Study Comparing Upadacitinib, Placebo, and Adalimumab for Patients with Moderate to Severe Rheumatoid Arthritis on Stable Methotrexate Treatment

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What is this study about?

This clinical trial is focused on studying the effects of treatments for rheumatoid arthritis, a condition that causes pain and swelling in the joints. The study involves two main treatments: Upadacitinib, also known by its code name ABT-494, which is taken as a tablet, and Adalimumab, marketed as Humira, which is given as an injection. Participants in the study will also be on a stable dose of Methotrexate, a common medication used to treat rheumatoid arthritis, but who have not responded adequately to it.

The purpose of the study is to compare the effectiveness and safety of Upadacitinib and Adalimumab against a placebo in people with moderate to severe rheumatoid arthritis. The study will be conducted in two periods. In the first period, participants will receive either Upadacitinib, Adalimumab, or a placebo to see how well these treatments work in reducing the symptoms of rheumatoid arthritis. The second period will focus on evaluating the long-term safety and effectiveness of Upadacitinib for those who complete the first period.

Participants will be monitored over a period of time to assess improvements in their condition, such as reduced joint pain and swelling, and to ensure the treatments are safe. The study aims to provide valuable information on how these treatments can help manage rheumatoid arthritis for those who have not had success with Methotrexate alone.

1 joining the study

Upon joining the study, you will be assigned to one of the treatment groups. This assignment is random, meaning it is like flipping a coin to decide which group you will be in. The groups include receiving either upadacitinib, adalimumab, or a placebo. A placebo is a substance that looks like the medicine but does not have any active ingredients.

2 treatment period 1

During this period, you will take the assigned medication. If you are in the upadacitinib group, you will take a tablet by mouth once daily. If you are in the adalimumab group, you will receive an injection under the skin every other week. The placebo group will follow the same schedule as the upadacitinib or adalimumab group, depending on the assignment.

This period lasts for 12 weeks. During this time, you will continue taking your regular dose of methotrexate, a medication you are already using for rheumatoid arthritis.

3 evaluation at week 12

At the end of 12 weeks, your response to the treatment will be evaluated. This includes checking if there is a 20% improvement in your rheumatoid arthritis symptoms, known as an ACR20 response. Your doctor will also assess if you have reached a state of clinical remission, meaning your disease activity is very low.

4 treatment period 2

If you complete the first period, you may continue into the second period of the study. This period focuses on the long-term safety and effectiveness of upadacitinib. The duration of this period will be explained to you by the study team.

5 ongoing assessments

Throughout the study, you will have regular check-ups to monitor your health and the effects of the treatment. These assessments will include physical exams, blood tests, and questionnaires about your health and well-being.

6 end of study

At the end of your participation in the study, you will have a final evaluation. This will help determine the overall impact of the treatment on your rheumatoid arthritis.

Who Can Join the Study?

Must be an adult, male or female, at least 18 years old.
Must have been diagnosed with rheumatoid arthritis for at least 3 months.
Must have been taking methotrexate (MTX), a medication for rheumatoid arthritis, for at least 3 months. The dose should be stable between 15 to 25 mg per week (or at least 10 mg per week if higher doses are not tolerated) for at least 4 weeks before starting the study medication. Additionally, participants should take a dietary supplement of folic acid or folinic acid during the study.
Must have at least 6 swollen joints and 6 tender joints at the start of the study, and a blood test showing high-sensitivity C-reactive protein (hsCRP) levels of at least 5 mg/L, which indicates inflammation.
Must have at least one of the following: 3 or more bone erosions visible on an x-ray, or 1 or more bone erosions with a positive test for rheumatoid factor, or 1 or more bone erosions with a positive test for anti-cyclic citrullinated peptide (anti-CCP) autoantibodies. These are markers that help confirm rheumatoid arthritis.
May have been treated with only one biologic disease-modifying anti-rheumatic drug (bDMARD), except for adalimumab (ADA). This applies to up to 20% of the study participants.
Must have stopped taking all other conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) except for methotrexate.

Who Cannot Join the Study?

Patients who have a history of severe allergic reactions to any of the study medications cannot participate.
Patients with active infections, such as tuberculosis, cannot participate.
Patients with a history of cancer within the last 5 years, except for certain skin cancers, cannot participate.
Patients with liver disease or abnormal liver function tests cannot participate.
Patients with a history of blood disorders, such as low white blood cell count, cannot participate.
Patients who are pregnant or breastfeeding cannot participate.
Patients who have received certain other medications for rheumatoid arthritis recently cannot participate.
Patients with a history of heart disease or stroke cannot participate.
Patients with uncontrolled high blood pressure cannot participate.
Patients with a history of alcohol or drug abuse cannot participate.

Where you can join this trial?

Verified and Recommended Sites

No sites found in this category

Verified Sites

Site Name	City	Country
Osteo-Medic s.c. Artur Racewicz, Jerzy Supronik	Bialystok	Poland
Poliklinika Vlatka Cavka d.o.o.	Zagreb	Croatia
Futuremeds Warszawa Centrum	Warsaw	Poland

Other Sites

Site Name	City	Country
Revita Kft.	Budapest	Hungary
Dkc Fokus-5 Lzip OOD	Sofia	Bulgaria
University Multiprofile Hospital For Active Treatment St. Ivan Rilski EAD	Sofia	Bulgaria
Hopital Purpan	Toulouse	France
MVZ Rheumatologie und Autoimmunmedizin Hamburg GmbH	Hamburg	Germany
Rheuma Medicus Sp. z o.o.	Warsaw	Poland
MUDR. Zuzana URBANOVA	Prague	Czechia
Rushelzvvhytur Ujzjw	Prague	Czechia
Mpxpyalho Iwijsklrut Clwlntjn Synmruqc Sgy z ojho	Warsaw	Poland
Czawhunkl Uuschjqirskbim Sxjeasduy	Woluwe-Saint-Lambert	Belgium
Laiaj Gbayxjh Hkkzbuoo Oo Ahzrah	Athens	Greece
Nkzex Eyyrxif Mdhzjjf Cbqzli Fkhhitbwdc	Tallin	Estonia
Hbgfzfti Upinujhfpkznc dr A Cfsvmw	A Coruna Galicia	Spain
Vyuqhurm uzkakmpufkey lhmjtjtb Sezaasfs kcsogfoa Vst	Vilnius	Lithuania
Cjxucq Honokduuvll Udxmdekecqbew Dp Mxmoouwdmes	Montpellier	France
Kiy Snzwb	Split	Croatia
Usbuzveskyju Ztscxxjqlx Gyab	Gent	Belgium
Hsggjofc Ueadnfzuedgai Mlyftdj Ds Vspatgcefm	Santander	Spain
Uwphgfcnna Mzwxqukdcmrl Hpcbtxcv Fcd Ahaqxb Tznghfhap Snkeq Glsqan Emu	Plovdiv	Bulgaria
Unkwztjxzc Msbfiloipjjg Hfbsmgup Fja Aagvtg Tdrbbbfrw Sjstotdr Ozp	Sofia	Bulgaria
Cjwjtxu Gxhhh Sqschsgo	Santiago De Compostela	Spain
Kdfvjmbvfx Fxvk Fgeqwe Kkyksl	Kistarcsa	Hungary
Cib Hilhrwu Kdyw	Encs	Hungary
Mgsnzkopdp Om	Tartu	Estonia
Rezrmsshgrqqur akldgzpuqp	Sabinov	Slovakia
Beyrzvmvtl Iynqefjtzpzp Bfffq Ipilhfdfywedy Kvntki	Budapest	Hungary
Mheqdjnqhe csnqos Kcsf Piuon ddeudg	Zagreb	Croatia
D Sftcgphj Kvaqjdoqge Pnkqhka Pehnmvlj	Liepaja	Latvia
Kwcvjfwp bwuyquyy cjlgpd Rhgqmr (ixrhelgj Hunbaszy Cdmvxi Rmbttcd	Rijeka	Croatia
Slfaplt Pmsubr Sky z oyum	Gdansk	Poland
Cox Hrgxlb	Mons	Belgium
Fyxgjdii Tvdqoekmxcw nvtuzuavm	Prague	Czechia
Esyj Tnlishg Cgqxajw Hbznxdwz	Tallin	Estonia
Serntqb Pjqhks Syp z owry	Poznan	Poland
Rozrokwzh skzpkl	Nove Mesto Nad Vahom	Slovakia
Cdwzto Rzwppidv Czixexom Dn Vpydzc Sjquii	Verona	Italy
Scpkf Mfqnb Hiyzrqet	Bucharest	Romania
Uvfrznf Lnoql De Sodat Dh Gvkeazmxjydb Eugtxv	Vila Nova De Gaia	Portugal
Legrtwin seaorjcst mjcfli usglyjporzgn llgchufn Kwkvm kwphbvdh	Kaunas	Lithuania
Wwbbxnwho I Bawkibbg A Strjsfaeqexz snyb	Wroclaw	Poland
Mgsfau schooh	Martin	Slovakia
Rtwvvy Seq z outy	Lublin	Poland
Ujmmlpmsxa Mmmkoqxixkgn Hidzecqz Fbf Alxksj Tbakmusqt Kirgmdu Egqf	Plovdiv	Bulgaria
Chzbpymfs Dieaucx Ntmrr Smw ka	Bialystok	Poland
Rmzcnx sgpsrb	Rimavska Sobota	Slovakia
Alddeng srpeyq	Zvolen	Slovakia
Qkjhqguowhl Kcke	Budapest	Hungary
Tbowommu snuhsn	Piestany	Slovakia
Izbbmygmx Pjjjntozu Dh Rgyazpuflhzz	Lisbon	Portugal
Mgrpmgizllt Cdouwum Kycrpbuzm	Cracow	Poland
Urgtfqk Lkkik Dw Sxguc Du Avxb Mmmju Ejequm	Ponte De Lima	Portugal
Mxvg svbl Imnls Ctvuctkpta Ajtq Pqhjbipo Snhuudwrdqm	Grodzisk Mazowiecki	Poland
M &csuc M cliiuu Sdh	Adazi	Latvia
Cxdtgtlu Mafw sirtbt	Nova Ulice	Czechia
Vcohrdfphmidea Kboa	Veszprem	Hungary
Rcekgshjsfce Bpwrayh semhdt	Prostejov	Czechia
Hyxvxhbsvksxbpj Eo Sfuhz Adzzwb Rledbaplwfx	Heviz	Hungary
Tiooec suytbn	Stara Lubovna	Slovakia
Rfnuydlyrxfhdiea Pcjamg Dif Jyzpbr Wpgper	Rendsburg	Germany
Pnsmsp Slzn	Skorzewo	Poland
Asqm Fbdrssdxgcilhjie Swico	Milan	Italy
Cuhlhe hmcvbbustwb uixqbxgrbnbtg dv Logba	Liege	Belgium

Trial status

Country	Status	Recruitment Start
Belgium	Not recruiting	30.11.2015
Bulgaria	Not recruiting	30.11.2015
Croatia	Not recruiting	30.11.2015
Czechia	Not recruiting	30.11.2015
Estonia	Not recruiting	30.11.2015
France	Not recruiting	30.11.2015
Germany	Not recruiting	30.11.2015
Greece	Not recruiting	30.11.2015
Hungary	Not recruiting	30.11.2015
Italy	Not recruiting	30.11.2015
Latvia	Not recruiting	30.11.2015
Lithuania	Not recruiting	30.11.2015
Poland	Not recruiting	30.11.2015
Portugal	Not recruiting	30.11.2015
Romania	Not recruiting	30.11.2015
Slovakia	Not recruiting	30.11.2015
Spain	Not recruiting	30.11.2015

Trial locations

Investigated Drugs:

Upadacitinib is a medication being tested in this clinical trial for people with rheumatoid arthritis, a condition that causes pain and swelling in the joints. It is taken once a day and works by blocking certain enzymes in the body that lead to inflammation and joint damage. The goal of using upadacitinib is to reduce the symptoms of rheumatoid arthritis and prevent further joint damage.

Adalimumab is another medication used in this trial. It is a well-known treatment for rheumatoid arthritis and works by blocking a specific protein in the body that causes inflammation. By doing this, adalimumab helps to reduce pain and swelling in the joints, improving the quality of life for people with this condition.

Methotrexate is a medication that participants in the trial are already taking. It is a common treatment for rheumatoid arthritis and helps to slow down the disease’s progression by affecting the immune system. In this trial, methotrexate is used as a background treatment, meaning it is continued alongside the new medications being tested to see if they work better together.

Investigated Diseases:

Rheumatoid arthritis

Rheumatoid arthritis – Rheumatoid arthritis is a chronic inflammatory disorder that primarily affects the joints. It typically begins with inflammation in the small joints of the hands and feet, leading to pain, swelling, and stiffness. As the disease progresses, it can cause joint damage and deformities. The inflammation can also spread to larger joints and, in some cases, affect other organs such as the skin, eyes, and lungs. Over time, the persistent inflammation can lead to the destruction of cartilage and bone within the joint. This disease often results in reduced joint function and mobility.

Trial ID:

2022-501017-31-00

Protocol code:

M14-465

NCT ID:

NCT02629159

Trial Phase:

Therapeutic confirmatory (Phase III)

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Study Comparing Upadacitinib, Placebo, and Adalimumab for Patients with Moderate to Severe Rheumatoid Arthritis on Stable Methotrexate Treatment

What is this study about?

Who Can Join the Study?

Who Cannot Join the Study?