A Study Comparing Upadacitinib (ABT-494) to Placebo in Adults With Rheumatoid Arthritis on a Stable Dose of Conventional Synthetic Disease-Modifying Antirheumatic Drugs (csDMARDs) Who Have an Inadequate Response to csDMARDs Alone (SELECT-NEXT)
Rheumatoid Arthritis

About this trial
This is an interventional treatment trial for Rheumatoid Arthritis focused on measuring Musculoskeletal Disease, Arthritis, Joint Disease, Anti-inflammatory agents, Antirheumatic agents, Upadacitinib, ABT-494
Eligibility Criteria
Inclusion Criteria:
- Adult male or female, at least 18 years old.
- Diagnosis of Rheumatoid Arthritis (RA) for greater than or equal to 3 months.
- Subjects have been receiving conventional synthetic DMARD (csDMARD) therapy for greater than or equal to 3 months and on a stable dose for greater than or equal to 4 weeks prior to the first dose of study drug. The following csDMARDs are allowed: Methotrexate (MTX), sulfasalazine, hydroxychloroquine, chloroquine, and leflunomide.
- Meets the following minimum disease activity criteria: greater than or equal to 6 swollen joints (based on 66 joint counts) and greater than or equal to 6 tender joints (based on 68 joint counts) at Screening and Baseline Visits.
- Subjects with prior exposure to at most one biologic DMARD (bDMARD) may be enrolled (up to 20% of study population) if they have documented evidence of intolerance to bDMARDs or limited exposure (less than 3 months) and have satisfied required washout periods.
Exclusion Criteria:
- Prior exposure to any Janus kinase (JAK) inhibitor (including but not limited to tofacitinib, baricitinib, and filgotinib).
- History of inflammatory joint disease other than RA. History of secondary Sjogren's Syndrome is permitted.
- Subjects who are considered inadequate responders to bDMARD therapy as determined by the Investigator.
Sites / Locations
- AZ Arthritis and Rheum Assoc /ID# 148651
- SunValley Arthritis Center, Lt /ID# 140452
- AZ Arthritis and Rheum Researc /ID# 138500
- AZ Arthritis and Rheum Researc /ID# 139286
- AZ Arthritis & Rheuma Research /ID# 138598
- Arizona Research Center, Inc. /ID# 140448
- University of Arizona Cancer Center - North Campus /ID# 140451
- Covina Arthritis Clinic /ID# 139881
- T. Joseph Raoof, MD, Inc. /ID# 140964
- Allergy and Rheum Med Clin /ID# 146082
- Pacific Arthritis Ctr Med Grp /ID# 138744
- Robin K. Dore MD, Inc /ID# 138688
- Inland Rheum Clin Trials Inc. /ID# 138853
- Denver Arthritis Clinic /ID# 139876
- Clinical Res of West FL, Inc. /ID# 138854
- Ctr Arthritis & Rheumatic Dise /ID# 141696
- Medallion Clinical Research Institute, LLC /ID# 140074
- Suncoast Clinical Research /ID# 138633
- Omega Research Consultants /ID# 139877
- Arthritis Center, Inc. /ID# 141363
- Institute of Arthritis Res /ID# 138548
- OrthoIllinois /ID# 139695
- Clinical Investigation Special /ID# 139696
- Springfield Clinic /ID# 138602
- Deerbrook Medical Associates /ID# 139694
- Indiana Univ School of Med /ID# 140077
- Bluegrass Community Research /ID# 138295
- Four Rivers Clinical Research /ID# 141134
- MMP Women's Health /ID# 141542
- The Center for Rheumatology & /ID# 139203
- Mansfield Health Center /ID# 141357
- Advanced Rheumatology, PC /ID# 140071
- Justus J. Fiechtner, MD, PC /ID# 138697
- Physician Res. Collaboration /ID# 138533
- Westroads Clinical Research /ID# 138304
- The Center for Rheumatology /ID# 138746
- PMG Research of Salisbury /ID# 141023
- PMG Research of Wilmington LLC /ID# 140951
- Cincinnati Rheumatic Disease Study Group, Inc. /ID# 138868
- Arthritis Assoc of NW Ohio /ID# 140953
- Health Research Oklahoma /ID# 138535
- Altoona Ctr Clinical Res /ID# 138741
- Articularis Healthcare Group, Inc d/b/a Low Country Rheumatology /ID# 138689
- Comprehensive Arthritis Care, a division of Comprehensive Rheumatology Care PLLC /ID# 141021
- Tekton Research, Inc. /ID# 141428
- Trinity Universal Res Assoc /ID# 149271
- Arth and Osteo Clin Brazo Valley /ID# 147809
- Metroplex Clinical Research /ID# 138698
- Baylor College of Medicine /ID# 138682
- Houston Institute for Clin Res /ID# 138716
- Arthritis Consultants, P.A. /ID# 141138
- Trinity Universal Research Association /ID# 148649
- Accurate Clinical Management /ID# 139338
- Arthritis & Osteoporosis Clinic /ID# 138703
- Western Washington Arthritis C /ID# 138728
- Arthritis Northwest, PLLC /ID# 138539
- Aurora Rheumatology and Immunotherapy Center /ID# 139306
- Mautalen Salud e Investigacion /ID# 141419
- Inst. Rheumatologic Strusberg /ID# 145648
- Coffs Clinical Trials /ID# 138747
- Optimus Clinical Research Pty. /ID# 138769
- Emeritus Research /ID# 138773
- Barwon Rheumatology /ID# 138772
- Rheuma Zentrum Favoriten GmbH /ID# 138787
- Wilhelminenspital der Stadt Wien /ID# 138788
- Rhumaconsult SPRL /ID# 138813
- UZ Gent /ID# 138806
- AZ Sint Lucas /ID# 141338
- University Clinical Centre of the Republic of Srpska /ID# 138819
- University Clinical Centre of the Republic of Srpska /ID# 140372
- Diag Consult Ctr 17 Sofia EOOD /ID# 141006
- Diagnostic Consultative Center /ID# 138882
- Manitoba Clinic /ID# 139086
- Eastern Health /ID# 140431
- Groupe de Recherche en Maladies Osseuses /ID# 138906
- Dr. Latha Naik /ID# 139089
- Klinicki bolnicki centar Rijeka /ID# 138649
- Klinicka bolnica Sveti Duh /ID# 152812
- Medical Center Kuna-Peric /ID# 140365
- Poliklinika Bonifarm /ID# 141415
- L.K.N. Arthrocentrum, s.r.o /ID# 141340
- Revmatologie, s.r.o. /ID# 138899
- Artroscan s.r.o. /ID# 138833
- Nemocnice Slany /ID# 141112
- PV-MEDICAL s.r.o. /ID# 138913
- Center of Clinical and Basic Research /ID# 141116
- Paernu Hospital /ID# 138961
- East Tallinn Central Hospital /ID# 140618
- Helsinki Univ Central Hospital /ID# 140381
- Kiljava Medical Research /ID# 139260
- South Karelia Central Hospital /ID# 139973
- Hopital Saint Joseph /ID# 149188
- CHRU Tours - Hopital Trousseau /ID# 138969
- Uniklinik Koln /ID# 139084
- Charité Universitätsmedizin Campus Mitte /ID# 139052
- Immanuel-Krankenhaus /ID# 139059
- Asklepios Klinik Altona /ID# 140466
- Welcker, Planegg, DE /ID# 140467
- University General Hospital of Heraklion "PA.G.N.I" /ID# 139115
- Prince of Wales Hospital /ID# 139314
- Revita Reumatologiai Rendelo /ID# 140761
- Fejer Megyei Szent Gyorgy Korh /ID# 138554
- St Vincent's University Hosp /ID# 138562
- Universita di Catanzaro Magna Graecia /ID# 139316
- JSC Nat Scientific Med Res Ctr /ID# 140575
- Inha University Hospital /ID# 149310
- Ajou University Hospital /ID# 149311
- Chonnam National University Hospital /ID# 138651
- Hanyang University Seoul Hospi /ID# 138655
- Cath Univ Seoul St Mary's Hosp /ID# 138652
- Daegu Catholic University Med /ID# 139249
- Chungnam National University Hospital /ID# 138653
- Seoul National University Hospital /ID# 138659
- Asan Medical Center /ID# 140579
- LTD M+M Centers /ID# 138818
- Klaipeda University Hospital /ID# 141416
- Vilnius University Hospital /ID# 141348
- Centro Peninsular de Investigación Clínica SCP /ID# 148160
- Unidad de Investigacion de las Enfermedades Reumatologicas SA de CV /ID# 138841
- Porter Rheumatology Ltd /ID# 138347
- NZOZ Nasz Lekarz /ID# 138374
- McBk Sc /Id# 138360
- Osteo-Medic spolka cywilna /ID# 138371
- NZOZ Centrum Reumatologiczne /ID# 138353
- Rheuma Medicus /ID# 138372
- Instituto Portugues De Reumatologia /ID# 148315
- Centro Hospitalar Lisboa Ocidental, EPE /ID# 140594
- School of Medicine University of Puerto Rico-Medical Sciences Campus /ID# 139328
- Spitalul Clinic Judetean de Urgenta /ID# 138407
- Spitalul Municipal Ploiesti /ID# 138405
- Spitalul Clinic Judetean de Ur /ID# 138393
- LLC Novaya Klinika /ID# 139269
- Kazan State Medical University /ID# 138413
- Republican Clin Hos n.a. Baran /ID# 139273
- Samara Regional Clinical Hosp /ID# 148642
- Ulyanovsk Regional Clin Hosp /ID# 139279
- Voronezh State Medical Univers /ID# 148431
- Yaroslavi State Medical Univer /ID# 139908
- ARTROMAC n.o. /ID# 138428
- Nemocnica Kosice Saca, a.s. /ID# 138918
- Slovak research center Team Member, Thermium s.r.o. /ID# 139924
- Narodny ustav reumatickych chorob Piestany /ID# 138427
- REUMA-GLOBAL, s.r.o. /ID# 139912
- St. Augustine's Medical Centre /ID# 141352
- Arthritis Clinical Research Tr /ID# 138945
- Winelands Medical Research Ctr /ID# 138944
- Hospital Regional de Malaga /ID# 138975
- Hospital General Univ de Elche /ID# 138991
- Hospital Clin Univ San Carlos /ID# 138993
- Hosp Nuestra Senora Esperanza /ID# 138997
- HFR Fribourg - Hopital Canton /ID# 139155
- China Medical University Hosp /ID# 139232
- National Cheng Kung University Hospital /ID# 140868
- National Taiwan Univ Hosp /ID# 141443
- Kaohsiung Medical University Chung-Ho Memorial Hospital /ID# 140869
- Far Eastern Memorial Hospital /ID# 140871
- Taipei Veterans General Hosp /ID# 139234
- Ankara Numune Training and Res /ID# 139237
- LLC Revmocentr /ID# 139872
- MNCE "Lviv City Clinical Hospital #4" /ID# 139873
- Odessa National Medical Univ /ID# 139179
- Leicester Royal Infirmary /ID# 139184
- Whipps Cross Univ Hospital /ID# 139523
- The Royal Free Hospital /ID# 139191
- Western General Hospital /ID# 139524
- Southampton General Hospital /ID# 139169
- Warrington + Halton Hosp NHS /ID# 139195
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Experimental
Experimental
Experimental
Experimental
Upadacitinib 15 mg
Upadacitinib 30 mg
Placebo / Upadacitinib 15 mg
Placebo / Upadacitinib 30 mg
Period 1: Participants receive upadacitinib 15 mg once daily for 12 weeks. Period 2: Participants continue to receive upadacitinib 15 mg once daily for an additional 248 weeks.
Period 1: Participants receive upadacitinib 30 mg once daily for 12 weeks. Period 2: Participants continue to receive upadacitinib 30 mg once daily for an additional 248 weeks or until implementation of Protocol Amendment 6 at which time participants switch to receive upadacitinib 15 mg once daily.
Period 1: Participants receive placebo once daily for 12 weeks. Period 2: Participants receive upadacitinib 15 mg once daily for 248 weeks.
Period 1: Participants receive placebo once daily for 12 weeks. Period 2: Participants receive upadacitinib 30 mg once daily for 248 weeks or until implementation of Protocol Amendment 6 at which time participants switch to receive upadacitinib 15 mg once daily.