A Study of the Efficacy and Safety of Upadacitinib (ABT-494) in subjects with Moderately to Severely Active Ulcerative Colitis

• Register: EUCTR
• Last refreshed on: 5 April 2021
• Main ID: EUCTR2016-000642-62-LV
• Date of registration: 15/10/2018
• Prospective Registration: Yes
• Primary sponsor: AbbVie Deutschland GmbH & Co. KG
• Public title: A Study of the Efficacy and Safety of Upadacitinib (ABT-494) in subjects with Moderately to Severely Active Ulcerative Colitis
• Scientific title: M14-675, A Multicenter, Randomized, Double-Blind, Placebo-Controlled Induction Study to Evaluate the Efficacy and Safety of Upadacitinib (ABT-494) in Subjects with Moderately to Severely Active Ulcerative Colitis
• Date of first enrolment: 13/12/2018
• Target sample size: 462
• Recruitment status: Not Recruiting
• URL: https://www.clinicaltrialsregister.eu/ctr-search/search?query=eudract_number:2016-000642-62
• Study type: Interventional clinical trial of medicinal product
• Study design: Controlled: yes; Randomised: yes; Open: no; Single blind: no; Double blind: yes; Parallel group: no; Cross over: no; Other: no; If controlled, specify comparator, Other Medicinial Product: no; Placebo: yes; Other: no; Number of treatment arms in the trial: 2
• Phase: Human pharmacology (Phase I): no Therapeutic exploratory (Phase II): no Therapeutic confirmatory - (Phase III): yes Therapeutic use (Phase IV): no

Countries of recruitment

Argentina, Australia, Austria, Belarus, Bosnia and Herzegovina, Brazil, Canada, Chile, China, Colombia, Croatia, Czech Republic, Finland, France, Germany, Greece, Hungary, Ireland, Israel, Japan, Korea, Republic of, Latvia, Lithuania, Malaysia, Mexico, Netherlands, Norway, Poland, Portugal, Puerto Rico, Russian Federation, Serbia, Singapore, Slovakia, South Africa, Spain, Sweden, Switzerland, Taiwan, Turkey, Ukraine, United Kingdom, United States

Contacts

• Name: EU Clinical Trials Helpdesk
• Affiliation: AbbVie Ltd

• Name: EU Clinical Trials Helpdesk
• Affiliation: AbbVie Ltd

Key inclusion & exclusion criteria

Inclusion criteria:
1. Male or female between 18 and 75 years of age at Baseline.
2. Diagnosis of UC for 90 days or greater prior to Baseline, confirmed by colonoscopy during the Screening Period, with exclusion of current infection, colonic dysplasia and/or malignancy. Appropriate documentation of biopsy results consistent with the diagnosis of UC, in the assessment of the Investigator, must be available.
3. Active UC with an Adapted Mayo score of 5 to 9 points and endoscopic subscore of 2 to 3 (confirmed by central reader).
4. Demonstrated an inadequate response, loss of response, or intolerance to at least one of the following including, oral aminosalicylates, corticosteroids, immunosuppressants, and/or biologic therapies, in the opinion of the investigator, as defined below:
• Oral aminosalicylates (e.g., mesalamine, sulfasalazine, olsalazine, balsalazide)
o Signs and symptoms of persistently active disease, in the opinion of the investigator, during a current or prior course of at least 4 weeks of treatment with 2.4 g/day mesalamine, 4 g/day sulfasalazine, 1 g/day olsalazine, or 6.75 g/day balsalazide.
• Corticosteroids
o Signs and symptoms of persistently active disease despite a history of at least one induction regimen that included a dose equivalent to prednisone = 40 mg/day orally for 3 to 4 weeks or intravenously for 1 week, OR
o Unable to taper corticosteroids to below a dose equivalent to prednisone 10 mg daily orally without recurrent active disease, OR
o History of intolerance to corticosteroids (including, but not limited to Cushing's syndrome, osteopenia/osteoporosis, hyperglycemia, insomnia, infection).
• Immunosuppressants
o Signs and symptoms of persistently active disease despite a history of at least one 90 day regimen of oral azathioprine (= 1.5 mg/kg/day; for subjects in Japan, China, and Taiwan only: = 1.0 mg/kg/day), 6-MP (= 1 mg/kg/day; [for subjects in Japan, China, and Taiwan only: = 0.6 mg/kg/day, rounded to the nearest available tablet of half tablet formulation] or a documented 6-TGN level of 230 – 450 pmol/8 × 108 RBC or higher on the current dosing regimen), injectable MTX (= 15 mg/week subcutaneous [SC] or intramuscular), or tacrolimus (for subjects in Japan and Taiwan only: documented trough level of 5 – 10 ng/mL), OR
o History of intolerance to at least one immunosuppressant (including, but not limited to nausea/vomiting, abdominal pain, pancreatitis, liver enzyme abnormalities, lymphopenia, infection)
Note: Oral MTX use is allowed during the study, however prior or current use of oral MTX is not sufficient for inclusion into the study unless these subjects were previously treated with aminosalicylates, corticosteroids or immunosuppressants (azathioprine or 6-MP) and have inadequate response to, loss of response to or intolerance to the therapy as defined above.
• Biologic Agents for UC
o Signs and symptoms of persistently active disease despite a history of any of the following:
o at least one 6-week induction regimen of infliximab (= 5 mg/kg IV at 0, 2, and 6 weeks),
o at least one 4-week induction regimen of adalimumab (one 160 mg SC dose followed by one 80 mg SC dose [or one 80 mg SC dose in countries where this dosing regimen is allowed] followed by one 40 mg SC dose at least 2 weeks apart),
o at least one 2-week induction regimen of golimumab (one 200 mg SC dose followed by one 100 mg SC dose at least 2 weeks apart),
o at least one 6-week induction regimen of vedolizumab (300 mg IV a
Exclusion criteria:
1. Subject with current diagnosis of Crohn's disease (CD) or diagnosis of indeterminate colitis (IC).
2. Current diagnosis of fulminant colitis and/or toxic megacolon.
3. Subject with disease limited to the rectum (ulcerative proctitis) during the Screening endoscopy.
4. Received cyclosporine, tacrolimus, or mycophenolate mofetil within 30 days prior to Baseline.
5. Subject who received azathioprine or 6-MP within 10 days of Baseline.
6. Received intravenous corticosteroids within 14 days prior to Screening or during the Screening Period.
7. Subject with previous exposure to JAK inhibitor (e.g., tofacitinib, baricitinib, filgotinib, upadacitinib).
8. Screening laboratory and other analyses show any of the following abnormal results:
• Serum Aspartate Transaminase (AST) or Alanine Transaminase (ALT) > 2.0 × upper limit of the reference range (ULN);
• Estimated glomerular filtration rate by simplified 4-variable Modification of Diet in Renal Disease (MDRD) formula < 30 mL/min/1.73 m2;
• Total White Blood Cell (WBC) count < 2500/µL;
• Absolute neutrophil count (ANC) < 1,200/µL;
• Platelet count < 100,000/µL;
• Absolute lymphocytes count < 750/µL;
• Hemoglobin < 9g/dL.


Age minimum:
Age maximum:
Gender:
Female: yes
Male: yes

Health Condition(s) or Problem(s) studied

Therapeutic area: Diseases [C] - Digestive System Diseases [C06]

Ulcerative Colitis
MedDRA version: 20.0 Level: PT Classification code 10009900 Term: Colitis ulcerative System Organ Class: 10017947 - Gastrointestinal disorders

Intervention(s)

Product Name: Upadacitinib
Product Code: ABT-494
Pharmaceutical Form: Tablet
INN or Proposed INN: Upadacitinib
CAS Number: 1310726-60-3
Current Sponsor code: ABT-494
Other descriptive name: ABT-494
Concentration unit: mg milligram(s)
Concentration type: equal
Concentration number: 45-
Pharmaceutical form of the placebo: Tablet
Route of administration of the placebo: Oral use

Primary Outcome(s)

Main Objective: The objective of Study M14-675 (Phase 3 induction) is to evaluate the efficacy and safety of upadacitinib 45 mg once daily (QD) compared to placebo in inducing clinical remission (per Adapted Mayo score) in subjects with moderately to severely active ulcerative colitis.

Timepoint(s) of evaluation of this end point: Part 1: Week 8 and Part 2: Week 16 (Extended Treatment Period; as applicable)

Secondary Objective: The secondary objectives of the study are to evaluate the efficacy of upadacitinib 45 mg QD comparing with placebo in ranked secondary endpoints of achieving endoscopic improvement, endoscopic remission, clinical response per Adapted Mayo Score ,clinical response per Partial Adapted Mayo score, no bowel urgency, no abdominal pain, histologic improvement, response in IBDQ Below symptom domain, mucosal healing, UC-related hospitalization, UC-related surgery, and response in IBDQ fatigue item

Primary end point(s): The primary endpoint for Study M14-675 is the proportion of subjects who achieve clinical remission per Adapted Mayo score (defined as SFS = 1 and not greater than baseline, RBS of 0, and endoscopic sub score = 1) at Week 8.

Secondary Outcome(s)

Secondary end point(s): 1. Proportion of subjects with endoscopic improvement at Week 8
2. Proportion of subjects with endoscopic remission at Week 8
3. Proportion of subjects achieving clinical response per Adapted Mayo Score at Week 8
4. Proportion of subjects achieving clinical response per Partial Adapted Mayo score (defined as decrease from Baseline = 1 points and = 30% from Baseline, PLUS a decrease in RBS = 1 or an absolute RBS = 1 )at Week 2
5. Proportion of subjects who reported no bowel urgency at Week 8
6. Proportion of subjects who reported no abdominal pain at Week 8
7. Proportion of subjects who achieved histologic improvement (defined as decrease from Baseline in Geboes score) at Week 8
8. Proportion of subjects achieving response in IBDQ Bowel Symptom domain (increase of IBDQ bowel symptom domain score =6) at Week 8
9. Proportion of subjects with mucosal healing (endoscopic and histologic remission) at Week 8
10. Proportion of subjects with UC-related hospitalizations through Week 8
11. Proportion of subjects with UC-related surgeries through Week 8
12. Proportion of subjects achieving response in IBDQ fatigue item (increase of IBDQ fatigue item score =1) at Week 8.

Timepoint(s) of evaluation of this end point: For points 1, 2, 3, 5, 6, 7, 8, 9, 10, 11, 12 - week 8
For point 4 - Week 2

Secondary ID(s)

2016-000642-62-NL

M14-675

Source(s) of Monetary Support

AbbVie Inc

Ethics review

Status: Approved
Approval date: 13/12/2018
Contact: