activity. A DAS28 score less than or equal to 3.2 indicates low disease activity.
Percentage of Participants Achieving Clinical Remission Based on DAS28 (CRP) at Week 12Week 12Clinical remission (CR) based on DAS28 (CRP) is defined as achieving a DAS28 (CRP) score of less than 2.6. DAS28 (CRP) is a composite index used to assess rheumatoid arthritis disease activity, calculated based on the tender joint count (out of 28 evaluated joints), swollen joint count (out of 28 evaluated joints), Patient's Global Assessment of Disease Activity (0-100), and hsCRP (in mg/L). Scores on the DAS28 range from 0 to 10, where higher scores indicate more disease activity.
Change From Baseline in Disease Activity Score Based on CRP (DAS28 [CRP]) at Week 12Baseline and Week 12The DAS28 (CRP) is a composite index used to assess rheumatoid arthritis disease activity, calculated based on the tender joint count (out of 28 evaluated joints), swollen joint count (out of 28 evaluated joints), Patient's Global Assessment of Disease Activity (0-100), and hsCRP (in mg/L). Scores on the DAS28 range from 0 to 10, where higher scores indicate more disease activity. A negative change from Baseline in DAS28 (CRP) indicates improvement in disease activity.
Percentage of Participants With an American College of Rheumatology 50% (ACR50) Response at Week 12Baseline and Week 12Participants who met the following 3 conditions for improvement from Baseline were classified as meeting the ACR50 response criteria: 1. ≥ 50% improvement in 68-tender joint count; 2. ≥ 50% improvement in 66-swollen joint count; and 3. ≥ 50% improvement in at least 3 of the 5 following parameters: * Physician global assessment of disease activity * Patient global assessment of disease activity * Patient assessment of pain * Health Assessment Questionnaire - Disability Index (HAQ-DI) * High-sensitivity C-reactive protein (hsCRP).
Percentage of Participants With an American College of Rheumatology 70% (ACR70) Response at Week 12Baseline and Week 12Participants who met the following 3 conditions for improvement from Baseline were classified as meeting the ACR70 response criteria: 1. ≥ 70% improvement in 68-tender joint count; 2. ≥ 70% improvement in 66-swollen joint count; and 3. ≥ 70% improvement in at least 3 of the 5 following parameters: * Physician global assessment of disease activity * Patient global assessment of disease activity * Patient assessment of pain * Health Assessment Questionnaire - Disability Index (HAQ-DI) * High-sensitivity C-reactive protein (hsCRP).
Percentage of Participants With an American College of Rheumatology 20% (ACR20) Response at Week 1Baseline and Week 1Participants who met the following 3 conditions for improvement from Baseline were classified as meeting the ACR20 response criteria: 1. ≥ 20% improvement in 68-tender joint count; 2. ≥ 20% improvement in 66-swollen joint count; and 3. ≥ 20% improvement in at least 3 of the 5 following parameters: * Physician global assessment of disease activity * Patient global assessment of disease activity * Patient assessment of pain * Health Assessment Questionnaire - Disability Index (HAQ-DI) * High-sensitivity C-reactive protein (hsCRP).
Percentage of Participants Achieving Low Disease Activity Based on Clinical Disease Activity Index (CDAI) at Week 12Week 12Low disease activity based on CDAI is defined as a CDAI score ≤ 10. CDAI is a composite index for assessing disease activity based on the summation of the total tender joint count (out of 28 evaluated joints), swollen joint count (out of 28 evaluated joints), patient global assessment of disease activity measured on a VAS from 0 to 10 cm, and physician global assessment of disease activity measured on a VAS from 0 to 10 cm. The total CDAI score ranges from 0 to 76 with higher scores indicating higher disease activity.

Countries

Brazil, China, South Korea

Participant flow

Recruitment details

Participants were enrolled at 37 sites in Brazil, China, and South Korea. The study consisted of a 12-week placebo-controlled, double-blind period (Period 1), and an open-label 52-week extension period (Period 2).

Pre-assignment details

Participants who met eligibility criteria were randomized in a 1:1 ratio to one of two treatment groups. Randomization was stratified by country and the Chinese population was expected to comprise up to 80% of the total study population.

Participants by arm

ArmCount
Placebo
Participants randomized to receive placebo once daily for 12 weeks in Period 1.
169
Upadacitinib 15 mg
Participants randomized to receive upadacitinib 15 mg once daily for 12 weeks in Period 1.
169
Total338

Withdrawals & dropouts

PeriodReasonFG000FG001
Period 1: Double-blind Treatment PeriodAdverse Event47
Period 1: Double-blind Treatment PeriodLost to Follow-up10
Period 1: Double-blind Treatment PeriodOther32
Period 1: Double-blind Treatment PeriodWithdrawal by Subject83
Period 2: Open-label ExtensionAdverse Event117
Period 2: Open-label ExtensionCOVID-19 Logistical Restrictions01
Period 2: Open-label ExtensionLack of Efficacy32
Period 2: Open-label ExtensionOther24
Period 2: Open-label ExtensionWithdrawal by Subject14

Baseline characteristics

CharacteristicPlaceboUpadacitinib 15 mgTotal
Age, Continuous51.7 years
STANDARD_DEVIATION 11.39
51.7 years
STANDARD_DEVIATION 10.63
51.7 years
STANDARD_DEVIATION 11
Duration Since Rheumatoid Arthritis (RA) Diagnosis7.5 years
STANDARD_DEVIATION 7.55
7.2 years
STANDARD_DEVIATION 7.16
7.3 years
STANDARD_DEVIATION 7.35
Enrollment by Country
Brazil
26 Participants26 Participants52 Participants
Enrollment by Country
China
114 Participants114 Participants228 Participants
Enrollment by Country
South Korea
29 Participants29 Participants58 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
21 Participants24 Participants45 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
148 Participants145 Participants293 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Health Assessment Questionnaire - Disability Index (HAQ-DI)1.4 units on a scale
STANDARD_DEVIATION 0.65
1.3 units on a scale
STANDARD_DEVIATION 0.66
1.3 units on a scale
STANDARD_DEVIATION 0.65
High-sensitivity C-reactive Protein (CRP)20.2 mg/L
STANDARD_DEVIATION 25.15
20.0 mg/L
STANDARD_DEVIATION 21.46
20.1 mg/L
STANDARD_DEVIATION 23.34
Patient's Assessment of Pain63.8 units on a scale
STANDARD_DEVIATION 20.62
66.8 units on a scale
STANDARD_DEVIATION 20.59
65.3 units on a scale
STANDARD_DEVIATION 20.63
Patient's Global Assessment of Disease Activity63.9 units on a scale
STANDARD_DEVIATION 22.32
64.4 units on a scale
STANDARD_DEVIATION 20.52
64.1 units on a scale
STANDARD_DEVIATION 21.41
Physician's Global Assessment of Disease Activity67.0 units on a scale
STANDARD_DEVIATION 13.83
66.7 units on a scale
STANDARD_DEVIATION 17.51
66.9 units on a scale
STANDARD_DEVIATION 15.74
Race/Ethnicity, Customized
American Indian/Alaska Native
0 Participants0 Participants0 Participants
Race/Ethnicity, Customized
Asian
142 Participants141 Participants283 Participants
Race/Ethnicity, Customized
Black or African American
3 Participants3 Participants6 Participants
Race/Ethnicity, Customized
Multiple
5 Participants6 Participants11 Participants
Race/Ethnicity, Customized
Native Hawaiian or other Pacific Islander
0 Participants0 Participants0 Participants
Race/Ethnicity, Customized
White
19 Participants19 Participants38 Participants
Sex: Female, Male
Female
139 Participants135 Participants274 Participants
Sex: Female, Male
Male
30 Participants34 Participants64 Participants
Swollen Joint Count11.9 joints
STANDARD_DEVIATION 6
11.9 joints
STANDARD_DEVIATION 6.89
11.9 joints
STANDARD_DEVIATION 6.45
Tender Joint Count23.0 joints
STANDARD_DEVIATION 14.45
21.5 joints
STANDARD_DEVIATION 14.84
22.3 joints
STANDARD_DEVIATION 14.64

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
0 / 1690 / 1690 / 322
other
Total, other adverse events
13 / 16925 / 169198 / 322
serious
Total, serious adverse events
5 / 16912 / 16955 / 322

Outcome results

Primary

Percentage of Participants With an American College of Rheumatology 20% (ACR20) Response at Week 12

Participants who met the following 3 conditions for improvement from Baseline were classified as meeting the ACR20 response criteria: 1. ≥ 20% improvement in 68-tender joint count; 2. ≥ 20% improvement in 66-swollen joint count; and 3. ≥ 20% improvement in at least 3 of the 5 following parameters: * Physician global assessment of disease activity * Patient global assessment of disease activity * Patient assessment of pain * Health Assessment Questionnaire - Disability Index (HAQ-DI) * High-sensitivity C-reactive protein (hsCRP).

Time frame: Baseline and Week 12

Population: Full analysis set; participants who prematurely discontinued from study drug prior to Week 12 or for whom ACR data were missing at Week 12 were considered non-responders.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants With an American College of Rheumatology 20% (ACR20) Response at Week 1231.4 percentage of participants
Upadacitinib 15 mgPercentage of Participants With an American College of Rheumatology 20% (ACR20) Response at Week 1271.6 percentage of participants
p-value: <0.00195% CI: [30.5, 50]Cochran-Mantel-Haenszel
Secondary

Change From Baseline in Disease Activity Score Based on CRP (DAS28 [CRP]) at Week 12

The DAS28 (CRP) is a composite index used to assess rheumatoid arthritis disease activity, calculated based on the tender joint count (out of 28 evaluated joints), swollen joint count (out of 28 evaluated joints), Patient's Global Assessment of Disease Activity (0-100), and hsCRP (in mg/L). Scores on the DAS28 range from 0 to 10, where higher scores indicate more disease activity. A negative change from Baseline in DAS28 (CRP) indicates improvement in disease activity.

Time frame: Baseline and Week 12

Population: Full analysis set; multiple imputation was used for missing data.

ArmMeasureValue (LEAST_SQUARES_MEAN)
PlaceboChange From Baseline in Disease Activity Score Based on CRP (DAS28 [CRP]) at Week 12-0.95 units on a scale
Upadacitinib 15 mgChange From Baseline in Disease Activity Score Based on CRP (DAS28 [CRP]) at Week 12-2.56 units on a scale
p-value: <0.00195% CI: [-1.86, -1.36]ANCOVA
Secondary

Change From Baseline in Health Assessment Questionnaire Disability Index (HAQ-DI) at Week 12

The Health Assessment Questionnaire - Disability Index is a patient-reported questionnaire that measures the degree of difficulty a person has in accomplishing tasks in 8 functional areas (dressing, arising, eating, walking, hygiene, reaching, gripping, and errands and chores) over the past week. Participants assessed their ability to do each task on a scale from 0 (without any difficulty) to 3 (unable to do). Scores were averaged to provide an overall score ranging from 0 to 3, where 0 represents no disability and 3 represents very severe, high-dependency disability. A negative change from Baseline in the overall score indicates improvement.

Time frame: Baseline and Week 12

Population: Full analysis set; multiple imputation was used for missing data.

ArmMeasureValue (LEAST_SQUARES_MEAN)
PlaceboChange From Baseline in Health Assessment Questionnaire Disability Index (HAQ-DI) at Week 12-0.18 units on a scale
Upadacitinib 15 mgChange From Baseline in Health Assessment Questionnaire Disability Index (HAQ-DI) at Week 12-0.62 units on a scale
p-value: <0.00195% CI: [-0.55, -0.33]ANCOVA
Secondary

Change From Baseline in Short-Form 36 (SF-36) Physical Component Score (PCS) at Week 12

The Short Form 36-Item Health Survey (SF-36) Version 2 is a self-administered questionnaire that measures the impact of disease on overall quality of life during the past 4 weeks. The SF-36 consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). The physical component score is a weighted combination of the 8 subscales with positive weighting for physical functioning, role-physical, bodily pain, and general health. The PCS was calculated using norm-based scoring so that 50 is the average score and the standard deviation equals 10. Higher scores are associated with better functioning/quality of life; a positive change from baseline score indicates an improvement.

Time frame: Baseline and Week 12

Population: Full analysis set participants with available data; a mixed effect model repeat measurement (MMRM) analysis with data from observed cases to Week 12 was used.

ArmMeasureValue (LEAST_SQUARES_MEAN)
PlaceboChange From Baseline in Short-Form 36 (SF-36) Physical Component Score (PCS) at Week 123.36 units on a scale
Upadacitinib 15 mgChange From Baseline in Short-Form 36 (SF-36) Physical Component Score (PCS) at Week 128.93 units on a scale
p-value: <0.00195% CI: [4.13, 7.01]Mixed Effect Model Repeat Measurement
Secondary

Percentage of Participants Achieving Clinical Remission Based on DAS28 (CRP) at Week 12

Clinical remission (CR) based on DAS28 (CRP) is defined as achieving a DAS28 (CRP) score of less than 2.6. DAS28 (CRP) is a composite index used to assess rheumatoid arthritis disease activity, calculated based on the tender joint count (out of 28 evaluated joints), swollen joint count (out of 28 evaluated joints), Patient's Global Assessment of Disease Activity (0-100), and hsCRP (in mg/L). Scores on the DAS28 range from 0 to 10, where higher scores indicate more disease activity.

Time frame: Week 12

Population: Full analysis set; participants who prematurely discontinued from study drug prior to Week 12 or for whom DAS28 (CRP) data were missing at Week 12 were considered non-responders.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Achieving Clinical Remission Based on DAS28 (CRP) at Week 125.3 percentage of participants
Upadacitinib 15 mgPercentage of Participants Achieving Clinical Remission Based on DAS28 (CRP) at Week 1229.6 percentage of participants
p-value: <0.00124.3% CI: [16.6, 31.9]Cochran-Mantel-Haenszel
Secondary

Percentage of Participants Achieving Low Disease Activity Based on Clinical Disease Activity Index (CDAI) at Week 12

Low disease activity based on CDAI is defined as a CDAI score ≤ 10. CDAI is a composite index for assessing disease activity based on the summation of the total tender joint count (out of 28 evaluated joints), swollen joint count (out of 28 evaluated joints), patient global assessment of disease activity measured on a VAS from 0 to 10 cm, and physician global assessment of disease activity measured on a VAS from 0 to 10 cm. The total CDAI score ranges from 0 to 76 with higher scores indicating higher disease activity.

Time frame: Week 12

Population: Full analysis set; participants who prematurely discontinued from study drug prior to Week 12 or for whom CDAI data were missing at Week 12 were considered non-responders.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Achieving Low Disease Activity Based on Clinical Disease Activity Index (CDAI) at Week 1211.2 percentage of participants
Upadacitinib 15 mgPercentage of Participants Achieving Low Disease Activity Based on Clinical Disease Activity Index (CDAI) at Week 1235.5 percentage of participants
p-value: <0.00195% CI: [15.6, 32.9]Cochran-Mantel-Haenszel
Secondary

Percentage of Participants Achieving Low Disease Activity (LDA) Based on DAS28 (CRP) at Week 12

Low disease activity based on DAS28 (CRP) is defined a DAS28 (CRP) score of ≤ 3.2. The DAS28 is a composite index used to assess rheumatoid arthritis disease activity, calculated based on the tender joint count (out of 28 evaluated joints), swollen joint count (out of 28 evaluated joints), Patient's Global Assessment of Disease Activity (0-100), and hsCRP (in mg/L). Scores on the DAS28 range from 0 to 10, where higher scores indicate more disease activity. A DAS28 score less than or equal to 3.2 indicates low disease activity.

Time frame: Week 12

Population: Full analysis set; participants who prematurely discontinued from study drug prior to Week 12 or for whom DAS28 data were missing at Week 12 were considered non-responders.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Achieving Low Disease Activity (LDA) Based on DAS28 (CRP) at Week 1213.6 percentage of participants
Upadacitinib 15 mgPercentage of Participants Achieving Low Disease Activity (LDA) Based on DAS28 (CRP) at Week 1246.2 percentage of participants
p-value: <0.00195% CI: [23.4, 41.7]Cochran-Mantel-Haenszel
Secondary

Percentage of Participants With an American College of Rheumatology 20% (ACR20) Response at Week 1

Participants who met the following 3 conditions for improvement from Baseline were classified as meeting the ACR20 response criteria: 1. ≥ 20% improvement in 68-tender joint count; 2. ≥ 20% improvement in 66-swollen joint count; and 3. ≥ 20% improvement in at least 3 of the 5 following parameters: * Physician global assessment of disease activity * Patient global assessment of disease activity * Patient assessment of pain * Health Assessment Questionnaire - Disability Index (HAQ-DI) * High-sensitivity C-reactive protein (hsCRP).

Time frame: Baseline and Week 1

Population: Full analysis set; participants who prematurely discontinued from study drug prior to Week 1 or for whom ACR data were missing at Week 1 were considered non-responders.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants With an American College of Rheumatology 20% (ACR20) Response at Week 15.9 percentage of participants
Upadacitinib 15 mgPercentage of Participants With an American College of Rheumatology 20% (ACR20) Response at Week 125.4 percentage of participants
p-value: <0.00195% CI: [12.1, 27]Cochran-Mantel-Haenszel
Secondary

Percentage of Participants With an American College of Rheumatology 50% (ACR50) Response at Week 12

Participants who met the following 3 conditions for improvement from Baseline were classified as meeting the ACR50 response criteria: 1. ≥ 50% improvement in 68-tender joint count; 2. ≥ 50% improvement in 66-swollen joint count; and 3. ≥ 50% improvement in at least 3 of the 5 following parameters: * Physician global assessment of disease activity * Patient global assessment of disease activity * Patient assessment of pain * Health Assessment Questionnaire - Disability Index (HAQ-DI) * High-sensitivity C-reactive protein (hsCRP).

Time frame: Baseline and Week 12

Population: Full analysis set; participants who prematurely discontinued from study drug prior to Week 12 or for whom ACR data were missing at Week 12 were considered non-responders.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants With an American College of Rheumatology 50% (ACR50) Response at Week 128.3 percentage of participants
Upadacitinib 15 mgPercentage of Participants With an American College of Rheumatology 50% (ACR50) Response at Week 1240.8 percentage of participants
p-value: <0.00195% CI: [24, 41]Cochran-Mantel-Haenszel
Secondary

Percentage of Participants With an American College of Rheumatology 70% (ACR70) Response at Week 12

Participants who met the following 3 conditions for improvement from Baseline were classified as meeting the ACR70 response criteria: 1. ≥ 70% improvement in 68-tender joint count; 2. ≥ 70% improvement in 66-swollen joint count; and 3. ≥ 70% improvement in at least 3 of the 5 following parameters: * Physician global assessment of disease activity * Patient global assessment of disease activity * Patient assessment of pain * Health Assessment Questionnaire - Disability Index (HAQ-DI) * High-sensitivity C-reactive protein (hsCRP).

Time frame: Baseline and Week 12

Population: Full analysis set; participants who prematurely discontinued from study drug prior to Week 12 or for whom ACR data were missing at Week 12 were considered non-responders.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants With an American College of Rheumatology 70% (ACR70) Response at Week 123.6 percentage of participants
Upadacitinib 15 mgPercentage of Participants With an American College of Rheumatology 70% (ACR70) Response at Week 1221.3 percentage of participants
p-value: <0.00195% CI: [11, 24.5]Cochran-Mantel-Haenszel

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026