Spondyloarthritis
Conditions
Keywords
Upadacitinib, Axial Spondyloarthritis (axSpA), Spondyloarthritis, Ankylosing Spondylitis (AS)
Brief summary
This protocol includes 2 standalone studies with randomization, data collection, analysis and reporting conducted independently. The main objectives of this protocol are: * To evaluate the efficacy of upadacitinib compared with placebo on reduction of signs and symptoms in adults with active axial spondyloarthritis (axSpA) including biologic disease-modifying antirheumatic drug inadequate responders (bDMARD-IR) ankylosing spondylitis (AS) (Study 1) and non-radiographic axial spondyloarthritis (nr-axSpA) (Study 2). * To assess the safety and tolerability of upadacitinib in adults with active axSpA including bDMARD-IR AS (Study 1) and nr-axSpA (Study 2). * To evaluate the safety and tolerability of upadacitinib in extended treatment in adult participants with active axSpA including bDMARD-IR AS who have completed the Double-Blind Period (Study 1) and nr-axSpA who have completed the Double-Blind Period (Study 2). * To evaluate the maintenance of disease control after withdrawal of upadacitinib.
Detailed description
Study 1 (bDMARD-IR AS) is comprised of a 14-week randomized, double-blind, parallel-group, placebo-controlled period (the Double-Blind Period); a 90-week open-label, long-term extension period (the Open-Label Extension Period); and a 30-day Follow-Up Visit (F/U Visit). Study 2 (nr-axSpA) is comprised of a 52-week randomized, double-blind, parallel-group, placebo-controlled period (the Double-Blind Period); a 52-week open-label, long-term extension period (the Open-Label Extension Period); and a 30-day F/U Visit. In the Double-Blind Period for both studies, participants are randomized in a 1:1 ratio to receive either upadacitinib or placebo once daily (QD). Participants in the placebo group switch to upadacitinib 15 mg QD at Week 14 in the Open-Label Extension Period for Study 1 (bDMARD-IR AS) and Week 52 in the Open-Label Extension Period for Study 2 (nr-axSpA). Participants in remission at Week 104 have the option to enroll in a remission-withdrawal period. Study M19-944 protocol uses a common screening platform for determining eligibility into Study 1 and Study 2. Each study has its own objectives, hypothesis testing, randomization, data collection, and adequate power for primary and secondary endpoints. Analysis and reporting are conducted separately and independently for each study.
Interventions
Upadacitinib tablet administered orally
Placebo for upadacitinib tablet administered orally
Sponsors
Study design
Eligibility
Inclusion criteria
* Study 1: * Must have a clinical diagnosis of ankylosing spondylitis (AS) and meet the modified New York Criteria for AS, * Must not have total spinal ankylosis * Must have been previously exposed to 1 or 2 bDMARDs (at least 1 tumor necrosis factor \[TNF\] inhibitor or 1 interleukin \[IL\]-17 inhibitor \[IL-17i\]), and must have discontinued the bDMARD therapy due to either lack of efficacy (after at least 12 weeks of treatment with a bDMARD at an adequate dose) or intolerance (irrespective of treatment duration). Prior exposure to two bDMARDs was allowed for no more than 30% of patients; among patients with prior exposure to two bDMARDs, a lack of efficacy to one bDMARD and intolerance to another was permitted, but a patient could not have a lack of efficacy to two bDMARDs * Study 2: * Must have a clinical diagnosis of nr-axSpA fulfilling the 2009 Assessment of SpondyloArthritis international Society (ASAS) classification criteria for axSpA but not meeting the radiologic criterion of the modified New York criteria for AS * Must have objective signs of active inflammation consistent with axSpA on magnetic resonance imaging (MRI) of sacroiliac (SI) joints or based on high sensitivity C-reactive protein (hsCRP) \> the upper limit of normal (ULN). * Prior treatment with at most one bDMARD (either TNF inhibitor or IL-17i) is allowed for at least 20% but no more than 35% of enrolled patients who had to discontinue the prior bDMARD due to either lack of efficacy (after ≥ 12 weeks at an adequate dose) or intolerance (regardless of treatment duration). * Must have a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score ≥ 4 at the Screening and Baseline Visits. * Must have a Total Back Pain score ≥ 4 based on a 0 - 10 numerical rating scale at the Screening and Baseline Visits. * Has had an inadequate response to at least 2 nonsteroidal anti-inflammatory drugs (NSAIDs) over an at least 4-week period in total at maximum recommended or tolerated doses, or has an intolerance to or contraindication for NSAIDs as defined by the Investigator.
Exclusion criteria
* Must not have been exposed to any Janus kinase (JAK) inhibitor (including but not limited to upadacitinib \[Rinvoq®\], tofacitinib \[Xeljanz®\], baricitinib \[Olumiant®\], filgotinib, ruxolitinib \[Jakafi®\], abrocitinib \[PF-04965842\], and peficitinib \[Smyraf®\]). * Prior bDMARD therapy must be washed out. * Participant must not have a history of an allergic reaction or significant sensitivity to constituents of the study drug.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Study 1: Percentage of Participants Achieving Assessment of SpondyloArthritis International Society 40 (ASAS40) Response at Week 14 | Baseline and Week 14 | ASAS40 response was defined as improvement of ≥ 40% relative to Baseline and absolute improvement of ≥ 2 units (on a scale from 0 to 10) in ≥ 3 of the following 4 domains with no deterioration (defined as a net worsening of \> 0 units) in the potential remaining domain: * Patient's global assessment of disease activity, measured on a numeric rating scale (NRS) from 0 (no activity) to 10 (severe activity); * Pain, measured by the total back pain NRS from 0 (no pain) to 10 (most severe pain); * Function, measured by the Bath Ankylosing Spondylitis Functional Index (BASFI) which consists of 10 items assessing participants' ability to perform activities on an NRS ranging from 0 (easy) to 10 (impossible); * Inflammation, measured by the mean of the 2 morning stiffness-related Bath AS Disease Activity Index (BASDAI) NRS scores (items 5 \[level of stiffness\] and 6 \[duration of stiffness\]) each on a scale from 0 (none/0 hours) to 10 (very severe/2 hours or more duration). |
| Study 2: Percentage of Participants Achieving an ASAS40 Response at Week 14 | Baseline and Week 14 | ASAS40 response was defined as improvement of ≥ 40% relative to Baseline and absolute improvement of ≥ 2 units (on a scale from 0 to 10) in ≥ 3 of the following 4 domains with no deterioration (defined as a net worsening of \> 0 units) in the potential remaining domain: * Patient's global assessment of disease activity, measured on a numeric rating scale (NRS) from 0 (no activity) to 10 (severe activity); * Pain, measured by the total back pain NRS from 0 (no pain) to 10 (most severe pain); * Function, measured by the Bath Ankylosing Spondylitis Functional Index (BASFI) which consists of 10 items assessing participants' ability to perform activities on an NRS ranging from 0 (easy) to 10 (impossible); * Inflammation, measured by the mean of the 2 morning stiffness-related Bath AS Disease Activity Index (BASDAI) NRS scores (items 5 \[level of stiffness\] and 6 \[duration of stiffness\]) each on a scale from 0 (none/0 hours) to 10 (very severe/2 hours or more duration). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Study 1: Change From Baseline in Ankylosing Spondylitis Disease Activity Score (ASDAS) at Week 14 | Baseline and Week 14 | ASDAS is a composite index to assess disease activity in Ankylosing Spondylitis. ASDAS combines the following 5 disease activity variables using a weighted formula: 1. Patient's assessment of total back pain (BASDAI Question 2; NRS score 0 \[none\] - 10 \[very severe\]) 2. Patient global assessment of disease activity (NRS score 0 \[no activity\] - 10 \[severe activity\]) 3. Peripheral pain/swelling (BASDAI Question 3; NRS score 0 \[none\] - 10 \[very severe\]) 4. Duration of morning stiffness (BASDAI Question 6; NRS score 0 \[0 hours\] - 10 \[2 or more hours\]) 5. High-sensitivity C-reactive protein (hs-CRP) in mg/L. The overall score ranges from 0 with no defined upper score; published ranges for disease activity states as defined by the ASDAS include Inactive disease (ASDAS \< 1.3) and very high disease (ASDAS \> 3.5). A negative change from Baseline score indicates improvement in disease activity. |
| Study 1: Change From Baseline in Ankylosing Spondylitis Quality of Life (ASQoL) Score at Week 14 | Baseline and Week 14 | The ASQoL consists of 18 items related to quality of life, including the impact of pain on sleep, mood, motivation, ability to cope, activities of daily living, independence, relationships, and social life. Each item is answered as yes (scored as 1) or no (scored as 0). Scores are summed to obtain the overall score which ranges from 0 to 18, where higher scores indicate a worse quality of life. A negative change from Baseline in ASQoL indicates improvement in quality of life. |
| Study 1: Change From Baseline in Magnetic Resonance Imaging (MRI) Spondyloarthritis Research Consortium of Canada (SPARCC) Score for the Spine at Week 14 | Baseline and Week 14 | In the SPARCC MRI assessment of the spine, the entire spine was evaluated for active inflammation (bone marrow edema). Six discovertebral units (DVU) representing the 6 most abnormal DVUs were selected to calculate the MRI Spine SPARCC score. For each of the 6 DVUs, 3 consecutive sagittal slices were assessed in 4 quadrants to evaluate the extent of inflammation in all three dimensions. Each quadrant was scored for the presence (1) or absence (0) of edema. If edema was present in at least one quadrant of a DVU slice, it was also scored for intensity and depth of the edema representing that slice: An additional score of 1 was assigned if an intense signal was seen in any quadrant on a DVU slice. Slices that included a lesion demonstrating continuous increased signal of depth ≥ 1 cm extending from the endplate were scored as an additional 1 per slice. The maximum (worst) overall score for all 6 DVUs is 108. A negative change from Baseline indicates improvement. |
| Study 1: Percentage of Participants With Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) 50 Response at Week 14 | Baseline and Week 14 | The BASDAI assesses disease activity by asking the participant to answer 6 questions (each on an 11 point numeric rating scale \[NRS\]) pertaining to symptoms experienced for the past week. For Questions 1 to 5 (level of fatigue/tiredness, level of AS neck, back or hip pain, level of pain/swelling in joints, other than neck, back or hips, level of discomfort from any areas tender to touch or pressure, and level of morning stiffness), the response is from 0 (none) to 10 (very severe); for Question 6 (duration of morning stiffness), the response is from 0 (0 hours) to 10 (≥ 2 hours). The overall BASDAI score ranges from 0 to 10. Lower scores indicate less disease activity. A BASDAI 50 response is defined as improvement of 50% or more from Baseline in BASDAI score. |
| Study 1: Percentage of Participants With an ASAS20 Response at Week 14 | Baseline and Week 14 | ASAS20 response was defined as an improvement of ≥ 20% and an absolute improvement of ≥ 1 unit (on a scale of 0 to 10) from Baseline in at least 3 of the following 4 domains, with no deterioration (defined as a worsening of ≥ 20% and a net worsening of ≥ 1 units \[on a scale of 0 to 10\]) in the remaining domain: * Patient's global assessment of disease activity, measured on a NRS from 0 (no activity) to 10 (severe activity); * Pain, measured by the total back pain NRS from 0 (no pain) to 10 (most severe pain); * Function, measured by the BASFI which consists of 10 items assessing participants' ability to perform activities on an NRS ranging from 0 (easy) to 10 (impossible); * Inflammation, measured by the mean of the 2 morning stiffness-related BASDAI NRS scores (items 5 \[level of stiffness\] and 6 \[duration of stiffness\]) each on a scale from 0 (none/0 hours) to 10 (very severe/2 hours or more duration). |
| Study 1: Percentage of Participants With ASDAS Inactive Disease at Week 14 | Week 14 | ASDAS is a composite index to assess disease activity in Ankylosing Spondylitis. ASDAS combines the following 5 disease activity variables using a weighted formula: 1. Patient's assessment of total back pain (BASDAI Question 2; NRS score 0 \[none\] - 10 \[very severe\]) 2. Patient global assessment of disease activity (NRS score 0 \[no activity\] - 10 \[severe activity\]) 3. Peripheral pain/swelling (BASDAI Question 3; NRS score 0 \[none\] - 10 \[very severe\]) 4. Duration of morning stiffness (BASDAI Question 6; NRS score 0 \[0 hours\] - 10 \[2 or more hours\]) 5. High-sensitivity C-reactive protein (hs-CRP) in mg/L. The overall score ranges from 0 with no defined upper score. ASDAS Inactive Disease is defined as an ASDAS score \< 1.3. |
| Study 1: Change From Baseline in Patient's Assessment of Total Back Pain at Week 14 | Baseline and Week 14 | Participants assessed their total back pain during the last week on a 0 to 10 numerical rating scale (NRS), where 0 represents no pain and 10 represents most severe pain. |
| Study 1: Change From Baseline in Patient's Assessment of Nocturnal Back Pain at Week 14 | Baseline and Week 14 | Participants assessed the amount of back pain at night over the last week on a 0 to 10 NRS, where 0 represents no pain and 10 represents most severe pain. |
| Study 1: Percentage of Participants With ASDAS Low Disease Activity at Week 14 | Week 14 | ASDAS is a composite index to assess disease activity in Ankylosing Spondylitis. ASDAS combines the following 5 disease activity variables using a weighted formula: 1. Patient's assessment of total back pain (BASDAI Question 2; NRS score 0 \[none\] - 10 \[very severe\]) 2. Patient global assessment of disease activity (NRS score 0 \[no activity\] - 10 \[severe activity\]) 3. Peripheral pain/swelling (BASDAI Question 3; NRS score 0 \[none\] - 10 \[very severe\]) 4. Duration of morning stiffness (BASDAI Question 6; NRS score 0 \[0 hours\] - 10 \[2 or more hours\]) 5. High-sensitivity C-reactive protein (hs-CRP) in mg/L. The overall score ranges from 0 with no defined upper score. ASDAS Low Disease Activity is defined as an ASDAS score \< 2.1. |
| Study 1: Change From Baseline in Bath Ankylosing Spondylitis Functional Index (BASFI) at Week 14 | Baseline and Week 14 | The Bath Ankylosing Spondylitis Functional Index is a validated index to determine the degree of functional limitation in patients with AS. BASFI consists of 10 questions assessing participants' ability to perform activities such as putting on socks, bending, reaching, getting up from the floor or an armless chair, standing, climbing and other physical activities. Each item is scored on a NRS ranging from 0 (easy to perform an activity) to 10 (impossible to perform an activity). The overall score is the mean of the 10 items and ranges from 0 to 10 with higher scores indicating more functional limitations. A negative change from Baseline in BASFI indicates improvement. |
| Study 1: Percentage of Participants With ASAS Partial Remission at Week 14 | Week 14 | ASAS partial remission (PR) is defined as an absolute score of ≤ 2 units on a 0 to 10 scale for each of the four following domains: * Patient's global assessment of disease activity, measured on a numeric rating scale (NRS) from 0 (no activity) to 10 (severe activity); * Pain, measured by the total back pain NRS from 0 (no pain) to 10 (most severe pain); * Function, measured by the Bath Ankylosing Spondylitis Functional Index (BASFI) which consists of 10 items assessing participants' ability to perform activities on an NRS ranging from 0 (easy) to 10 (impossible); * Inflammation, measured by the mean of the 2 morning stiffness-related Bath AS Disease Activity Index (BASDAI) NRS scores (items 5 \[level of stiffness\] and 6 \[duration of stiffness\]) each on a scale from 0 (none/0 hours) to 10 (very severe/2 hours or more duration). |
| Study 1: Change From Baseline in ASAS Health Index at Week 14 | Baseline and Week 14 | The ASAS health index (HI) measures functioning and health across 17 aspects of health in patients with AS, including pain, emotional functions, sleep, sexual function, mobility, self care, and community life. Each of the 17 questions is answered by the participant as "I agree" (score = 1) or "I disagree" (score = 0). The responses to the 17 dichotomous items are summed up to give a total score ranging from 0 to 17, where a higher score indicates a worse health status. A negative change from Baseline indicates improvement. |
| Study 1: Change From Baseline in Linear Bath Ankylosing Spondylitis Metrology Index (BASMI[Lin]) at Week 14 | Baseline and Week 14 | The BASMI is a composite score based on 5 direct measurements of spinal mobility: 1. cervical rotation (measured in degrees), 2. tragus to wall distance (in centimeters \[cm\]) 3. lumbar side flexion (in cm), 4. lumbar flexion (modified Schober's) (in cm) and 5. intermalleolar distance (in cm). Each measurement is converted to a linear score between 0 and 10. The total BASMI(lin) score is the average of the 5 scores and ranges from 0 to 10; the higher the BASMI(lin) score the more severe the patient's limitation of movement due to their ankylosing spondylitis. A negative change from Baseline indicates improvement. |
| Study 1: Change From Baseline in Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) at Week 14 | Baseline and Week 14 | The MASES evaluation was conducted to assess the presence or absence of enthesitis (inflammation of the entheses, or sites where tendons or ligaments insert into the bone) at 13 different sites (first costochondral joint left/right, seventh costochondral joint left/right, posterior superior iliac spine left/right, anterior superior iliac spine left/right, iliac crest left/right, fifth lumbar spinous process, and proximal insertion of Achilles tendon left/right. Each site was scored for presence (1) or absence (0) of enthesitis. The MASES is the sum of the 13 site scores, and ranges from 0 to 13, with higher scores indicating more inflammation of the entheses. A negative change from Baseline indicates improvement. |
| Study 1: Change From Baseline in MRI SPARCC Score for Sacroiliac Joints at Week 14 | Baseline and Week 14 | In the SPARCC MRI assessment of the sacroiliac (SI) joints 6 consecutive sacroiliac joint image coronal slices representing the largest proportion of the synovial compartment of the SI joints were assessed for edema, intensity and depth of edema. Each SI joint (left and right) was divided into quadrants for a total of 8 SI scoring locations. Each quadrant was scored for the presence (1) or absence (0) of edema, intensity of edema (a score of 1 was assigned for each SI joint (left and right) if an intense signal was seen in any quadrant of that joint for each slice), and a lesion was graded as deep (score of 1) if there was homogeneous and unequivocal increase in signal extending over a depth of at least 1 cm from the articular surface of the SI joint in any quadrant. The total maximum (worst) score for all SI joints across 6 slices is 72. A negative change from Baseline indicates improvement. |
| Study 2: Change From Baseline in ASDAS at Week 14 | Baseline and Week 14 | ASDAS is a composite index to assess disease activity in Ankylosing Spondylitis. ASDAS combines the following 5 disease activity variables using a weighted formula: 1. Patient's assessment of total back pain (BASDAI Question 2; NRS score 0 \[none\] - 10 \[very severe\]) 2. Patient global assessment of disease activity (NRS score 0 \[no activity\] - 10 \[severe activity\]) 3. Peripheral pain/swelling (BASDAI Question 3; NRS score 0 \[none\] - 10 \[very severe\]) 4. Duration of morning stiffness (BASDAI Question 6; NRS score 0 \[0 hours\] - 10 \[2 or more hours\]) 5. High-sensitivity C-reactive protein (hs-CRP) in mg/L. The overall score ranges from 0 with no defined upper score; published ranges for disease activity states as defined by the ASDAS include Inactive disease (ASDAS \< 1.3) and very high disease (ASDAS \> 3.5). A negative change from Baseline score indicates improvement in disease activity. |
| Study 2: Change From Baseline in MRI SPARCC Score for SI Joints at Week 14 | Baseline and Week 14 | In the SPARCC MRI assessment of the sacroiliac (SI) joints 6 consecutive sacroiliac joint image coronal slices representing the largest proportion of the synovial compartment of the SI joints were assessed for edema, intensity and depth of edema. Each SI joint (left and right) was divided into quadrants for a total of 8 SI scoring locations. Each quadrant was scored for the presence (1) or absence (0) of edema, intensity of edema (a score of 1 was assigned for each SI joint (left and right) if an intense signal was seen in any quadrant of that joint for each slice), and a lesion was graded as deep (score of 1) if there was homogeneous and unequivocal increase in signal extending over a depth of at least 1 cm from the articular surface of the SI joint in any quadrant. The total maximum (worst) score for all SI joints across 6 slices is 72. A negative change from Baseline indicates improvement. |
| Study 2: Percentage of Participants With BASDAI 50 Response at Week 14 | Baseline and Week 14 | The BASDAI assesses disease activity by asking the participant to answer 6 questions (each on an 11 point numeric rating scale \[NRS\]) pertaining to symptoms experienced for the past week. For Questions 1 to 5 (level of fatigue/tiredness, level of AS neck, back or hip pain, level of pain/swelling in joints, other than neck, back or hips, level of discomfort from any areas tender to touch or pressure, and level of morning stiffness), the response is from 0 (none) to 10 (very severe); for Question 6 (duration of morning stiffness), the response is from 0 (0 hours) to 10 (≥ 2 hours). The overall BASDAI score ranges from 0 to 10. Lower scores indicate less disease activity. A BASDAI 50 response is defined as improvement of 50% or more from Baseline in BASDAI score. |
| Study 2: Percentage of Participants With ASDAS Inactive Disease at Week 14 | Week 14 | ASDAS is a composite index to assess disease activity in Ankylosing Spondylitis. ASDAS combines the following 5 disease activity variables using a weighted formula: 1. Patient's assessment of total back pain (BASDAI Question 2; NRS score 0 \[none\] - 10 \[very severe\]) 2. Patient global assessment of disease activity (NRS score 0 \[no activity\] - 10 \[severe activity\]) 3. Peripheral pain/swelling (BASDAI Question 3; NRS score 0 \[none\] - 10 \[very severe\]) 4. Duration of morning stiffness (BASDAI Question 6; NRS score 0 \[0 hours\] - 10 \[2 or more hours\]) 5. High-sensitivity C-reactive protein (hs-CRP) in mg/L. The overall score ranges from 0 with no defined upper score. ASDAS Inactive Disease is defined as an ASDAS score \< 1.3. |
| Study 2: Change From Baseline in Patient's Assessment of Total Back Pain at Week 14 | Baseline and Week 14 | Participants assessed their total back pain during the last week on a 0 to 10 numerical rating scale (NRS), where 0 represents no pain and 10 represents most severe pain. |
| Study 2: Change From Baseline in Patient's Assessment of Nocturnal Back Pain at Week 14 | Baseline and Week 14 | Participants assessed the amount of back pain at night over the last week on a 0 to 10 NRS, where 0 represents no pain and 10 represents most severe pain. |
| Study 2: Percentage of Participants With ASDAS Low Disease Activity at Week 14 | Week 14 | ASDAS is a composite index to assess disease activity in Ankylosing Spondylitis. ASDAS combines the following 5 disease activity variables using a weighted formula: 1. Patient's assessment of total back pain (BASDAI Question 2; NRS score 0 \[none\] - 10 \[very severe\]) 2. Patient global assessment of disease activity (NRS score 0 \[no activity\] - 10 \[severe activity\]) 3. Peripheral pain/swelling (BASDAI Question 3; NRS score 0 \[none\] - 10 \[very severe\]) 4. Duration of morning stiffness (BASDAI Question 6; NRS score 0 \[0 hours\] - 10 \[2 or more hours\]) 5. High-sensitivity C-reactive protein (hs-CRP) in mg/L. The overall score ranges from 0 with no defined upper score. ASDAS Low Disease Activity is defined as an ASDAS score \< 2.1. |
| Study 2: Percentage of Participants With ASAS Partial Remission at Week 14 | Week 14 | ASAS partial remission (PR) is defined as an absolute score of ≤ 2 units on a 0 to 10 scale for each of the four following domains: * Patient's global assessment of disease activity, measured on a numeric rating scale (NRS) from 0 (no activity) to 10 (severe activity); * Pain, measured by the total back pain NRS from 0 (no pain) to 10 (most severe pain); * Function, measured by the Bath Ankylosing Spondylitis Functional Index (BASFI) which consists of 10 items assessing participants' ability to perform activities on an NRS ranging from 0 (easy) to 10 (impossible); * Inflammation, measured by the mean of the 2 morning stiffness-related Bath AS Disease Activity Index (BASDAI) NRS scores (items 5 \[level of stiffness\] and 6 \[duration of stiffness\]) each on a scale from 0 (none/0 hours) to 10 (very severe/2 hours or more duration). |
| Study 2: Change From Baseline in BASFI at Week 14 | Baseline and Week 14 | The Bath Ankylosing Spondylitis Functional Index is a validated index to determine the degree of functional limitation in patients with AS. BASFI consists of 10 questions assessing participants' ability to perform activities such as putting on socks, bending, reaching, getting up from the floor or an armless chair, standing, climbing and other physical activities. Each item is scored on a NRS ranging from 0 (easy to perform an activity) to 10 (impossible to perform an activity). The overall score is the mean of the 10 items and ranges from 0 to 10 with higher scores indicating more functional limitations. A negative change from Baseline in BASFI indicates improvement. |
| Study 2: Change From Baseline in ASQoL at Week 14 | Baseline and Week 14 | The ASQoL consists of 18 items related to quality of life, including the impact of pain on sleep, mood, motivation, ability to cope, activities of daily living, independence, relationships, and social life. Each item is answered as yes (scored as 1) or no (scored as 0). Scores are summed to obtain the overall score which ranges from 0 to 18, where higher scores indicate a worse quality of life. A negative change from Baseline in ASQoL indicates improvement in quality of life. |
| Study 2: Change From Baseline in ASAS Health Index at Week 14 | Baseline and Week 14 | The ASAS HI measures functioning and health across 17 aspects of health in patients with AS, including pain, emotional functions, sleep, sexual function, mobility, self care, and community life. Each of the 17 questions is answered by the participant as "I agree" (score = 1) or "I disagree" (score = 0). The responses to the 17 dichotomous items are summed up to give a total score ranging from 0 to 17, where a higher score indicates a worse health status. A negative change from Baseline indicates improvement. |
| Study 2: Percentage of Participants Achieving an ASAS20 Response at Week 14 | Baseline and Week 14 | ASAS20 response was defined as an improvement of ≥ 20% and an absolute improvement of ≥ 1 unit (on a scale of 0 to 10) from Baseline in at least 3 of the following 4 domains, with no deterioration (defined as a worsening of ≥ 20% and a net worsening of ≥ 1 units \[on a scale of 0 to 10\]) in the remaining domain: * Patient's global assessment of disease activity, measured on a NRS from 0 (no activity) to 10 (severe activity); * Pain, measured by the total back pain NRS from 0 (no pain) to 10 (most severe pain); * Function, measured by the BASFI which consists of 10 items assessing participants' ability to perform activities on an NRS ranging from 0 (easy) to 10 (impossible); * Inflammation, measured by the mean of the 2 morning stiffness-related BASDAI NRS scores (items 5 \[level of stiffness\] and 6 \[duration of stiffness\]) each on a scale from 0 (none/0 hours) to 10 (very severe/2 hours or more duration). |
| Study 2: Change From Baseline in BASMI(Lin) at Week 14 | Baseline and Week 14 | The BASMI is a composite score based on 5 direct measurements of spinal mobility: 1. cervical rotation (measured in degrees), 2. tragus to wall distance (in centimeters \[cm\]) 3. lumbar side flexion (in cm), 4. lumbar flexion (modified Schober's) (in cm) and 5. intermalleolar distance (in cm). Each measurement is converted to a linear score between 0 and 10. The total BASMI(lin) score is the average of the 5 scores and ranges from 0 to 10; the higher the BASMI(lin) score the more severe the patient's limitation of movement due to their ankylosing spondylitis. A negative change from Baseline indicates improvement. |
| Study 2: Change From Baseline in MASES at Week 14 | Baseline and Week 14 | The MASES evaluation was conducted to assess the presence or absence of enthesitis (inflammation of the entheses, or sites where tendons or ligaments insert into the bone) at 13 different sites (first costochondral joint left/right, seventh costochondral joint left/right, posterior superior iliac spine left/right, anterior superior iliac spine left/right, iliac crest left/right, fifth lumbar spinous process, and proximal insertion of Achilles tendon left/right. Each site was scored for presence (1) or absence (0) of enthesitis. The MASES is the sum of the 13 site scores, and ranges from 0 to 13, with higher scores indicating more inflammation of the entheses. A negative change from Baseline indicates improvement. |
| Study 2: Percentage of Participants Achieving an ASAS40 Response at Week 52 | Baseline and Week 52 | ASAS40 response was defined as improvement of ≥ 40% relative to Baseline and absolute improvement of ≥ 2 units (on a scale from 0 to 10) in ≥ 3 of the following 4 domains with no deterioration (defined as a net worsening of \> 0 units) in the potential remaining domain: * Patient's global assessment of disease activity, measured on a numeric rating scale (NRS) from 0 (no activity) to 10 (severe activity); * Pain, measured by the total back pain NRS from 0 (no pain) to 10 (most severe pain); * Function, measured by the Bath Ankylosing Spondylitis Functional Index (BASFI) which consists of 10 items assessing participants' ability to perform activities on an NRS ranging from 0 (easy) to 10 (impossible); * Inflammation, measured by the mean of the 2 morning stiffness-related Bath AS Disease Activity Index (BASDAI) NRS scores (items 5 \[level of stiffness\] and 6 \[duration of stiffness\]) each on a scale from 0 (none/0 hours) to 10 (very severe/2 hours or more duration). |
| Study 2: Change From Baseline in MRI SPARCC Score for the Spine at Week 14 | Baseline and Week 14 | In the SPARCC MRI assessment of the spine, the entire spine is evaluated for active inflammation (bone marrow edema). Six discovertebral units (DVU) representing the 6 most abnormal DVUs were selected to calculate the MRI Spine SPARCC score. For each of the 6 DVUs, 3 consecutive sagittal slices were assessed in 4 quadrants to evaluate the extent of inflammation in all three dimensions. Each quadrant was scored for the presence (1) or absence (0) of edema. If edema was present in at least one quadrant of a DVU slice, it was also scored for intensity and depth of the edema representing that slice: An additional score of 1 was assigned if an intense signal was seen in any quadrant on a DVU slice. Slices that included a lesion demonstrating continuous increased signal of depth ≥ 1 cm extending from the endplate were scored as an additional 1 per slice. The maximum (worst) overall score for all 6 DVUs is 108. A negative change from Baseline indicates improvement. |
| Study 2: Percentage of Participants Who Initiated Rescue Treatment Between Week 24 and Week 52 | Week 24, Week 32, Week 40, and Week 52 | Participants who did not achieve an ASAS20 response at any 2 consecutive scheduled visits from Week 24 through Week 52 were to be rescued with standard of care treatment as described in the protocol. |
| Study 2: Percentage of Participants With ASDAS Major Improvement at Week 52 | Baseline and Week 52 | ASDAS is a composite index to assess disease activity in Ankylosing Spondylitis. ASDAS combines the following 5 disease activity variables using a weighted formula: 1. Patient's assessment of total back pain (BASDAI Question 2; NRS score 0 \[none\] - 10 \[very severe\]) 2. Patient global assessment of disease activity (NRS score 0 \[no activity\] - 10 \[severe activity\]) 3. Peripheral pain/swelling (BASDAI Question 3; NRS score 0 \[none\] - 10 \[very severe\]) 4. Duration of morning stiffness (BASDAI Question 6; NRS score 0 \[0 hours\] - 10 \[2 or more hours\]) 5. High-sensitivity C-reactive protein (hs-CRP) in mg/L. The overall score ranges from 0 with no defined upper score; published ranges for disease activity states as defined by the ASDAS include Inactive disease (ASDAS \< 1.3) and very high disease (ASDAS \> 3.5). Major Improvement is defined as a change from Baseline of ≤ -2.0. |
| Study 2: Percentage of Participants With ASDAS Inactive Disease at Week 52 | Week 52 | ASDAS is a composite index to assess disease activity in Ankylosing Spondylitis. ASDAS combines the following 5 disease activity variables using a weighted formula: 1. Patient's assessment of total back pain (BASDAI Question 2; NRS score 0 \[none\] - 10 \[very severe\]) 2. Patient global assessment of disease activity (NRS score 0 \[no activity\] - 10 \[severe activity\]) 3. Peripheral pain/swelling (BASDAI Question 3; NRS score 0 \[none\] - 10 \[very severe\]) 4. Duration of morning stiffness (BASDAI Question 6; NRS score 0 \[0 hours\] - 10 \[2 or more hours\]) 5. High-sensitivity C-reactive protein (hs-CRP) in mg/L. The overall score ranges from 0 with no defined upper score. ASDAS Inactive Disease is defined as an ASDAS score \< 1.3. |
| Study 2: Percentage of Participants With ASDAS Low Disease Activity at Week 52 | Week 52 | ASDAS is a composite index to assess disease activity in Ankylosing Spondylitis. ASDAS combines the following 5 disease activity variables using a weighted formula: 1. Patient's assessment of total back pain (BASDAI Question 2; NRS score 0 \[none\] - 10 \[very severe\]) 2. Patient global assessment of disease activity (NRS score 0 \[no activity\] - 10 \[severe activity\]) 3. Peripheral pain/swelling (BASDAI Question 3; NRS score 0 \[none\] - 10 \[very severe\]) 4. Duration of morning stiffness (BASDAI Question 6; NRS score 0 \[0 hours\] - 10 \[2 or more hours\]) 5. High-sensitivity C-reactive protein (hs-CRP) in mg/L. The overall score ranges from 0 with no defined upper score. ASDAS Low Disease Activity is defined as an ASDAS score \< 2.1. |
Countries
Argentina, Australia, Belgium, Brazil, Bulgaria, Canada, China, Czechia, France, Germany, Hungary, Israel, Japan, Mexico, New Zealand, Poland, Russia, Slovakia, South Korea, Spain, Taiwan, Turkey (Türkiye), Ukraine, United Kingdom, United States
Contacts
AbbVie
Participant flow
Recruitment details
This master protocol consists of 2 independent studies with a common screening platform for adults with active axial spondyloarthritis (axSpA). Study 1 enrolled adults with ankylosing spondylitis (AS) who had an inadequate response (IR) to biologic disease-modifying antirheumatic drug (bDMARD) therapy. Study 2 enrolled adults with non-radiographic axSpA (nr-axSpA). Each study includes a double-blind treatment period and an ongoing open-label extension period. RW period entry was optional.
Pre-assignment details
In each study participants were randomized equally to one of two treatment groups. In Study 1 randomization was stratified by high-sensitivity C-reactive protein (hsCRP) at Screening, class of the prior bDMARD use, and geographic region. In Study 2 randomization was stratified by magnetic resonance imaging (MRI) and Screening hsCRP status, and exposure to bDMARDs. For both studies Japan and China each had a separate randomization schedule stratified by Screening hsCRP and MRI (Study 2 only).
Participants by arm
| Arm | Count |
|---|---|
| Study 1: Placebo Participants with bDMARD-IR AS received placebo tablets orally once a day for 14 weeks. At Week 14 participants switched to receive 15 mg upadacitinib once daily in the open-label extension period. | 209 |
| Study 1: Upadacitinib 15 mg Participants with bDMARD-IR AS received 15 mg upadacitinib orally once a day for 14 weeks and continued to receive 15 mg upadacitinib once daily from Week 14 in the open-label extension period. | 211 |
| Study 2: Placebo Participants with nr-axSpA received placebo tablets orally once a day for 52 weeks. | 157 |
| Study 2: Upadacitinib 15 mg Participants with nr-axSpA received 15 mg upadacitinib orally once a day for 52 weeks. | 156 |
| Total | 733 |
Baseline characteristics
| Characteristic | Study 1: Placebo | Study 1: Upadacitinib 15 mg | Total | Study 2: Placebo | Study 2: Upadacitinib 15 mg |
|---|---|---|---|---|---|
| Age, Continuous Study 1 | 42.2 years STANDARD_DEVIATION 11.78 | 42.6 years STANDARD_DEVIATION 12.39 | 42.4 years STANDARD_DEVIATION 12.08 | — | — |
| Age, Continuous Study 2 | — | — | 42.1 years STANDARD_DEVIATION 12.21 | 42.5 years STANDARD_DEVIATION 12.44 | 41.6 years STANDARD_DEVIATION 12 |
| Age, Customized Study 1 40 - < 65 years | 108 Participants | 112 Participants | 220 Participants | — | — |
| Age, Customized Study 1 < 40 years | 92 Participants | 87 Participants | 179 Participants | — | — |
| Age, Customized Study 1 ≥ 65 years | 9 Participants | 12 Participants | 21 Participants | — | — |
| Age, Customized Study 2 40 - < 65 years | — | — | 165 Participants | 84 Participants | 81 Participants |
| Age, Customized Study 2 < 40 years | — | — | 139 Participants | 67 Participants | 72 Participants |
| Age, Customized Study 2 ≥ 65 years | — | — | 9 Participants | 6 Participants | 3 Participants |
| Bath Ankylosing Spondylitis Functional Index Study 1 | 6.2 score on a scale STANDARD_DEVIATION 1.87 | 6.3 score on a scale STANDARD_DEVIATION 2.03 | 6.2 score on a scale STANDARD_DEVIATION 1.95 | — | — |
| Bath Ankylosing Spondylitis Functional Index Study 2 | — | — | 5.9 score on a scale STANDARD_DEVIATION 2.11 | 6.0 score on a scale STANDARD_DEVIATION 2.14 | 5.9 score on a scale STANDARD_DEVIATION 2.08 |
| Duration of AS / nr-axSpA Symptoms Study 1 -Duration of AS symptoms | 12.6 years STANDARD_DEVIATION 9.29 | 12.9 years STANDARD_DEVIATION 9.08 | 12.8 years STANDARD_DEVIATION 9.18 | — | — |
| Duration of AS / nr-axSpA Symptoms Study 2 - Duration of nr-axSpA symptoms | — | — | 9.1 years STANDARD_DEVIATION 7.98 | 9.2 years STANDARD_DEVIATION 8.12 | 9.0 years STANDARD_DEVIATION 7.86 |
| Ethnicity (NIH/OMB) Study 1 Hispanic or Latino | 20 Participants | 17 Participants | 37 Participants | — | — |
| Ethnicity (NIH/OMB) Study 1 Not Hispanic or Latino | 189 Participants | 194 Participants | 383 Participants | — | — |
| Ethnicity (NIH/OMB) Study 1 Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | — | — |
| Ethnicity (NIH/OMB) Study 2 Hispanic or Latino | — | — | 39 Participants | 15 Participants | 24 Participants |
| Ethnicity (NIH/OMB) Study 2 Not Hispanic or Latino | — | — | 274 Participants | 142 Participants | 132 Participants |
| Ethnicity (NIH/OMB) Study 2 Unknown or Not Reported | — | — | 0 Participants | 0 Participants | 0 Participants |
| High-sensitivity C-reactive Protein (hsCRP) Level at Screening Study 1 ≤ upper limit of normal | 46 Participants | 46 Participants | 92 Participants | — | — |
| High-sensitivity C-reactive Protein (hsCRP) Level at Screening Study 1 > upper limit of normal | 163 Participants | 165 Participants | 328 Participants | — | — |
| High-sensitivity C-reactive Protein (hsCRP) Level at Screening Study 2 ≤ upper limit of normal | — | — | 64 Participants | 31 Participants | 33 Participants |
| High-sensitivity C-reactive Protein (hsCRP) Level at Screening Study 2 > upper limit of normal | — | — | 249 Participants | 126 Participants | 123 Participants |
| Inflammation Study 1 | 6.8 score on a scale STANDARD_DEVIATION 1.55 | 6.9 score on a scale STANDARD_DEVIATION 1.84 | 6.8 score on a scale STANDARD_DEVIATION 1.7 | — | — |
| Inflammation Study 2 | — | — | 6.6 score on a scale STANDARD_DEVIATION 1.75 | 6.7 score on a scale STANDARD_DEVIATION 1.67 | 6.6 score on a scale STANDARD_DEVIATION 1.83 |
| Patient's Assessment of Total Back Pain Study 1 | 7.4 units on a scale STANDARD_DEVIATION 1.43 | 7.5 units on a scale STANDARD_DEVIATION 1.48 | 7.4 units on a scale STANDARD_DEVIATION 1.46 | — | — |
| Patient's Assessment of Total Back Pain Study 2 | — | — | 7.3 units on a scale STANDARD_DEVIATION 1.47 | 7.3 units on a scale STANDARD_DEVIATION 1.39 | 7.2 units on a scale STANDARD_DEVIATION 1.55 |
| Patient's Global Assessment of Disease Activity (PtGA) Study 1 | 7.2 units on a scale STANDARD_DEVIATION 1.4 | 7.4 units on a scale STANDARD_DEVIATION 1.48 | 7.3 units on a scale STANDARD_DEVIATION 1.44 | — | — |
| Patient's Global Assessment of Disease Activity (PtGA) Study 2 | — | — | 7.1 units on a scale STANDARD_DEVIATION 1.51 | 7.3 units on a scale STANDARD_DEVIATION 1.38 | 7.0 units on a scale STANDARD_DEVIATION 1.62 |
| Race (NIH/OMB) Study 1 American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants | — | — |
| Race (NIH/OMB) Study 1 Asian | 37 Participants | 42 Participants | 79 Participants | — | — |
| Race (NIH/OMB) Study 1 Black or African American | 3 Participants | 1 Participants | 4 Participants | — | — |
| Race (NIH/OMB) Study 1 More than one race | 0 Participants | 0 Participants | 0 Participants | — | — |
| Race (NIH/OMB) Study 1 Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants | — | — |
| Race (NIH/OMB) Study 1 Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | — | — |
| Race (NIH/OMB) Study 1 White | 169 Participants | 168 Participants | 337 Participants | — | — |
| Race (NIH/OMB) Study 2 American Indian or Alaska Native | — | — | 1 Participants | 0 Participants | 1 Participants |
| Race (NIH/OMB) Study 2 Asian | — | — | 47 Participants | 28 Participants | 19 Participants |
| Race (NIH/OMB) Study 2 Black or African American | — | — | 3 Participants | 1 Participants | 2 Participants |
| Race (NIH/OMB) Study 2 More than one race | — | — | 1 Participants | 1 Participants | 0 Participants |
| Race (NIH/OMB) Study 2 Native Hawaiian or Other Pacific Islander | — | — | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Study 2 Unknown or Not Reported | — | — | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Study 2 White | — | — | 261 Participants | 127 Participants | 134 Participants |
| Region Study 1 Asia | 34 Participants | 41 Participants | 75 Participants | — | — |
| Region Study 1 Eastern Europe | 98 Participants | 109 Participants | 207 Participants | — | — |
| Region Study 1 North America | 25 Participants | 25 Participants | 50 Participants | — | — |
| Region Study 1 Other | 13 Participants | 7 Participants | 20 Participants | — | — |
| Region Study 1 South/Central America | 14 Participants | 13 Participants | 27 Participants | — | — |
| Region Study 1 Western Europe | 25 Participants | 16 Participants | 41 Participants | — | — |
| Region Study 2 Asia | — | — | 46 Participants | 27 Participants | 19 Participants |
| Region Study 2 Eastern Europe | — | — | 140 Participants | 72 Participants | 68 Participants |
| Region Study 2 North America | — | — | 45 Participants | 19 Participants | 26 Participants |
| Region Study 2 Other | — | — | 14 Participants | 7 Participants | 7 Participants |
| Region Study 2 South/Central America | — | — | 25 Participants | 13 Participants | 12 Participants |
| Region Study 2 Western Europe | — | — | 43 Participants | 19 Participants | 24 Participants |
| Sex: Female, Male Study 1 Female | 51 Participants | 58 Participants | 109 Participants | — | — |
| Sex: Female, Male Study 1 Male | 158 Participants | 153 Participants | 311 Participants | — | — |
| Sex: Female, Male Study 2 Female | — | — | 183 Participants | 94 Participants | 89 Participants |
| Sex: Female, Male Study 2 Male | — | — | 130 Participants | 63 Participants | 67 Participants |
| SPARCC MRI Sacroiliac Joint Score Study 1 | 5.6 score on a scale STANDARD_DEVIATION 10.63 | 5.0 score on a scale STANDARD_DEVIATION 10.8 | 5.3 score on a scale STANDARD_DEVIATION 10.71 | — | — |
| SPARCC MRI Sacroiliac Joint Score Study 2 | — | — | 3.9 score on a scale STANDARD_DEVIATION 8.18 | 3.5 score on a scale STANDARD_DEVIATION 7.6 | 4.4 score on a scale STANDARD_DEVIATION 8.74 |
| Spondyloarthritis Research Consortium of Canada (SPARCC) MRI Spine Score Study 1 | 8.8 score on a scale STANDARD_DEVIATION 12.52 | 10.7 score on a scale STANDARD_DEVIATION 15.43 | 9.7 score on a scale STANDARD_DEVIATION 14.05 | — | — |
| Spondyloarthritis Research Consortium of Canada (SPARCC) MRI Spine Score Study 2 | — | — | 2.1 score on a scale STANDARD_DEVIATION 5.52 | 1.4 score on a scale STANDARD_DEVIATION 3.72 | 2.7 score on a scale STANDARD_DEVIATION 6.88 |
| Study 1: Class of Prior bDMARD Use Missing (no prior bDMARD use) | 1 Participants | 0 Participants | 1 Participants | — | — |
| Study 1: Class of Prior bDMARD Use One interleukin-17 (IL-17) inhibitor | 24 Participants | 29 Participants | 53 Participants | — | — |
| Study 1: Class of Prior bDMARD Use One tumor necrosis factor (TNF) inhibitor | 158 Participants | 154 Participants | 312 Participants | — | — |
| Study 1: Class of Prior bDMARD Use Prior exposure to 2 bDMARDs | 26 Participants | 28 Participants | 54 Participants | — | — |
| Study 2: Magnetic Resonance Imaging (MRI) Inflammation Status MRI-negative | — | — | 177 Participants | 91 Participants | 86 Participants |
| Study 2: Magnetic Resonance Imaging (MRI) Inflammation Status MRI-positive | — | — | 136 Participants | 66 Participants | 70 Participants |
| Study 2: MRI Inflammation and hsCRP Status MRI negative and hsCRP > ULN | — | — | 177 Participants | 91 Participants | 86 Participants |
| Study 2: MRI Inflammation and hsCRP Status MRI positive and hsCRP ≤ ULN | — | — | 63 Participants | 31 Participants | 32 Participants |
| Study 2: MRI Inflammation and hsCRP Status MRI positive and hsCRP > ULN | — | — | 73 Participants | 35 Participants | 38 Participants |
| Study 2: Prior bDMARD Use No | — | — | 210 Participants | 103 Participants | 107 Participants |
| Study 2: Prior bDMARD Use Yes | — | — | 103 Participants | 54 Participants | 49 Participants |
| Time Since AS / nr-axSpA Diagnosis Study 1 - Duration since AS diagnosis | 7.5 years STANDARD_DEVIATION 7.51 | 7.9 years STANDARD_DEVIATION 7.54 | 7.7 years STANDARD_DEVIATION 7.52 | — | — |
| Time Since AS / nr-axSpA Diagnosis Study 2 - Duration since nr-axSpA diagnosis | — | — | 4.4 years STANDARD_DEVIATION 5.68 | 4.4 years STANDARD_DEVIATION 5.83 | 4.5 years STANDARD_DEVIATION 5.54 |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk | EG004 affected / at risk | EG005 affected / at risk | EG006 affected / at risk | EG007 affected / at risk | EG008 affected / at risk | EG009 affected / at risk | EG010 affected / at risk | EG011 affected / at risk | EG012 affected / at risk | EG013 affected / at risk |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 209 | 0 / 211 | 1 / 410 | 0 / 158 | 0 / 156 | 0 / 271 | 0 / 3 | 0 / 5 | 0 / 93 | 0 / 52 | 0 / 18 | 0 / 23 | 0 / 66 | 0 / 61 |
| other Total, other adverse events | 35 / 209 | 41 / 211 | 172 / 410 | 69 / 158 | 67 / 156 | 107 / 271 | 2 / 3 | 4 / 5 | 28 / 93 | 19 / 52 | 4 / 18 | 6 / 23 | 20 / 66 | 22 / 61 |
| serious Total, serious adverse events | 1 / 209 | 6 / 211 | 44 / 410 | 6 / 158 | 7 / 156 | 22 / 271 | 0 / 3 | 1 / 5 | 2 / 93 | 3 / 52 | 0 / 18 | 2 / 23 | 2 / 66 | 2 / 61 |
Outcome results
Study 1: Percentage of Participants Achieving Assessment of SpondyloArthritis International Society 40 (ASAS40) Response at Week 14
ASAS40 response was defined as improvement of ≥ 40% relative to Baseline and absolute improvement of ≥ 2 units (on a scale from 0 to 10) in ≥ 3 of the following 4 domains with no deterioration (defined as a net worsening of \> 0 units) in the potential remaining domain: * Patient's global assessment of disease activity, measured on a numeric rating scale (NRS) from 0 (no activity) to 10 (severe activity); * Pain, measured by the total back pain NRS from 0 (no pain) to 10 (most severe pain); * Function, measured by the Bath Ankylosing Spondylitis Functional Index (BASFI) which consists of 10 items assessing participants' ability to perform activities on an NRS ranging from 0 (easy) to 10 (impossible); * Inflammation, measured by the mean of the 2 morning stiffness-related Bath AS Disease Activity Index (BASDAI) NRS scores (items 5 \[level of stiffness\] and 6 \[duration of stiffness\]) each on a scale from 0 (none/0 hours) to 10 (very severe/2 hours or more duration).
Time frame: Baseline and Week 14
Population: Full analysis set; participants who discontinued study drug prior to Week 14 or with missing data for reasons other than COVID-19 were counted as non-responders (non-responder imputation); Missing data due to COVID-19 infection or logistical restriction was handled by multiple imputation (MI).
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Study 1: Placebo | Study 1: Percentage of Participants Achieving Assessment of SpondyloArthritis International Society 40 (ASAS40) Response at Week 14 | 18.2 percentage of participants |
| Study 1: Upadacitinib 15 mg | Study 1: Percentage of Participants Achieving Assessment of SpondyloArthritis International Society 40 (ASAS40) Response at Week 14 | 44.5 percentage of participants |
Study 2: Percentage of Participants Achieving an ASAS40 Response at Week 14
ASAS40 response was defined as improvement of ≥ 40% relative to Baseline and absolute improvement of ≥ 2 units (on a scale from 0 to 10) in ≥ 3 of the following 4 domains with no deterioration (defined as a net worsening of \> 0 units) in the potential remaining domain: * Patient's global assessment of disease activity, measured on a numeric rating scale (NRS) from 0 (no activity) to 10 (severe activity); * Pain, measured by the total back pain NRS from 0 (no pain) to 10 (most severe pain); * Function, measured by the Bath Ankylosing Spondylitis Functional Index (BASFI) which consists of 10 items assessing participants' ability to perform activities on an NRS ranging from 0 (easy) to 10 (impossible); * Inflammation, measured by the mean of the 2 morning stiffness-related Bath AS Disease Activity Index (BASDAI) NRS scores (items 5 \[level of stiffness\] and 6 \[duration of stiffness\]) each on a scale from 0 (none/0 hours) to 10 (very severe/2 hours or more duration).
Time frame: Baseline and Week 14
Population: Full analysis set; participants who discontinued study drug prior to Week 14 or with missing data for reasons other than COVID-19 were counted as non-responders (non-responder imputation); Missing data due to COVID-19 infection or logistical restriction was handled by multiple imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Study 1: Placebo | Study 2: Percentage of Participants Achieving an ASAS40 Response at Week 14 | 22.5 percentage of participants |
| Study 1: Upadacitinib 15 mg | Study 2: Percentage of Participants Achieving an ASAS40 Response at Week 14 | 44.9 percentage of participants |
Study 1: Change From Baseline in Ankylosing Spondylitis Disease Activity Score (ASDAS) at Week 14
ASDAS is a composite index to assess disease activity in Ankylosing Spondylitis. ASDAS combines the following 5 disease activity variables using a weighted formula: 1. Patient's assessment of total back pain (BASDAI Question 2; NRS score 0 \[none\] - 10 \[very severe\]) 2. Patient global assessment of disease activity (NRS score 0 \[no activity\] - 10 \[severe activity\]) 3. Peripheral pain/swelling (BASDAI Question 3; NRS score 0 \[none\] - 10 \[very severe\]) 4. Duration of morning stiffness (BASDAI Question 6; NRS score 0 \[0 hours\] - 10 \[2 or more hours\]) 5. High-sensitivity C-reactive protein (hs-CRP) in mg/L. The overall score ranges from 0 with no defined upper score; published ranges for disease activity states as defined by the ASDAS include Inactive disease (ASDAS \< 1.3) and very high disease (ASDAS \> 3.5). A negative change from Baseline score indicates improvement in disease activity.
Time frame: Baseline and Week 14
Population: Full analysis set participants with at least one available change from Baseline value; a mixed-effect model repeat measurement (MMRM) analysis including all observed data up to Week 14 was used.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) |
|---|---|---|
| Study 1: Placebo | Study 1: Change From Baseline in Ankylosing Spondylitis Disease Activity Score (ASDAS) at Week 14 | -0.49 score on a scale |
| Study 1: Upadacitinib 15 mg | Study 1: Change From Baseline in Ankylosing Spondylitis Disease Activity Score (ASDAS) at Week 14 | -1.52 score on a scale |
Study 1: Change From Baseline in Ankylosing Spondylitis Quality of Life (ASQoL) Score at Week 14
The ASQoL consists of 18 items related to quality of life, including the impact of pain on sleep, mood, motivation, ability to cope, activities of daily living, independence, relationships, and social life. Each item is answered as yes (scored as 1) or no (scored as 0). Scores are summed to obtain the overall score which ranges from 0 to 18, where higher scores indicate a worse quality of life. A negative change from Baseline in ASQoL indicates improvement in quality of life.
Time frame: Baseline and Week 14
Population: Full analysis set participants with at least one available change from Baseline value; a mixed-effect model repeat measurement analysis including all observed data up to Week 14 was used.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) |
|---|---|---|
| Study 1: Placebo | Study 1: Change From Baseline in Ankylosing Spondylitis Quality of Life (ASQoL) Score at Week 14 | -2.03 score on a scale |
| Study 1: Upadacitinib 15 mg | Study 1: Change From Baseline in Ankylosing Spondylitis Quality of Life (ASQoL) Score at Week 14 | -5.10 score on a scale |
Study 1: Change From Baseline in ASAS Health Index at Week 14
The ASAS health index (HI) measures functioning and health across 17 aspects of health in patients with AS, including pain, emotional functions, sleep, sexual function, mobility, self care, and community life. Each of the 17 questions is answered by the participant as I agree (score = 1) or I disagree (score = 0). The responses to the 17 dichotomous items are summed up to give a total score ranging from 0 to 17, where a higher score indicates a worse health status. A negative change from Baseline indicates improvement.
Time frame: Baseline and Week 14
Population: Full analysis set participants with at least one available change from Baseline value; a mixed-effect model repeat measurement analysis including all observed data up to Week 14 was used.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) |
|---|---|---|
| Study 1: Placebo | Study 1: Change From Baseline in ASAS Health Index at Week 14 | -1.07 score on a scale |
| Study 1: Upadacitinib 15 mg | Study 1: Change From Baseline in ASAS Health Index at Week 14 | -2.93 score on a scale |
Study 1: Change From Baseline in Bath Ankylosing Spondylitis Functional Index (BASFI) at Week 14
The Bath Ankylosing Spondylitis Functional Index is a validated index to determine the degree of functional limitation in patients with AS. BASFI consists of 10 questions assessing participants' ability to perform activities such as putting on socks, bending, reaching, getting up from the floor or an armless chair, standing, climbing and other physical activities. Each item is scored on a NRS ranging from 0 (easy to perform an activity) to 10 (impossible to perform an activity). The overall score is the mean of the 10 items and ranges from 0 to 10 with higher scores indicating more functional limitations. A negative change from Baseline in BASFI indicates improvement.
Time frame: Baseline and Week 14
Population: Full analysis set participants with at least one available change from Baseline value; a mixed-effect model repeat measurement analysis including all observed data up to Week 14 was used.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) |
|---|---|---|
| Study 1: Placebo | Study 1: Change From Baseline in Bath Ankylosing Spondylitis Functional Index (BASFI) at Week 14 | -1.09 score on a scale |
| Study 1: Upadacitinib 15 mg | Study 1: Change From Baseline in Bath Ankylosing Spondylitis Functional Index (BASFI) at Week 14 | -2.26 score on a scale |
Study 1: Change From Baseline in Linear Bath Ankylosing Spondylitis Metrology Index (BASMI[Lin]) at Week 14
The BASMI is a composite score based on 5 direct measurements of spinal mobility: 1. cervical rotation (measured in degrees), 2. tragus to wall distance (in centimeters \[cm\]) 3. lumbar side flexion (in cm), 4. lumbar flexion (modified Schober's) (in cm) and 5. intermalleolar distance (in cm). Each measurement is converted to a linear score between 0 and 10. The total BASMI(lin) score is the average of the 5 scores and ranges from 0 to 10; the higher the BASMI(lin) score the more severe the patient's limitation of movement due to their ankylosing spondylitis. A negative change from Baseline indicates improvement.
Time frame: Baseline and Week 14
Population: Full analysis set participants with available change from Baseline data
| Arm | Measure | Value (LEAST_SQUARES_MEAN) |
|---|---|---|
| Study 1: Placebo | Study 1: Change From Baseline in Linear Bath Ankylosing Spondylitis Metrology Index (BASMI[Lin]) at Week 14 | -0.16 score on a scale |
| Study 1: Upadacitinib 15 mg | Study 1: Change From Baseline in Linear Bath Ankylosing Spondylitis Metrology Index (BASMI[Lin]) at Week 14 | -0.48 score on a scale |
Study 1: Change From Baseline in Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) at Week 14
The MASES evaluation was conducted to assess the presence or absence of enthesitis (inflammation of the entheses, or sites where tendons or ligaments insert into the bone) at 13 different sites (first costochondral joint left/right, seventh costochondral joint left/right, posterior superior iliac spine left/right, anterior superior iliac spine left/right, iliac crest left/right, fifth lumbar spinous process, and proximal insertion of Achilles tendon left/right. Each site was scored for presence (1) or absence (0) of enthesitis. The MASES is the sum of the 13 site scores, and ranges from 0 to 13, with higher scores indicating more inflammation of the entheses. A negative change from Baseline indicates improvement.
Time frame: Baseline and Week 14
Population: Full analysis set participants with Baseline enthesitis and at least one available change from Baseline value; a mixed-effect model repeat measurement analysis including all observed data up to Week 14 was used.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) |
|---|---|---|
| Study 1: Placebo | Study 1: Change From Baseline in Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) at Week 14 | -1.1 score on a scale |
| Study 1: Upadacitinib 15 mg | Study 1: Change From Baseline in Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) at Week 14 | -2.6 score on a scale |
Study 1: Change From Baseline in Magnetic Resonance Imaging (MRI) Spondyloarthritis Research Consortium of Canada (SPARCC) Score for the Spine at Week 14
In the SPARCC MRI assessment of the spine, the entire spine was evaluated for active inflammation (bone marrow edema). Six discovertebral units (DVU) representing the 6 most abnormal DVUs were selected to calculate the MRI Spine SPARCC score. For each of the 6 DVUs, 3 consecutive sagittal slices were assessed in 4 quadrants to evaluate the extent of inflammation in all three dimensions. Each quadrant was scored for the presence (1) or absence (0) of edema. If edema was present in at least one quadrant of a DVU slice, it was also scored for intensity and depth of the edema representing that slice: An additional score of 1 was assigned if an intense signal was seen in any quadrant on a DVU slice. Slices that included a lesion demonstrating continuous increased signal of depth ≥ 1 cm extending from the endplate were scored as an additional 1 per slice. The maximum (worst) overall score for all 6 DVUs is 108. A negative change from Baseline indicates improvement.
Time frame: Baseline and Week 14
Population: Full analysis set participants with available change from Baseline data
| Arm | Measure | Value (LEAST_SQUARES_MEAN) |
|---|---|---|
| Study 1: Placebo | Study 1: Change From Baseline in Magnetic Resonance Imaging (MRI) Spondyloarthritis Research Consortium of Canada (SPARCC) Score for the Spine at Week 14 | -0.04 score on a scale |
| Study 1: Upadacitinib 15 mg | Study 1: Change From Baseline in Magnetic Resonance Imaging (MRI) Spondyloarthritis Research Consortium of Canada (SPARCC) Score for the Spine at Week 14 | -3.95 score on a scale |
Study 1: Change From Baseline in MRI SPARCC Score for Sacroiliac Joints at Week 14
In the SPARCC MRI assessment of the sacroiliac (SI) joints 6 consecutive sacroiliac joint image coronal slices representing the largest proportion of the synovial compartment of the SI joints were assessed for edema, intensity and depth of edema. Each SI joint (left and right) was divided into quadrants for a total of 8 SI scoring locations. Each quadrant was scored for the presence (1) or absence (0) of edema, intensity of edema (a score of 1 was assigned for each SI joint (left and right) if an intense signal was seen in any quadrant of that joint for each slice), and a lesion was graded as deep (score of 1) if there was homogeneous and unequivocal increase in signal extending over a depth of at least 1 cm from the articular surface of the SI joint in any quadrant. The total maximum (worst) score for all SI joints across 6 slices is 72. A negative change from Baseline indicates improvement.
Time frame: Baseline and Week 14
Population: Full analysis set participants with available change from Baseline data.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) |
|---|---|---|
| Study 1: Placebo | Study 1: Change From Baseline in MRI SPARCC Score for Sacroiliac Joints at Week 14 | 1.05 score on a scale |
| Study 1: Upadacitinib 15 mg | Study 1: Change From Baseline in MRI SPARCC Score for Sacroiliac Joints at Week 14 | -2.26 score on a scale |
Study 1: Change From Baseline in Patient's Assessment of Nocturnal Back Pain at Week 14
Participants assessed the amount of back pain at night over the last week on a 0 to 10 NRS, where 0 represents no pain and 10 represents most severe pain.
Time frame: Baseline and Week 14
Population: Full analysis set participants with at least one available change from Baseline value; a mixed-effect model repeat measurement analysis including all observed data up to Week 14 was used.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) |
|---|---|---|
| Study 1: Placebo | Study 1: Change From Baseline in Patient's Assessment of Nocturnal Back Pain at Week 14 | -1.52 score on a scale |
| Study 1: Upadacitinib 15 mg | Study 1: Change From Baseline in Patient's Assessment of Nocturnal Back Pain at Week 14 | -3.21 score on a scale |
Study 1: Change From Baseline in Patient's Assessment of Total Back Pain at Week 14
Participants assessed their total back pain during the last week on a 0 to 10 numerical rating scale (NRS), where 0 represents no pain and 10 represents most severe pain.
Time frame: Baseline and Week 14
Population: Full analysis set participants with at least one available change from Baseline value; a mixed-effect model repeat measurement analysis including all observed data up to Week 14 was used.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) |
|---|---|---|
| Study 1: Placebo | Study 1: Change From Baseline in Patient's Assessment of Total Back Pain at Week 14 | -1.47 score on a scale |
| Study 1: Upadacitinib 15 mg | Study 1: Change From Baseline in Patient's Assessment of Total Back Pain at Week 14 | -3.00 score on a scale |
Study 1: Percentage of Participants With an ASAS20 Response at Week 14
ASAS20 response was defined as an improvement of ≥ 20% and an absolute improvement of ≥ 1 unit (on a scale of 0 to 10) from Baseline in at least 3 of the following 4 domains, with no deterioration (defined as a worsening of ≥ 20% and a net worsening of ≥ 1 units \[on a scale of 0 to 10\]) in the remaining domain: * Patient's global assessment of disease activity, measured on a NRS from 0 (no activity) to 10 (severe activity); * Pain, measured by the total back pain NRS from 0 (no pain) to 10 (most severe pain); * Function, measured by the BASFI which consists of 10 items assessing participants' ability to perform activities on an NRS ranging from 0 (easy) to 10 (impossible); * Inflammation, measured by the mean of the 2 morning stiffness-related BASDAI NRS scores (items 5 \[level of stiffness\] and 6 \[duration of stiffness\]) each on a scale from 0 (none/0 hours) to 10 (very severe/2 hours or more duration).
Time frame: Baseline and Week 14
Population: Full analysis set; participants who discontinued study drug prior to Week 14 or with missing data for reasons other than COVID-19 were counted as non-responders (non-responder imputation); Missing data due to COVID-19 infection or logistical restriction was handled by multiple imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Study 1: Placebo | Study 1: Percentage of Participants With an ASAS20 Response at Week 14 | 38.3 percentage of participants |
| Study 1: Upadacitinib 15 mg | Study 1: Percentage of Participants With an ASAS20 Response at Week 14 | 65.4 percentage of participants |
Study 1: Percentage of Participants With ASAS Partial Remission at Week 14
ASAS partial remission (PR) is defined as an absolute score of ≤ 2 units on a 0 to 10 scale for each of the four following domains: * Patient's global assessment of disease activity, measured on a numeric rating scale (NRS) from 0 (no activity) to 10 (severe activity); * Pain, measured by the total back pain NRS from 0 (no pain) to 10 (most severe pain); * Function, measured by the Bath Ankylosing Spondylitis Functional Index (BASFI) which consists of 10 items assessing participants' ability to perform activities on an NRS ranging from 0 (easy) to 10 (impossible); * Inflammation, measured by the mean of the 2 morning stiffness-related Bath AS Disease Activity Index (BASDAI) NRS scores (items 5 \[level of stiffness\] and 6 \[duration of stiffness\]) each on a scale from 0 (none/0 hours) to 10 (very severe/2 hours or more duration).
Time frame: Week 14
Population: Full analysis set; participants who discontinued study drug prior to Week 14 or with missing data for reasons other than COVID-19 were counted as non-responders (non-responder imputation); Missing data due to COVID-19 infection or logistical restriction was handled by multiple imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Study 1: Placebo | Study 1: Percentage of Participants With ASAS Partial Remission at Week 14 | 4.3 percentage of participants |
| Study 1: Upadacitinib 15 mg | Study 1: Percentage of Participants With ASAS Partial Remission at Week 14 | 17.5 percentage of participants |
Study 1: Percentage of Participants With ASDAS Inactive Disease at Week 14
ASDAS is a composite index to assess disease activity in Ankylosing Spondylitis. ASDAS combines the following 5 disease activity variables using a weighted formula: 1. Patient's assessment of total back pain (BASDAI Question 2; NRS score 0 \[none\] - 10 \[very severe\]) 2. Patient global assessment of disease activity (NRS score 0 \[no activity\] - 10 \[severe activity\]) 3. Peripheral pain/swelling (BASDAI Question 3; NRS score 0 \[none\] - 10 \[very severe\]) 4. Duration of morning stiffness (BASDAI Question 6; NRS score 0 \[0 hours\] - 10 \[2 or more hours\]) 5. High-sensitivity C-reactive protein (hs-CRP) in mg/L. The overall score ranges from 0 with no defined upper score. ASDAS Inactive Disease is defined as an ASDAS score \< 1.3.
Time frame: Week 14
Population: Full analysis set; participants who discontinued study drug prior to Week 14 or with missing data for reasons other than COVID-19 were counted as non-responders (non-responder imputation); Missing data due to COVID-19 infection or logistical restriction was handled by multiple imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Study 1: Placebo | Study 1: Percentage of Participants With ASDAS Inactive Disease at Week 14 | 1.9 percentage of participants |
| Study 1: Upadacitinib 15 mg | Study 1: Percentage of Participants With ASDAS Inactive Disease at Week 14 | 12.8 percentage of participants |
Study 1: Percentage of Participants With ASDAS Low Disease Activity at Week 14
ASDAS is a composite index to assess disease activity in Ankylosing Spondylitis. ASDAS combines the following 5 disease activity variables using a weighted formula: 1. Patient's assessment of total back pain (BASDAI Question 2; NRS score 0 \[none\] - 10 \[very severe\]) 2. Patient global assessment of disease activity (NRS score 0 \[no activity\] - 10 \[severe activity\]) 3. Peripheral pain/swelling (BASDAI Question 3; NRS score 0 \[none\] - 10 \[very severe\]) 4. Duration of morning stiffness (BASDAI Question 6; NRS score 0 \[0 hours\] - 10 \[2 or more hours\]) 5. High-sensitivity C-reactive protein (hs-CRP) in mg/L. The overall score ranges from 0 with no defined upper score. ASDAS Low Disease Activity is defined as an ASDAS score \< 2.1.
Time frame: Week 14
Population: Full analysis set; participants who discontinued study drug prior to Week 14 or with missing data for reasons other than COVID-19 were counted as non-responders (non-responder imputation); Missing data due to COVID-19 infection or logistical restriction was handled by multiple imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Study 1: Placebo | Study 1: Percentage of Participants With ASDAS Low Disease Activity at Week 14 | 10.1 percentage of participants |
| Study 1: Upadacitinib 15 mg | Study 1: Percentage of Participants With ASDAS Low Disease Activity at Week 14 | 44.1 percentage of participants |
Study 1: Percentage of Participants With Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) 50 Response at Week 14
The BASDAI assesses disease activity by asking the participant to answer 6 questions (each on an 11 point numeric rating scale \[NRS\]) pertaining to symptoms experienced for the past week. For Questions 1 to 5 (level of fatigue/tiredness, level of AS neck, back or hip pain, level of pain/swelling in joints, other than neck, back or hips, level of discomfort from any areas tender to touch or pressure, and level of morning stiffness), the response is from 0 (none) to 10 (very severe); for Question 6 (duration of morning stiffness), the response is from 0 (0 hours) to 10 (≥ 2 hours). The overall BASDAI score ranges from 0 to 10. Lower scores indicate less disease activity. A BASDAI 50 response is defined as improvement of 50% or more from Baseline in BASDAI score.
Time frame: Baseline and Week 14
Population: Full analysis set; participants who discontinued study drug prior to Week 14 or with missing data for reasons other than COVID-19 were counted as non-responders (non-responder imputation); Missing data due to COVID-19 infection or logistical restriction was handled by multiple imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Study 1: Placebo | Study 1: Percentage of Participants With Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) 50 Response at Week 14 | 16.7 percentage of participants |
| Study 1: Upadacitinib 15 mg | Study 1: Percentage of Participants With Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) 50 Response at Week 14 | 43.1 percentage of participants |
Study 2: Change From Baseline in ASAS Health Index at Week 14
The ASAS HI measures functioning and health across 17 aspects of health in patients with AS, including pain, emotional functions, sleep, sexual function, mobility, self care, and community life. Each of the 17 questions is answered by the participant as I agree (score = 1) or I disagree (score = 0). The responses to the 17 dichotomous items are summed up to give a total score ranging from 0 to 17, where a higher score indicates a worse health status. A negative change from Baseline indicates improvement.
Time frame: Baseline and Week 14
Population: Full analysis set participants with at least one available change from Baseline value; a mixed-effect model repeat measurement analysis including all observed data up to Week 14 was used.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) |
|---|---|---|
| Study 1: Placebo | Study 2: Change From Baseline in ASAS Health Index at Week 14 | -1.48 score on a scale |
| Study 1: Upadacitinib 15 mg | Study 2: Change From Baseline in ASAS Health Index at Week 14 | -3.26 score on a scale |
Study 2: Change From Baseline in ASDAS at Week 14
ASDAS is a composite index to assess disease activity in Ankylosing Spondylitis. ASDAS combines the following 5 disease activity variables using a weighted formula: 1. Patient's assessment of total back pain (BASDAI Question 2; NRS score 0 \[none\] - 10 \[very severe\]) 2. Patient global assessment of disease activity (NRS score 0 \[no activity\] - 10 \[severe activity\]) 3. Peripheral pain/swelling (BASDAI Question 3; NRS score 0 \[none\] - 10 \[very severe\]) 4. Duration of morning stiffness (BASDAI Question 6; NRS score 0 \[0 hours\] - 10 \[2 or more hours\]) 5. High-sensitivity C-reactive protein (hs-CRP) in mg/L. The overall score ranges from 0 with no defined upper score; published ranges for disease activity states as defined by the ASDAS include Inactive disease (ASDAS \< 1.3) and very high disease (ASDAS \> 3.5). A negative change from Baseline score indicates improvement in disease activity.
Time frame: Baseline and Week 14
Population: Full analysis set participants with at least one available change from Baseline value; a mixed-effect model repeat measurement analysis including all observed data up to Week 14 was used.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) |
|---|---|---|
| Study 1: Placebo | Study 2: Change From Baseline in ASDAS at Week 14 | -0.71 score on a scale |
| Study 1: Upadacitinib 15 mg | Study 2: Change From Baseline in ASDAS at Week 14 | -1.36 score on a scale |
Study 2: Change From Baseline in ASQoL at Week 14
The ASQoL consists of 18 items related to quality of life, including the impact of pain on sleep, mood, motivation, ability to cope, activities of daily living, independence, relationships, and social life. Each item is answered as yes (scored as 1) or no (scored as 0). Scores are summed to obtain the overall score which ranges from 0 to 18, where higher scores indicate a worse quality of life. A negative change from Baseline in ASQoL indicates improvement in quality of life.
Time frame: Baseline and Week 14
Population: Full analysis set participants with at least one available change from Baseline value; a mixed-effect model repeat measurement analysis including all observed data up to Week 14 was used.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) |
|---|---|---|
| Study 1: Placebo | Study 2: Change From Baseline in ASQoL at Week 14 | -3.15 score on a scale |
| Study 1: Upadacitinib 15 mg | Study 2: Change From Baseline in ASQoL at Week 14 | -5.38 score on a scale |
Study 2: Change From Baseline in BASFI at Week 14
The Bath Ankylosing Spondylitis Functional Index is a validated index to determine the degree of functional limitation in patients with AS. BASFI consists of 10 questions assessing participants' ability to perform activities such as putting on socks, bending, reaching, getting up from the floor or an armless chair, standing, climbing and other physical activities. Each item is scored on a NRS ranging from 0 (easy to perform an activity) to 10 (impossible to perform an activity). The overall score is the mean of the 10 items and ranges from 0 to 10 with higher scores indicating more functional limitations. A negative change from Baseline in BASFI indicates improvement.
Time frame: Baseline and Week 14
Population: Full analysis set participants with at least one available change from Baseline value; a mixed-effect model repeat measurement analysis including all observed data up to Week 14 was used.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) |
|---|---|---|
| Study 1: Placebo | Study 2: Change From Baseline in BASFI at Week 14 | -1.47 score on a scale |
| Study 1: Upadacitinib 15 mg | Study 2: Change From Baseline in BASFI at Week 14 | -2.61 score on a scale |
Study 2: Change From Baseline in BASMI(Lin) at Week 14
The BASMI is a composite score based on 5 direct measurements of spinal mobility: 1. cervical rotation (measured in degrees), 2. tragus to wall distance (in centimeters \[cm\]) 3. lumbar side flexion (in cm), 4. lumbar flexion (modified Schober's) (in cm) and 5. intermalleolar distance (in cm). Each measurement is converted to a linear score between 0 and 10. The total BASMI(lin) score is the average of the 5 scores and ranges from 0 to 10; the higher the BASMI(lin) score the more severe the patient's limitation of movement due to their ankylosing spondylitis. A negative change from Baseline indicates improvement.
Time frame: Baseline and Week 14
Population: Full analysis set participants with available change from Baseline data
| Arm | Measure | Value (LEAST_SQUARES_MEAN) |
|---|---|---|
| Study 1: Placebo | Study 2: Change From Baseline in BASMI(Lin) at Week 14 | -0.19 score on a scale |
| Study 1: Upadacitinib 15 mg | Study 2: Change From Baseline in BASMI(Lin) at Week 14 | -0.29 score on a scale |
Study 2: Change From Baseline in MASES at Week 14
The MASES evaluation was conducted to assess the presence or absence of enthesitis (inflammation of the entheses, or sites where tendons or ligaments insert into the bone) at 13 different sites (first costochondral joint left/right, seventh costochondral joint left/right, posterior superior iliac spine left/right, anterior superior iliac spine left/right, iliac crest left/right, fifth lumbar spinous process, and proximal insertion of Achilles tendon left/right. Each site was scored for presence (1) or absence (0) of enthesitis. The MASES is the sum of the 13 site scores, and ranges from 0 to 13, with higher scores indicating more inflammation of the entheses. A negative change from Baseline indicates improvement.
Time frame: Baseline and Week 14
Population: Full analysis set participants with Baseline enthesitis and at least one available change from Baseline value; a mixed-effect model repeat measurement analysis including all observed data up to Week 14 was used.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) |
|---|---|---|
| Study 1: Placebo | Study 2: Change From Baseline in MASES at Week 14 | -1.6 score on a scale |
| Study 1: Upadacitinib 15 mg | Study 2: Change From Baseline in MASES at Week 14 | -2.3 score on a scale |
Study 2: Change From Baseline in MRI SPARCC Score for SI Joints at Week 14
In the SPARCC MRI assessment of the sacroiliac (SI) joints 6 consecutive sacroiliac joint image coronal slices representing the largest proportion of the synovial compartment of the SI joints were assessed for edema, intensity and depth of edema. Each SI joint (left and right) was divided into quadrants for a total of 8 SI scoring locations. Each quadrant was scored for the presence (1) or absence (0) of edema, intensity of edema (a score of 1 was assigned for each SI joint (left and right) if an intense signal was seen in any quadrant of that joint for each slice), and a lesion was graded as deep (score of 1) if there was homogeneous and unequivocal increase in signal extending over a depth of at least 1 cm from the articular surface of the SI joint in any quadrant. The total maximum (worst) score for all SI joints across 6 slices is 72. A negative change from Baseline indicates improvement.
Time frame: Baseline and Week 14
Population: Full analysis set participants with available change from Baseline data
| Arm | Measure | Value (LEAST_SQUARES_MEAN) |
|---|---|---|
| Study 1: Placebo | Study 2: Change From Baseline in MRI SPARCC Score for SI Joints at Week 14 | 0.57 score on a scale |
| Study 1: Upadacitinib 15 mg | Study 2: Change From Baseline in MRI SPARCC Score for SI Joints at Week 14 | -2.49 score on a scale |
Study 2: Change From Baseline in MRI SPARCC Score for the Spine at Week 14
In the SPARCC MRI assessment of the spine, the entire spine is evaluated for active inflammation (bone marrow edema). Six discovertebral units (DVU) representing the 6 most abnormal DVUs were selected to calculate the MRI Spine SPARCC score. For each of the 6 DVUs, 3 consecutive sagittal slices were assessed in 4 quadrants to evaluate the extent of inflammation in all three dimensions. Each quadrant was scored for the presence (1) or absence (0) of edema. If edema was present in at least one quadrant of a DVU slice, it was also scored for intensity and depth of the edema representing that slice: An additional score of 1 was assigned if an intense signal was seen in any quadrant on a DVU slice. Slices that included a lesion demonstrating continuous increased signal of depth ≥ 1 cm extending from the endplate were scored as an additional 1 per slice. The maximum (worst) overall score for all 6 DVUs is 108. A negative change from Baseline indicates improvement.
Time frame: Baseline and Week 14
Population: Full analysis set participants with available change from Baseline data
| Arm | Measure | Value (LEAST_SQUARES_MEAN) |
|---|---|---|
| Study 1: Placebo | Study 2: Change From Baseline in MRI SPARCC Score for the Spine at Week 14 | 0.34 score on a scale |
| Study 1: Upadacitinib 15 mg | Study 2: Change From Baseline in MRI SPARCC Score for the Spine at Week 14 | -0.79 score on a scale |
Study 2: Change From Baseline in Patient's Assessment of Nocturnal Back Pain at Week 14
Participants assessed the amount of back pain at night over the last week on a 0 to 10 NRS, where 0 represents no pain and 10 represents most severe pain.
Time frame: Baseline and Week 14
Population: Full analysis set participants with at least one available change from Baseline value; a mixed-effect model repeat measurement analysis including all observed data up to Week 14 was used.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) |
|---|---|---|
| Study 1: Placebo | Study 2: Change From Baseline in Patient's Assessment of Nocturnal Back Pain at Week 14 | -1.84 score on a scale |
| Study 1: Upadacitinib 15 mg | Study 2: Change From Baseline in Patient's Assessment of Nocturnal Back Pain at Week 14 | -2.96 score on a scale |
Study 2: Change From Baseline in Patient's Assessment of Total Back Pain at Week 14
Participants assessed their total back pain during the last week on a 0 to 10 numerical rating scale (NRS), where 0 represents no pain and 10 represents most severe pain.
Time frame: Baseline and Week 14
Population: Full analysis set participants with at least one available change from Baseline value; a mixed-effect model repeat measurement analysis including all observed data up to Week 14 was used.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) |
|---|---|---|
| Study 1: Placebo | Study 2: Change From Baseline in Patient's Assessment of Total Back Pain at Week 14 | -2.00 score on a scale |
| Study 1: Upadacitinib 15 mg | Study 2: Change From Baseline in Patient's Assessment of Total Back Pain at Week 14 | -2.91 score on a scale |
Study 2: Percentage of Participants Achieving an ASAS20 Response at Week 14
ASAS20 response was defined as an improvement of ≥ 20% and an absolute improvement of ≥ 1 unit (on a scale of 0 to 10) from Baseline in at least 3 of the following 4 domains, with no deterioration (defined as a worsening of ≥ 20% and a net worsening of ≥ 1 units \[on a scale of 0 to 10\]) in the remaining domain: * Patient's global assessment of disease activity, measured on a NRS from 0 (no activity) to 10 (severe activity); * Pain, measured by the total back pain NRS from 0 (no pain) to 10 (most severe pain); * Function, measured by the BASFI which consists of 10 items assessing participants' ability to perform activities on an NRS ranging from 0 (easy) to 10 (impossible); * Inflammation, measured by the mean of the 2 morning stiffness-related BASDAI NRS scores (items 5 \[level of stiffness\] and 6 \[duration of stiffness\]) each on a scale from 0 (none/0 hours) to 10 (very severe/2 hours or more duration).
Time frame: Baseline and Week 14
Population: Full analysis set; participants who discontinued study drug prior to Week 14 or with missing data for reasons other than COVID-19 were counted as non-responders (non-responder imputation); Missing data due to COVID-19 infection or logistical restriction was handled by multiple imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Study 1: Placebo | Study 2: Percentage of Participants Achieving an ASAS20 Response at Week 14 | 43.8 percentage of participants |
| Study 1: Upadacitinib 15 mg | Study 2: Percentage of Participants Achieving an ASAS20 Response at Week 14 | 66.7 percentage of participants |
Study 2: Percentage of Participants Achieving an ASAS40 Response at Week 52
ASAS40 response was defined as improvement of ≥ 40% relative to Baseline and absolute improvement of ≥ 2 units (on a scale from 0 to 10) in ≥ 3 of the following 4 domains with no deterioration (defined as a net worsening of \> 0 units) in the potential remaining domain: * Patient's global assessment of disease activity, measured on a numeric rating scale (NRS) from 0 (no activity) to 10 (severe activity); * Pain, measured by the total back pain NRS from 0 (no pain) to 10 (most severe pain); * Function, measured by the Bath Ankylosing Spondylitis Functional Index (BASFI) which consists of 10 items assessing participants' ability to perform activities on an NRS ranging from 0 (easy) to 10 (impossible); * Inflammation, measured by the mean of the 2 morning stiffness-related Bath AS Disease Activity Index (BASDAI) NRS scores (items 5 \[level of stiffness\] and 6 \[duration of stiffness\]) each on a scale from 0 (none/0 hours) to 10 (very severe/2 hours or more duration).
Time frame: Baseline and Week 52
Population: Full analysis set; participants who discontinued study drug prior to Week 52 or with missing data for reasons other than COVID-19 were counted as non-responders (non-responder imputation); Missing data due to COVID-19 infection or logistical restriction was handled by multiple imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Study 1: Placebo | Study 2: Percentage of Participants Achieving an ASAS40 Response at Week 52 | 42.7 percentage of participants |
| Study 1: Upadacitinib 15 mg | Study 2: Percentage of Participants Achieving an ASAS40 Response at Week 52 | 62.8 percentage of participants |
Study 2: Percentage of Participants Who Initiated Rescue Treatment Between Week 24 and Week 52
Participants who did not achieve an ASAS20 response at any 2 consecutive scheduled visits from Week 24 through Week 52 were to be rescued with standard of care treatment as described in the protocol.
Time frame: Week 24, Week 32, Week 40, and Week 52
Population: The analysis population is the Full Analysis Set, which includes all participants who were randomized and received at least one dose of study drug. Even though rescue was not assessed until after Week 24, the interpretation of the analysis is based on the percentage of participants who were rescued out of those who were randomized and received study drug, similar to the analysis of other binary endpoints.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Study 1: Placebo | Study 2: Percentage of Participants Who Initiated Rescue Treatment Between Week 24 and Week 52 | Week 32 | 1.9 percentage of participants |
| Study 1: Placebo | Study 2: Percentage of Participants Who Initiated Rescue Treatment Between Week 24 and Week 52 | Week 52 | 1.3 percentage of participants |
| Study 1: Placebo | Study 2: Percentage of Participants Who Initiated Rescue Treatment Between Week 24 and Week 52 | Week 40 | 0.6 percentage of participants |
| Study 1: Placebo | Study 2: Percentage of Participants Who Initiated Rescue Treatment Between Week 24 and Week 52 | Week 24 | 13.4 percentage of participants |
| Study 1: Upadacitinib 15 mg | Study 2: Percentage of Participants Who Initiated Rescue Treatment Between Week 24 and Week 52 | Week 40 | 0.6 percentage of participants |
| Study 1: Upadacitinib 15 mg | Study 2: Percentage of Participants Who Initiated Rescue Treatment Between Week 24 and Week 52 | Week 32 | 3.2 percentage of participants |
| Study 1: Upadacitinib 15 mg | Study 2: Percentage of Participants Who Initiated Rescue Treatment Between Week 24 and Week 52 | Week 24 | 5.1 percentage of participants |
| Study 1: Upadacitinib 15 mg | Study 2: Percentage of Participants Who Initiated Rescue Treatment Between Week 24 and Week 52 | Week 52 | 0 percentage of participants |
Study 2: Percentage of Participants With ASAS Partial Remission at Week 14
ASAS partial remission (PR) is defined as an absolute score of ≤ 2 units on a 0 to 10 scale for each of the four following domains: * Patient's global assessment of disease activity, measured on a numeric rating scale (NRS) from 0 (no activity) to 10 (severe activity); * Pain, measured by the total back pain NRS from 0 (no pain) to 10 (most severe pain); * Function, measured by the Bath Ankylosing Spondylitis Functional Index (BASFI) which consists of 10 items assessing participants' ability to perform activities on an NRS ranging from 0 (easy) to 10 (impossible); * Inflammation, measured by the mean of the 2 morning stiffness-related Bath AS Disease Activity Index (BASDAI) NRS scores (items 5 \[level of stiffness\] and 6 \[duration of stiffness\]) each on a scale from 0 (none/0 hours) to 10 (very severe/2 hours or more duration).
Time frame: Week 14
Population: Full analysis set; participants who discontinued study drug prior to Week 14 or with missing data for reasons other than COVID-19 were counted as non-responders (non-responder imputation); Missing data due to COVID-19 infection or logistical restriction was handled by multiple imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Study 1: Placebo | Study 2: Percentage of Participants With ASAS Partial Remission at Week 14 | 7.6 percentage of participants |
| Study 1: Upadacitinib 15 mg | Study 2: Percentage of Participants With ASAS Partial Remission at Week 14 | 18.6 percentage of participants |
Study 2: Percentage of Participants With ASDAS Inactive Disease at Week 14
ASDAS is a composite index to assess disease activity in Ankylosing Spondylitis. ASDAS combines the following 5 disease activity variables using a weighted formula: 1. Patient's assessment of total back pain (BASDAI Question 2; NRS score 0 \[none\] - 10 \[very severe\]) 2. Patient global assessment of disease activity (NRS score 0 \[no activity\] - 10 \[severe activity\]) 3. Peripheral pain/swelling (BASDAI Question 3; NRS score 0 \[none\] - 10 \[very severe\]) 4. Duration of morning stiffness (BASDAI Question 6; NRS score 0 \[0 hours\] - 10 \[2 or more hours\]) 5. High-sensitivity C-reactive protein (hs-CRP) in mg/L. The overall score ranges from 0 with no defined upper score. ASDAS Inactive Disease is defined as an ASDAS score \< 1.3.
Time frame: Week 14
Population: Full analysis set; participants who discontinued study drug prior to Week 14 or with missing data for reasons other than COVID-19 were counted as non-responders (non-responder imputation); Missing data due to COVID-19 infection or logistical restriction was handled by multiple imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Study 1: Placebo | Study 2: Percentage of Participants With ASDAS Inactive Disease at Week 14 | 5.2 percentage of participants |
| Study 1: Upadacitinib 15 mg | Study 2: Percentage of Participants With ASDAS Inactive Disease at Week 14 | 14.1 percentage of participants |
Study 2: Percentage of Participants With ASDAS Inactive Disease at Week 52
ASDAS is a composite index to assess disease activity in Ankylosing Spondylitis. ASDAS combines the following 5 disease activity variables using a weighted formula: 1. Patient's assessment of total back pain (BASDAI Question 2; NRS score 0 \[none\] - 10 \[very severe\]) 2. Patient global assessment of disease activity (NRS score 0 \[no activity\] - 10 \[severe activity\]) 3. Peripheral pain/swelling (BASDAI Question 3; NRS score 0 \[none\] - 10 \[very severe\]) 4. Duration of morning stiffness (BASDAI Question 6; NRS score 0 \[0 hours\] - 10 \[2 or more hours\]) 5. High-sensitivity C-reactive protein (hs-CRP) in mg/L. The overall score ranges from 0 with no defined upper score. ASDAS Inactive Disease is defined as an ASDAS score \< 1.3.
Time frame: Week 52
Population: Full analysis set; participants who discontinued study drug prior to Week 52 or with missing data for reasons other than COVID-19 were counted as non-responders (non-responder imputation); Missing data due to COVID-19 infection or logistical restriction was handled by multiple imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Study 1: Placebo | Study 2: Percentage of Participants With ASDAS Inactive Disease at Week 52 | 10.8 percentage of participants |
| Study 1: Upadacitinib 15 mg | Study 2: Percentage of Participants With ASDAS Inactive Disease at Week 52 | 32.7 percentage of participants |
Study 2: Percentage of Participants With ASDAS Low Disease Activity at Week 14
ASDAS is a composite index to assess disease activity in Ankylosing Spondylitis. ASDAS combines the following 5 disease activity variables using a weighted formula: 1. Patient's assessment of total back pain (BASDAI Question 2; NRS score 0 \[none\] - 10 \[very severe\]) 2. Patient global assessment of disease activity (NRS score 0 \[no activity\] - 10 \[severe activity\]) 3. Peripheral pain/swelling (BASDAI Question 3; NRS score 0 \[none\] - 10 \[very severe\]) 4. Duration of morning stiffness (BASDAI Question 6; NRS score 0 \[0 hours\] - 10 \[2 or more hours\]) 5. High-sensitivity C-reactive protein (hs-CRP) in mg/L. The overall score ranges from 0 with no defined upper score. ASDAS Low Disease Activity is defined as an ASDAS score \< 2.1.
Time frame: Week 14
Population: Full analysis set; participants who discontinued study drug prior to Week 14 or with missing data for reasons other than COVID-19 were counted as non-responders (non-responder imputation); Missing data due to COVID-19 infection or logistical restriction was handled by multiple imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Study 1: Placebo | Study 2: Percentage of Participants With ASDAS Low Disease Activity at Week 14 | 18.3 percentage of participants |
| Study 1: Upadacitinib 15 mg | Study 2: Percentage of Participants With ASDAS Low Disease Activity at Week 14 | 42.3 percentage of participants |
Study 2: Percentage of Participants With ASDAS Low Disease Activity at Week 52
ASDAS is a composite index to assess disease activity in Ankylosing Spondylitis. ASDAS combines the following 5 disease activity variables using a weighted formula: 1. Patient's assessment of total back pain (BASDAI Question 2; NRS score 0 \[none\] - 10 \[very severe\]) 2. Patient global assessment of disease activity (NRS score 0 \[no activity\] - 10 \[severe activity\]) 3. Peripheral pain/swelling (BASDAI Question 3; NRS score 0 \[none\] - 10 \[very severe\]) 4. Duration of morning stiffness (BASDAI Question 6; NRS score 0 \[0 hours\] - 10 \[2 or more hours\]) 5. High-sensitivity C-reactive protein (hs-CRP) in mg/L. The overall score ranges from 0 with no defined upper score. ASDAS Low Disease Activity is defined as an ASDAS score \< 2.1.
Time frame: Week 52
Population: Full analysis set; participants who discontinued study drug prior to Week 52 or with missing data for reasons other than COVID-19 were counted as non-responders (non-responder imputation); Missing data due to COVID-19 infection or logistical restriction was handled by multiple imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Study 1: Placebo | Study 2: Percentage of Participants With ASDAS Low Disease Activity at Week 52 | 32.5 percentage of participants |
| Study 1: Upadacitinib 15 mg | Study 2: Percentage of Participants With ASDAS Low Disease Activity at Week 52 | 55.8 percentage of participants |
Study 2: Percentage of Participants With ASDAS Major Improvement at Week 52
ASDAS is a composite index to assess disease activity in Ankylosing Spondylitis. ASDAS combines the following 5 disease activity variables using a weighted formula: 1. Patient's assessment of total back pain (BASDAI Question 2; NRS score 0 \[none\] - 10 \[very severe\]) 2. Patient global assessment of disease activity (NRS score 0 \[no activity\] - 10 \[severe activity\]) 3. Peripheral pain/swelling (BASDAI Question 3; NRS score 0 \[none\] - 10 \[very severe\]) 4. Duration of morning stiffness (BASDAI Question 6; NRS score 0 \[0 hours\] - 10 \[2 or more hours\]) 5. High-sensitivity C-reactive protein (hs-CRP) in mg/L. The overall score ranges from 0 with no defined upper score; published ranges for disease activity states as defined by the ASDAS include Inactive disease (ASDAS \< 1.3) and very high disease (ASDAS \> 3.5). Major Improvement is defined as a change from Baseline of ≤ -2.0.
Time frame: Baseline and Week 52
Population: Full analysis set; participants who discontinued study drug prior to Week 52 or with missing data for reasons other than COVID-19 were counted as non-responders (non-responder imputation); Missing data due to COVID-19 infection or logistical restriction was handled by multiple imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Study 1: Placebo | Study 2: Percentage of Participants With ASDAS Major Improvement at Week 52 | 20.4 percentage of participants |
| Study 1: Upadacitinib 15 mg | Study 2: Percentage of Participants With ASDAS Major Improvement at Week 52 | 37.8 percentage of participants |
Study 2: Percentage of Participants With BASDAI 50 Response at Week 14
The BASDAI assesses disease activity by asking the participant to answer 6 questions (each on an 11 point numeric rating scale \[NRS\]) pertaining to symptoms experienced for the past week. For Questions 1 to 5 (level of fatigue/tiredness, level of AS neck, back or hip pain, level of pain/swelling in joints, other than neck, back or hips, level of discomfort from any areas tender to touch or pressure, and level of morning stiffness), the response is from 0 (none) to 10 (very severe); for Question 6 (duration of morning stiffness), the response is from 0 (0 hours) to 10 (≥ 2 hours). The overall BASDAI score ranges from 0 to 10. Lower scores indicate less disease activity. A BASDAI 50 response is defined as improvement of 50% or more from Baseline in BASDAI score.
Time frame: Baseline and Week 14
Population: Full analysis set; participants who discontinued study drug prior to Week 14 or with missing data for reasons other than COVID-19 were counted as non-responders (non-responder imputation); Missing data due to COVID-19 infection or logistical restriction was handled by multiple imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Study 1: Placebo | Study 2: Percentage of Participants With BASDAI 50 Response at Week 14 | 22.1 percentage of participants |
| Study 1: Upadacitinib 15 mg | Study 2: Percentage of Participants With BASDAI 50 Response at Week 14 | 42.3 percentage of participants |