Systemic Lupus Erythematosus
Conditions
Keywords
SLE
Brief summary
The reason for this long term study is to see how safe and effective the study drug known as baricitinib is in participants with systemic lupus erythematosus (SLE) who have completed the final treatment visit of study I4V-MC-JAHZ (NCT03616912) or study I4V-MC-JAIA (NCT03616964).
Interventions
Administered orally.
Administered orally.
Sponsors
Study design
Eligibility
Inclusion criteria
* Have completed the final treatment study visit of an originating study, such as study JAHZ (NCT03616912) or Study JAIA (NCT03616964).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Treatment-Emergent Adverse Events (TEAEs) | Week 134 | Percentage of participants with TEAEs. A treatment-emergent AE (TEAE) is defined as an event that first occurred or worsened in severity after the first dose of study treatment in Study JAIM and on or prior to the last visit date during the analysis period. The analysis period is defined as the treatment period plus up to 30 days off-drug follow-up time. A summary of serious and other non-serious adverse events, regardless of causality, is located in the Reported Adverse Events module. |
| Percentage of Participants With Adverse Events of Special Interest (AESIs) | Week 134 | Percentage of Participants with AESIs. AESI consisted of infections, positively adjudicated arterial thromboembolic events (ATE), positively adjudicated venous thromboembolic events (VTE), positively adjudicated major adverse cardiovascular events (MACE), other positively adjudicated cardiovascular events, death, anaphylactic reactions, hypersensitivity, angioedema, and malignancies. |
| Percentage of Participants With Serious Adverse Events (SAEs) | Week 134 | Percentage of participants with SAEs. An SAE is any AE from this study that results in one of the following outcomes: Death; Initial or prolonged inpatient hospitalization; A life-threatening experience (that is, immediate risk of dying); Persistent or significant disability/incapacity; Congenital anomaly/birth defect; Important medical events that may not be immediately life-threatening or result in death or hospitalization, but may jeopardize the patient or may require intervention to prevent one of the other outcomes listed in the definition above. A summary of all SAE's, regardless of causality, is located in the Reported Adverse Events section. |
| Percentage of Participants With Temporary Investigational Product Interruptions | Week 134 | Percentage of participants with temporary investigational product interruptions. |
| Percentage of Participants With Permanent Investigational Product Discontinuations | Week 134 | Percentage of participants with permanent investigational product discontinuations. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change From Baseline in Tender Joint Count | Baseline through Week 48 | The number of tender and painful joints is determined by examination of 28 joints (14 on each side) which include: the 2 shoulders, the 2 elbows, the 2 wrists, the 10 metacarpophalangeal joints, the 2 interphalangeal joints of the thumb, the 8 proximal interphalangeal joints, and the 2 knees. The joints are assessed and classified as tender or not tender. LS mean was calculated using Mixed Model Repeated Measures (MMRM) analysis with treatment, baseline disease activity (total SLEDAI-2K \<10; \>=10), baseline corticosteroid dose (\<10 mg/day; \>=10 mg/day prednisone or equivalent), region (North America, Central/South America/Mexico, Europe, Asia and Rest of World), visit (as categorical variable), baseline value, treatment-by-visit interaction, and baseline value-by-visit interaction. |
| Change From Baseline in Swollen Joint Count | Baseline trough Week 48 | The number of swollen joints is determined by examination of 28 joints (14 on each side) which include: the 2 shoulders, the 2 elbows, the 2 wrists, the 10 metacarpophalangeal joints, the 2 interphalangeal joints of the thumb, the 8 proximal interphalangeal joints, and the 2 knees. The joints are assessed and classified as swollen or not swollen. LS mean was calculated using MMRM analysis with treatment, baseline disease activity (total SLEDAI-2K \<10; \>=10), baseline corticosteroid dose (\<10 mg/day; \>=10 mg/day prednisone or equivalent), region (North America, Central/South America/Mexico, Europe, Asia and Rest of World), visit (as categorical variable), baseline value, treatment-by-visit interaction, and baseline value-by-visit interaction. |
| Percentage of Participants Achieving a Systemic Lupus Erythematosus Responder Index 4 (SRI-4) Response | Week 134 | SRI-4 response defined as 1)greater than or equal to 4-point reduction in Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) total score 2)no new British Isles Lupus Assessment Group (BILAG) A and no more than 1 new BILAG B domain score and 3)no worsening in Physician Global Assessment (PGA) of Disease Activity (worsening defined as an increase of \>=0.3 from baseline on a 0-3 visual analogue scale). SLEDAI-2K assessment consists of 24 items with total score of 0(no symptoms) to 105 (presence of all defined symptoms) with higher scores representing increased disease activity. BILAG Index: assessing clinical signs, symptoms,or laboratory parameters related to Systemic Lupus Erythematosus (SLE),divided into 9 organ systems. For each organ system A=severe disease,B=moderate disease,C=mild stable disease,D=inactive,but previously active,E=inactive and never affected. PGA assesses disease activity on a visual analogue scale from 0 to 3 (1=mild, 2=moderate, 3=severe). |
| Change From Baseline in Worst Pain Numeric Rating Scale (NRS) | Baseline through Week 48 | Change from baseline in Worst Pain NRS. It is assessed using an 11-point Numeric Rating Scale (NRS) (0-10) where 0 represents no pain and 10 represents worst pain imaginable. Overall severity of a patient's pain is indicated by selecting the number that best describes the worst level of pain during the past 7 days. |
| Change From Baseline in Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index Total Score | Baseline through Week 48 | The SLICC/ACR damage index is a validated instrument to assess damage, defined as irreversible impairment, continuously persistent for 6 months (ascertained by clinical assessment), occurring since the onset of lupus, and it is based on a weighted scoring system. This index records damage occurring in participants with SLE regardless of cause, with demonstrated content, face, criterion, and discriminant validity. A score of 0 indicates no damage. Total maximum score is 47 and increasing score indicates increasing disease severity. |
| Percentage of Participants Achieving a Lupus Low Disease Activity State (LLDAS) | Week 48 | Percentage of participants achieving a LLDAS. The LLDAS is a composite measure designed to identify patients achieving a state of low disease activity. The LLDAS response criteria were: (1) SLEDAI-2K \<=4, with no activity in major organ systems (CNS, vascular, renal, cardiorespiratory and constitutional); where no activity is defined as all items of SLEDAI-2K within these major organ systems equal to 0. (2) no new features of lupus disease activity compared to previous occurred visit, where the new feature is defined as any of the SLEDAI-2K 24 items changed from 0 to greater than 0; (3) PGA (scale 0-3), \<=1; (4) current prednisolone (or equivalent) dose \<=7.5 mg daily. |
| Change From Baseline in Prednisone Dose | Baseline through Week 48 | Change from baseline in prednisone dose. |
| Annualized Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA)-Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) Flare Index Flare Rate | Baseline through Week 48 | The SELENA-SLEDAI tool is a cumulative and weighted index used to assess disease activity across 24 different disease descriptors in patients with lupus. A patient's SELENA-SLEDAI total score is the sum of all marked lupus related descriptors (seizure, psychosis, organic brain syndrome, visual disturbance, cranial nerve disorder, lupus headache, cerebrovascular accident, vasculitis, arthritis, myositis, urinary casts, hematuria, proteinuria, pyuria, new rash, alopecia, mucosal ulcers, pleurisy, pericarditis, low complement, increased DNA binding, fever, thrombocytopenia, leukopenia). A total score can fall between 0 and 105, with a higher score representing a more significant degree of disease activity. The annualized flare rate is calculated as the number of flares divided by the flare exposure time in days multiplied with 365.25. |
| Percentage of Participants With Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) Total Activity Score ≥10 at Baseline With ≥50% Reduction in CLASI Total Activity Score | Week 48 | The CLASI is a single-page tool that separately quantifies disease activity and damage. For the activity score, points are given for the presence of erythema, scale, mucous membrane lesions, recent hair loss, and inflammatory alopecia. The total score represents the sum of the individual scores and ranges from 0 to 70. Higher scores are awarded for more severe manifestations. |
Countries
Argentina, Australia, Austria, Belgium, Brazil, Chile, China, Colombia, Croatia, Czechia, France, Germany, Greece, Hungary, India, Israel, Italy, Japan, Mexico, Netherlands, Philippines, Poland, Romania, Russia, Serbia, South Africa, South Korea, Spain, Switzerland, Taiwan, United Kingdom, United States
Participant flow
Recruitment details
Participants who completed originating study \[I4V-MC-JAHZ (NCT03616912) or Study I4V-MC-JAIA (NCT03616964)\] were enrolled in this study.
Pre-assignment details
Participants who were randomized to placebo during originating Study I4V-MC-JAHZ (NCT03616912) or Study I4V-MC-JAIA (NCT03616964) were randomized 1:1 to receive baricitinib 4-milligrams (mg) or baricitinib 2-mg once daily (QD), administered orally.
Participants by arm
| Arm | Count |
|---|---|
| 2 mg Baricitinib Participants received one 2 mg Baricitinib tablet and one placebo tablet matching 4 mg Baricitinib administered orally QD. | 388 |
| 4 mg Baricitinib Participants received one 4 mg Baricitinib tablet and one placebo tablet matching 2 mg Baricitinib administered orally QD. | 379 |
| Placebo to 2 mg Baricitinib Participants who received placebo in the originating study (JAHZ or JAIA) were randomized to receive 2 mg Baricitinib administered orally QD. | 189 |
| Placebo to 4 mg Baricitinib Participants who received placebo in the originating study (JAHZ or JAIA) were randomized to receive 4 mg Baricitinib administered orally QD. | 191 |
| Total | 1,147 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 | FG003 |
|---|---|---|---|---|---|
| Overall Study | Adverse Event | 17 | 13 | 5 | 9 |
| Overall Study | Death | 0 | 6 | 2 | 0 |
| Overall Study | Due to Epidemic/Pandemic | 1 | 0 | 0 | 0 |
| Overall Study | Lack of Efficacy | 14 | 11 | 9 | 4 |
| Overall Study | Lost to Follow-up | 3 | 4 | 0 | 2 |
| Overall Study | Missing data | 0 | 1 | 1 | 0 |
| Overall Study | Other | 12 | 14 | 3 | 4 |
| Overall Study | Study Terminated by Sponsor | 318 | 318 | 163 | 163 |
| Overall Study | Withdrawal by Subject | 23 | 12 | 6 | 9 |
Baseline characteristics
| Characteristic | 2 mg Baricitinib | Total | Placebo to 4 mg Baricitinib | Placebo to 2 mg Baricitinib | 4 mg Baricitinib |
|---|---|---|---|---|---|
| Age, Continuous | 43.8 years STANDARD_DEVIATION 12.68 | 43.7 years STANDARD_DEVIATION 12.41 | 43.5 years STANDARD_DEVIATION 13.22 | 43.8 years STANDARD_DEVIATION 11.85 | 43.8 years STANDARD_DEVIATION 12.03 |
| Race (NIH/OMB) American Indian or Alaska Native | 21 Participants | 61 Participants | 11 Participants | 13 Participants | 16 Participants |
| Race (NIH/OMB) Asian | 79 Participants | 241 Participants | 41 Participants | 44 Participants | 77 Participants |
| Race (NIH/OMB) Black or African American | 32 Participants | 106 Participants | 19 Participants | 19 Participants | 36 Participants |
| Race (NIH/OMB) More than one race | 3 Participants | 9 Participants | 2 Participants | 2 Participants | 2 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 4 Participants | 16 Participants | 3 Participants | 2 Participants | 7 Participants |
| Race (NIH/OMB) White | 249 Participants | 714 Participants | 115 Participants | 109 Participants | 241 Participants |
| Region of Enrollment Argentina | 21 Participants | 73 Participants | 16 Participants | 13 Participants | 23 Participants |
| Region of Enrollment Australia | 5 Participants | 17 Participants | 2 Participants | 4 Participants | 6 Participants |
| Region of Enrollment Austria | 1 Participants | 2 Participants | 0 Participants | 0 Participants | 1 Participants |
| Region of Enrollment Belgium | 1 Participants | 3 Participants | 0 Participants | 1 Participants | 1 Participants |
| Region of Enrollment Brazil | 17 Participants | 60 Participants | 10 Participants | 14 Participants | 19 Participants |
| Region of Enrollment Chile | 12 Participants | 27 Participants | 4 Participants | 4 Participants | 7 Participants |
| Region of Enrollment China | 17 Participants | 51 Participants | 6 Participants | 10 Participants | 18 Participants |
| Region of Enrollment Colombia | 11 Participants | 39 Participants | 7 Participants | 8 Participants | 13 Participants |
| Region of Enrollment Croatia | 3 Participants | 6 Participants | 1 Participants | 1 Participants | 1 Participants |
| Region of Enrollment Czechia | 7 Participants | 28 Participants | 5 Participants | 7 Participants | 9 Participants |
| Region of Enrollment France | 0 Participants | 2 Participants | 1 Participants | 0 Participants | 1 Participants |
| Region of Enrollment Germany | 9 Participants | 29 Participants | 5 Participants | 4 Participants | 11 Participants |
| Region of Enrollment Greece | 8 Participants | 15 Participants | 3 Participants | 0 Participants | 4 Participants |
| Region of Enrollment Hungary | 16 Participants | 39 Participants | 5 Participants | 5 Participants | 13 Participants |
| Region of Enrollment India | 20 Participants | 65 Participants | 12 Participants | 13 Participants | 20 Participants |
| Region of Enrollment Israel | 3 Participants | 6 Participants | 0 Participants | 0 Participants | 3 Participants |
| Region of Enrollment Italy | 2 Participants | 4 Participants | 1 Participants | 1 Participants | 0 Participants |
| Region of Enrollment Japan | 6 Participants | 24 Participants | 5 Participants | 4 Participants | 9 Participants |
| Region of Enrollment Mexico | 40 Participants | 112 Participants | 17 Participants | 15 Participants | 40 Participants |
| Region of Enrollment Netherlands | 1 Participants | 2 Participants | 0 Participants | 0 Participants | 1 Participants |
| Region of Enrollment Philippines | 13 Participants | 33 Participants | 7 Participants | 5 Participants | 8 Participants |
| Region of Enrollment Poland | 27 Participants | 79 Participants | 13 Participants | 11 Participants | 28 Participants |
| Region of Enrollment Romania | 11 Participants | 24 Participants | 4 Participants | 3 Participants | 6 Participants |
| Region of Enrollment Russia | 19 Participants | 57 Participants | 11 Participants | 11 Participants | 16 Participants |
| Region of Enrollment Serbia | 18 Participants | 43 Participants | 7 Participants | 3 Participants | 15 Participants |
| Region of Enrollment South Africa | 13 Participants | 34 Participants | 6 Participants | 6 Participants | 9 Participants |
| Region of Enrollment South Korea | 7 Participants | 18 Participants | 2 Participants | 2 Participants | 7 Participants |
| Region of Enrollment Spain | 3 Participants | 21 Participants | 3 Participants | 6 Participants | 9 Participants |
| Region of Enrollment Switzerland | 0 Participants | 2 Participants | 0 Participants | 2 Participants | 0 Participants |
| Region of Enrollment Taiwan | 8 Participants | 30 Participants | 7 Participants | 5 Participants | 10 Participants |
| Region of Enrollment United Kingdom | 3 Participants | 10 Participants | 1 Participants | 3 Participants | 3 Participants |
| Region of Enrollment United States | 66 Participants | 192 Participants | 30 Participants | 28 Participants | 68 Participants |
| Sex: Female, Male Female | 361 Participants | 1075 Participants | 176 Participants | 181 Participants | 357 Participants |
| Sex: Female, Male Male | 27 Participants | 72 Participants | 15 Participants | 8 Participants | 22 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 388 | 6 / 378 | 2 / 189 | 0 / 191 |
| other Total, other adverse events | 54 / 388 | 54 / 378 | 35 / 189 | 29 / 191 |
| serious Total, serious adverse events | 43 / 388 | 53 / 378 | 21 / 189 | 22 / 191 |
Outcome results
Percentage of Participants With Adverse Events of Special Interest (AESIs)
Percentage of Participants with AESIs. AESI consisted of infections, positively adjudicated arterial thromboembolic events (ATE), positively adjudicated venous thromboembolic events (VTE), positively adjudicated major adverse cardiovascular events (MACE), other positively adjudicated cardiovascular events, death, anaphylactic reactions, hypersensitivity, angioedema, and malignancies.
Time frame: Week 134
Population: All participants who received at least one dose of study drug.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| 2 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Infections | 38.4 Percentage of participants |
| 2 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Positively adjudicated ATE | 0.3 Percentage of participants |
| 2 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Positively adjudicated VTE | 0.3 Percentage of participants |
| 2 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Positively adjudicated MACE | 0.3 Percentage of participants |
| 2 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Other positively adjudicated cardiovascular events | 0.3 Percentage of participants |
| 2 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Death | 0 Percentage of participants |
| 2 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Anaphylactic reactions | 3.6 Percentage of participants |
| 2 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Hypersensitivity | 3.6 Percentage of participants |
| 2 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Angioedema | 1.3 Percentage of participants |
| 2 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Malignancies | 0.5 Percentage of participants |
| 4 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Positively adjudicated VTE | 1.1 Percentage of participants |
| 4 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Angioedema | 0.8 Percentage of participants |
| 4 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Positively adjudicated MACE | 0.8 Percentage of participants |
| 4 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Other positively adjudicated cardiovascular events | 0.8 Percentage of participants |
| 4 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Death | 1.6 Percentage of participants |
| 4 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Anaphylactic reactions | 4.2 Percentage of participants |
| 4 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Malignancies | 0.3 Percentage of participants |
| 4 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Hypersensitivity | 4.2 Percentage of participants |
| 4 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Infections | 42.1 Percentage of participants |
| 4 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Positively adjudicated ATE | 0.8 Percentage of participants |
| Placebo to 2 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Hypersensitivity | 5.8 Percentage of participants |
| Placebo to 2 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Anaphylactic reactions | 5.8 Percentage of participants |
| Placebo to 2 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Malignancies | 0 Percentage of participants |
| Placebo to 2 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Infections | 36.5 Percentage of participants |
| Placebo to 2 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Positively adjudicated MACE | 0.5 Percentage of participants |
| Placebo to 2 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Death | 1.1 Percentage of participants |
| Placebo to 2 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Angioedema | 1.6 Percentage of participants |
| Placebo to 2 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Positively adjudicated ATE | 0.5 Percentage of participants |
| Placebo to 2 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Other positively adjudicated cardiovascular events | 0 Percentage of participants |
| Placebo to 2 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Positively adjudicated VTE | 0.5 Percentage of participants |
| Placebo to 4 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Other positively adjudicated cardiovascular events | 0.5 Percentage of participants |
| Placebo to 4 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Hypersensitivity | 3.1 Percentage of participants |
| Placebo to 4 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Death | 0 Percentage of participants |
| Placebo to 4 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Malignancies | 0 Percentage of participants |
| Placebo to 4 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Anaphylactic reactions | 3.1 Percentage of participants |
| Placebo to 4 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Positively adjudicated ATE | 0.5 Percentage of participants |
| Placebo to 4 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Positively adjudicated VTE | 0.5 Percentage of participants |
| Placebo to 4 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Positively adjudicated MACE | 0.5 Percentage of participants |
| Placebo to 4 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Infections | 35.1 Percentage of participants |
| Placebo to 4 mg Baricitinib | Percentage of Participants With Adverse Events of Special Interest (AESIs) | Angioedema | 0 Percentage of participants |
Percentage of Participants With Permanent Investigational Product Discontinuations
Percentage of participants with permanent investigational product discontinuations.
Time frame: Week 134
Population: All participants who received at least one dose of study drug.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| 2 mg Baricitinib | Percentage of Participants With Permanent Investigational Product Discontinuations | 5.2 Percentage of Participants |
| 4 mg Baricitinib | Percentage of Participants With Permanent Investigational Product Discontinuations | 5.8 Percentage of Participants |
| Placebo to 2 mg Baricitinib | Percentage of Participants With Permanent Investigational Product Discontinuations | 4.2 Percentage of Participants |
| Placebo to 4 mg Baricitinib | Percentage of Participants With Permanent Investigational Product Discontinuations | 5.8 Percentage of Participants |
Percentage of Participants With Serious Adverse Events (SAEs)
Percentage of participants with SAEs. An SAE is any AE from this study that results in one of the following outcomes: Death; Initial or prolonged inpatient hospitalization; A life-threatening experience (that is, immediate risk of dying); Persistent or significant disability/incapacity; Congenital anomaly/birth defect; Important medical events that may not be immediately life-threatening or result in death or hospitalization, but may jeopardize the patient or may require intervention to prevent one of the other outcomes listed in the definition above. A summary of all SAE's, regardless of causality, is located in the Reported Adverse Events section.
Time frame: Week 134
Population: All participants who received at least one dose of study drug.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| 2 mg Baricitinib | Percentage of Participants With Serious Adverse Events (SAEs) | 11.1 Percentage of Participants |
| 4 mg Baricitinib | Percentage of Participants With Serious Adverse Events (SAEs) | 13.5 Percentage of Participants |
| Placebo to 2 mg Baricitinib | Percentage of Participants With Serious Adverse Events (SAEs) | 11.1 Percentage of Participants |
| Placebo to 4 mg Baricitinib | Percentage of Participants With Serious Adverse Events (SAEs) | 11.5 Percentage of Participants |
Percentage of Participants With Temporary Investigational Product Interruptions
Percentage of participants with temporary investigational product interruptions.
Time frame: Week 134
Population: All participants who received at least one dose of study drug.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| 2 mg Baricitinib | Percentage of Participants With Temporary Investigational Product Interruptions | 19.1 Percentage of Participants |
| 4 mg Baricitinib | Percentage of Participants With Temporary Investigational Product Interruptions | 24.6 Percentage of Participants |
| Placebo to 2 mg Baricitinib | Percentage of Participants With Temporary Investigational Product Interruptions | 18.5 Percentage of Participants |
| Placebo to 4 mg Baricitinib | Percentage of Participants With Temporary Investigational Product Interruptions | 23.6 Percentage of Participants |
Percentage of Participants With Treatment-Emergent Adverse Events (TEAEs)
Percentage of participants with TEAEs. A treatment-emergent AE (TEAE) is defined as an event that first occurred or worsened in severity after the first dose of study treatment in Study JAIM and on or prior to the last visit date during the analysis period. The analysis period is defined as the treatment period plus up to 30 days off-drug follow-up time. A summary of serious and other non-serious adverse events, regardless of causality, is located in the Reported Adverse Events module.
Time frame: Week 134
Population: All participants who received at least one dose of study drug.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| 2 mg Baricitinib | Percentage of Participants With Treatment-Emergent Adverse Events (TEAEs) | 61.9 Percentage of Participants |
| 4 mg Baricitinib | Percentage of Participants With Treatment-Emergent Adverse Events (TEAEs) | 68.8 Percentage of Participants |
| Placebo to 2 mg Baricitinib | Percentage of Participants With Treatment-Emergent Adverse Events (TEAEs) | 65.1 Percentage of Participants |
| Placebo to 4 mg Baricitinib | Percentage of Participants With Treatment-Emergent Adverse Events (TEAEs) | 64.4 Percentage of Participants |
Annualized Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA)-Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) Flare Index Flare Rate
The SELENA-SLEDAI tool is a cumulative and weighted index used to assess disease activity across 24 different disease descriptors in patients with lupus. A patient's SELENA-SLEDAI total score is the sum of all marked lupus related descriptors (seizure, psychosis, organic brain syndrome, visual disturbance, cranial nerve disorder, lupus headache, cerebrovascular accident, vasculitis, arthritis, myositis, urinary casts, hematuria, proteinuria, pyuria, new rash, alopecia, mucosal ulcers, pleurisy, pericarditis, low complement, increased DNA binding, fever, thrombocytopenia, leukopenia). A total score can fall between 0 and 105, with a higher score representing a more significant degree of disease activity. The annualized flare rate is calculated as the number of flares divided by the flare exposure time in days multiplied with 365.25.
Time frame: Baseline through Week 48
Population: Due to early termination of the study, this population consisted of participants who completed Week 48 treatment, or discontinued treatment prior to Week 48 (but not due to study termination). Participants having values for this outcome were included.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| 2 mg Baricitinib | Annualized Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA)-Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) Flare Index Flare Rate | 0.978 flares per year |
| 4 mg Baricitinib | Annualized Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA)-Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) Flare Index Flare Rate | 0.926 flares per year |
| Placebo to 2 mg Baricitinib | Annualized Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA)-Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) Flare Index Flare Rate | 0.894 flares per year |
| Placebo to 4 mg Baricitinib | Annualized Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA)-Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) Flare Index Flare Rate | 0.746 flares per year |
Change From Baseline in Prednisone Dose
Change from baseline in prednisone dose.
Time frame: Baseline through Week 48
Population: Due to early termination of the study, this population consisted of participants who completed Week 48 treatment, or discontinued treatment prior to Week 48 (but not due to study termination). Participants having values for this outcome were included.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| 2 mg Baricitinib | Change From Baseline in Prednisone Dose | 2.35 milligrams (mg) | Standard Error 0.305 |
| 4 mg Baricitinib | Change From Baseline in Prednisone Dose | 2.27 milligrams (mg) | Standard Error 0.316 |
| Placebo to 2 mg Baricitinib | Change From Baseline in Prednisone Dose | 1.68 milligrams (mg) | Standard Error 0.426 |
| Placebo to 4 mg Baricitinib | Change From Baseline in Prednisone Dose | 1.00 milligrams (mg) | Standard Error 0.419 |
Change From Baseline in Swollen Joint Count
The number of swollen joints is determined by examination of 28 joints (14 on each side) which include: the 2 shoulders, the 2 elbows, the 2 wrists, the 10 metacarpophalangeal joints, the 2 interphalangeal joints of the thumb, the 8 proximal interphalangeal joints, and the 2 knees. The joints are assessed and classified as swollen or not swollen. LS mean was calculated using MMRM analysis with treatment, baseline disease activity (total SLEDAI-2K \<10; \>=10), baseline corticosteroid dose (\<10 mg/day; \>=10 mg/day prednisone or equivalent), region (North America, Central/South America/Mexico, Europe, Asia and Rest of World), visit (as categorical variable), baseline value, treatment-by-visit interaction, and baseline value-by-visit interaction.
Time frame: Baseline trough Week 48
Population: Due to early termination of the study, this population consisted of participants who completed Week 48 treatment, or discontinued treatment prior to Week 48 (but not due to study termination). Participants having values for this outcome were included.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| 2 mg Baricitinib | Change From Baseline in Swollen Joint Count | -4.03 swollen joints | Standard Error 0.191 |
| 4 mg Baricitinib | Change From Baseline in Swollen Joint Count | -4.01 swollen joints | Standard Error 0.196 |
| Placebo to 2 mg Baricitinib | Change From Baseline in Swollen Joint Count | -3.19 swollen joints | Standard Error 0.264 |
| Placebo to 4 mg Baricitinib | Change From Baseline in Swollen Joint Count | -2.94 swollen joints | Standard Error 0.257 |
Change From Baseline in Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index Total Score
The SLICC/ACR damage index is a validated instrument to assess damage, defined as irreversible impairment, continuously persistent for 6 months (ascertained by clinical assessment), occurring since the onset of lupus, and it is based on a weighted scoring system. This index records damage occurring in participants with SLE regardless of cause, with demonstrated content, face, criterion, and discriminant validity. A score of 0 indicates no damage. Total maximum score is 47 and increasing score indicates increasing disease severity.
Time frame: Baseline through Week 48
Population: Due to early termination of the study, this population consisted of participants who completed Week 48 treatment, or discontinued treatment prior to Week 48 (but not due to study termination). Participants having values for this outcome were included.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| 2 mg Baricitinib | Change From Baseline in Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index Total Score | -0.03 Score on a scale | Standard Deviation 0.569 |
| 4 mg Baricitinib | Change From Baseline in Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index Total Score | -0.04 Score on a scale | Standard Deviation 0.544 |
| Placebo to 2 mg Baricitinib | Change From Baseline in Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index Total Score | -0.04 Score on a scale | Standard Deviation 0.754 |
| Placebo to 4 mg Baricitinib | Change From Baseline in Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index Total Score | -0.06 Score on a scale | Standard Deviation 0.505 |
Change From Baseline in Tender Joint Count
The number of tender and painful joints is determined by examination of 28 joints (14 on each side) which include: the 2 shoulders, the 2 elbows, the 2 wrists, the 10 metacarpophalangeal joints, the 2 interphalangeal joints of the thumb, the 8 proximal interphalangeal joints, and the 2 knees. The joints are assessed and classified as tender or not tender. LS mean was calculated using Mixed Model Repeated Measures (MMRM) analysis with treatment, baseline disease activity (total SLEDAI-2K \<10; \>=10), baseline corticosteroid dose (\<10 mg/day; \>=10 mg/day prednisone or equivalent), region (North America, Central/South America/Mexico, Europe, Asia and Rest of World), visit (as categorical variable), baseline value, treatment-by-visit interaction, and baseline value-by-visit interaction.
Time frame: Baseline through Week 48
Population: Due to early termination of the study, this population consisted of participants who completed Week 48 treatment, or discontinued treatment prior to Week 48 (but not due to study termination). Participants having values for this outcome were included.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| 2 mg Baricitinib | Change From Baseline in Tender Joint Count | -5.68 tender joints | Standard Error 0.281 |
| 4 mg Baricitinib | Change From Baseline in Tender Joint Count | -5.85 tender joints | Standard Error 0.292 |
| Placebo to 2 mg Baricitinib | Change From Baseline in Tender Joint Count | -3.62 tender joints | Standard Error 0.383 |
| Placebo to 4 mg Baricitinib | Change From Baseline in Tender Joint Count | -3.73 tender joints | Standard Error 0.376 |
Change From Baseline in Worst Pain Numeric Rating Scale (NRS)
Change from baseline in Worst Pain NRS. It is assessed using an 11-point Numeric Rating Scale (NRS) (0-10) where 0 represents no pain and 10 represents worst pain imaginable. Overall severity of a patient's pain is indicated by selecting the number that best describes the worst level of pain during the past 7 days.
Time frame: Baseline through Week 48
Population: Due to early termination of the study, this population consisted of participants who completed Week 48 treatment, or discontinued treatment prior to Week 48 (but not due to study termination). Participants having values for this outcome were included.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| 2 mg Baricitinib | Change From Baseline in Worst Pain Numeric Rating Scale (NRS) | -0.96 Score on a scale | Standard Error 0.167 |
| 4 mg Baricitinib | Change From Baseline in Worst Pain Numeric Rating Scale (NRS) | -1.23 Score on a scale | Standard Error 0.173 |
| Placebo to 2 mg Baricitinib | Change From Baseline in Worst Pain Numeric Rating Scale (NRS) | -0.55 Score on a scale | Standard Error 0.222 |
| Placebo to 4 mg Baricitinib | Change From Baseline in Worst Pain Numeric Rating Scale (NRS) | -0.83 Score on a scale | Standard Error 0.218 |
Percentage of Participants Achieving a Lupus Low Disease Activity State (LLDAS)
Percentage of participants achieving a LLDAS. The LLDAS is a composite measure designed to identify patients achieving a state of low disease activity. The LLDAS response criteria were: (1) SLEDAI-2K \<=4, with no activity in major organ systems (CNS, vascular, renal, cardiorespiratory and constitutional); where no activity is defined as all items of SLEDAI-2K within these major organ systems equal to 0. (2) no new features of lupus disease activity compared to previous occurred visit, where the new feature is defined as any of the SLEDAI-2K 24 items changed from 0 to greater than 0; (3) PGA (scale 0-3), \<=1; (4) current prednisolone (or equivalent) dose \<=7.5 mg daily.
Time frame: Week 48
Population: All participants who received at least one dose of study drug and had SLEDAI-2K score of \>=4 at baseline. Due to early termination of the study, this population consisted of participants who completed Week 48 treatment, or discontinued treatment prior to Week 48 (but not due to study termination).
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| 2 mg Baricitinib | Percentage of Participants Achieving a Lupus Low Disease Activity State (LLDAS) | 29.8 Percentage of participants |
| 4 mg Baricitinib | Percentage of Participants Achieving a Lupus Low Disease Activity State (LLDAS) | 33.0 Percentage of participants |
| Placebo to 2 mg Baricitinib | Percentage of Participants Achieving a Lupus Low Disease Activity State (LLDAS) | 19.4 Percentage of participants |
| Placebo to 4 mg Baricitinib | Percentage of Participants Achieving a Lupus Low Disease Activity State (LLDAS) | 26.0 Percentage of participants |
Percentage of Participants Achieving a Systemic Lupus Erythematosus Responder Index 4 (SRI-4) Response
SRI-4 response defined as 1)greater than or equal to 4-point reduction in Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) total score 2)no new British Isles Lupus Assessment Group (BILAG) A and no more than 1 new BILAG B domain score and 3)no worsening in Physician Global Assessment (PGA) of Disease Activity (worsening defined as an increase of \>=0.3 from baseline on a 0-3 visual analogue scale). SLEDAI-2K assessment consists of 24 items with total score of 0(no symptoms) to 105 (presence of all defined symptoms) with higher scores representing increased disease activity. BILAG Index: assessing clinical signs, symptoms,or laboratory parameters related to Systemic Lupus Erythematosus (SLE),divided into 9 organ systems. For each organ system A=severe disease,B=moderate disease,C=mild stable disease,D=inactive,but previously active,E=inactive and never affected. PGA assesses disease activity on a visual analogue scale from 0 to 3 (1=mild, 2=moderate, 3=severe).
Time frame: Week 134
Population: All randomized participants who had SLEDAI-2K score of \>=4 at baseline.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| 2 mg Baricitinib | Percentage of Participants Achieving a Systemic Lupus Erythematosus Responder Index 4 (SRI-4) Response | 0 Percentage of participants |
| 4 mg Baricitinib | Percentage of Participants Achieving a Systemic Lupus Erythematosus Responder Index 4 (SRI-4) Response | 0 Percentage of participants |
| Placebo to 2 mg Baricitinib | Percentage of Participants Achieving a Systemic Lupus Erythematosus Responder Index 4 (SRI-4) Response | 0 Percentage of participants |
| Placebo to 4 mg Baricitinib | Percentage of Participants Achieving a Systemic Lupus Erythematosus Responder Index 4 (SRI-4) Response | 0 Percentage of participants |
Percentage of Participants With Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) Total Activity Score ≥10 at Baseline With ≥50% Reduction in CLASI Total Activity Score
The CLASI is a single-page tool that separately quantifies disease activity and damage. For the activity score, points are given for the presence of erythema, scale, mucous membrane lesions, recent hair loss, and inflammatory alopecia. The total score represents the sum of the individual scores and ranges from 0 to 70. Higher scores are awarded for more severe manifestations.
Time frame: Week 48
Population: All participants with CLASI Total Activity Score \>= 10 at baseline. Due to early termination of the study, this population consisted of participants who completed Week 48 treatment, or discontinued treatment prior to Week 48 (but not due to study termination).
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| 2 mg Baricitinib | Percentage of Participants With Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) Total Activity Score ≥10 at Baseline With ≥50% Reduction in CLASI Total Activity Score | 55.9 Percentage of participants |
| 4 mg Baricitinib | Percentage of Participants With Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) Total Activity Score ≥10 at Baseline With ≥50% Reduction in CLASI Total Activity Score | 64.0 Percentage of participants |
| Placebo to 2 mg Baricitinib | Percentage of Participants With Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) Total Activity Score ≥10 at Baseline With ≥50% Reduction in CLASI Total Activity Score | 60.0 Percentage of participants |
| Placebo to 4 mg Baricitinib | Percentage of Participants With Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) Total Activity Score ≥10 at Baseline With ≥50% Reduction in CLASI Total Activity Score | 20.0 Percentage of participants |