A Study to Compare Upadacitinib (ABT-494) Monotherapy to Methotrexate (MTX) Monotherapy in Adults With Rheumatoid Arthritis (RA) Who Have Not Previously Taken Methotrexate (SELECT-EARLY)
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, ABT-494, Upadacitinib
Eligibility Criteria
Inclusion Criteria:
- Duration of symptoms consistent with RA for ≥ 6 weeks who also fulfill the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification criteria for RA.
- Naïve to Methotrexate (MTX) or, if already on MTX, have received no more than 3 weekly MTX doses with requirement to complete a 4-week MTX washout before the first dose of study drug.
- Participants with prior exposure to conventional synthetic disease-modifying anti-rheumatic drugs(csDMARDs) other than MTX may be enrolled if completed the washout period.
Participant meets both of the following minimum disease activity criteria:
-≥ 6 swollen joints (based on 66 joint counts) and ≥ 6 tender joints (based on 68 joint counts) at Screening and Baseline Visits.
- high sensitivity C reactive protein (hsCRP) ≥ 5 mg/L (central lab, upper limit of normal [ULN] 2.87 mg/L at Screening Visit.
- Greater than or equal to 1 bone erosion on x-ray (by local reading) OR in the absence of documented bone erosion, both positive rheumatoid factor (RF) and positive anti-cyclic citrullinated peptide (anti CCP) autoantibodies are required at Screening.
- Stable dose of non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, oral corticosteroids (equivalent to prednisone ≤ 10 mg/day), or inhaled corticosteroids for stable medical conditions are allowed but must have been at a stable dose ≥ 1 week prior to the first dose of study drug.
Exclusion Criteria:
- Intolerant to Methotrexate (MTX).
- Prior exposure to any Janus kinase (JAK) inhibitor (including but not limited to tofacitinib, baricitinib, and filgotinib).
- Prior exposure to any biologic disease-modifying anti-rheumatic drugs (bDMARDs).
- History of any arthritis with onset prior to age 17 years or current diagnosis, inflammatory joint disease other than RA (including but not limited to gout, systemic lupus erythematosus, psoriatic arthritis, axial spondyloarthritis including ankylosing spondylitis and non-radiographic axial spondyloarthritis, reactive arthritis, overlap connective tissue diseases, scleroderma, polymyositis, dermatomyositis, fibromyalgia [currently with active symptoms]. Current diagnosis of secondary Sjogren's Syndrome is permitted.
- Has been treated with intra-articular, intramuscular, intravenous, trigger point or tender point, intra-bursa, or intra-tendon sheath corticosteroids in the preceding 8 weeks prior to the first dose of study drug.
Sites / Locations
- TriWest Research Associates- La Mesa /ID# 143738
- Desert Medical Advances /ID# 143730
- International Medical Research - Daytona /ID# 143748
- FL Med Ctr and Research, Inc. /ID# 143724
- Millennium Research /ID# 143736
- Arthritis Research of Florida /ID# 143743
- Sarasota Arthritis Center /ID# 145978
- FL Med Clinic, PA /ID# 143744
- Deerbrook Medical Associates /ID# 143728
- Four Rivers Clinical Research /ID# 143741
- Ocean Rheumatology, PA /ID# 143737
- Arthritis Rheumatic Back Disorder /ID# 143733
- Trinity Health Med Arts Clinic /ID# 143727
- STAT Research, Inc. /ID# 143750
- Healthcare Research Consultant /ID# 143747
- Advanced Rheumatology & Arthri /ID# 147947
- Articularis Healthcare Group, Inc d/b/a Low Country Rheumatology /ID# 145653
- West Tennessee Research Inst /ID# 143723
- Dr. Ramesh Gupta /ID# 143732
- Diagnostic Group Integrated He /ID# 152921
- Adriana Pop-Moody MD Clinic PA /ID# 147626
- Doctor's Hosp at Renaissance /ID# 156407
- MedResearch Inc. /ID# 156409
- Rheumatic Disease Clin Res Ctr /ID# 151103
- Accurate Clinical Research /ID# 143749
- SW Rheumatology Res. LLC /ID# 143745
- Sun Research Institute /ID# 159546
- Accurate Clinical Management /ID# 159543
- NextGen Clinical Trials LLP /ID# 150930
- Arthritis Clinic of Central TX /ID# 159541
- Arthritis & Osteoporosis Clinic /ID# 159542
- Arthritis Clinic of N. VA, P.C /ID# 143734
- Aprillus Asistencia e Investig /ID# 149179
- Iari /Id# 148595
- Instituto CAICI /ID# 143141
- Org Medica de Investigacion /ID# 143142
- Consultora Integral de Salud S /ID# 143144
- Centro Integral de Reumatologi /ID# 143143
- Centro Medico Privado/Reuma /ID# 143140
- Royal Prince Alfred Hospital /ID# 143149
- Rheumatology Research Unit /ID# 143147
- The Queen Elizabeth Hospital /ID# 143148
- Southern Clinical Research Pty /ID# 143150
- Emeritus Research /ID# 143146
- First City Clinical Hospital /ID# 159020
- City Clinical Hospital #9 /ID# 145650
- Rhumaconsult SPRL /ID# 143158
- Algemeen Stedelijk Ziekenhuis /ID# 153504
- UZ Gent /ID# 143157
- ReumaClinic Genk /ID# 143159
- CHU Ambroise Pare /ID# 152955
- University Clinical Centre of the Republic of Srpska /ID# 143161
- University Clinical Centre of the Republic of Srpska /ID# 143162
- Clinical Center University of Sarajevo /ID# 143164
- CIP - Centro Internacional de Pesquisa /ID# 143171
- Ceti - Centro de Estudos Em Terapias Inovadoras Ltda /Id# 143169
- Hospital de Clinicas de Porto Alegre /ID# 143168
- LMK Sevicos Medicos S/S /ID# 143167
- CEPIC - Centro Paulista de Investigação Clínica e Serviços Médicos Ltda /ID# 143166
- CCBR Brasil /ID# 150925
- MHAT Trimontsium /ID# 143173
- UMHAT Pulmed OOD /ID# 143176
- MHAT Kaspela /ID# 143172
- Diagnostic Consultative Center /ID# 143174
- UMHAT Sv. Ivan Rilski /ID# 143175
- Rheumatology Research Assoc /ID# 143206
- Manitoba Clinic /ID# 143203
- Ciads /Id# 143205
- CA Ctr for Clin Trials CCCT /ID# 159080
- Ctr. de Rheum de l'est du QC /ID# 151317
- Ctr de Inv Clinica del Sur /ID# 143208
- Someal /Id# 143207
- Quantum Research LTDA. /ID# 143210
- Quantum Research Stgo. /ID# 145651
- Soc. de Prestaciones medicas y Paramedicas Goecke /ID# 143209
- Investigaciones Medicas SSMSO /ID# 151685
- Centro de Estudios Clinicos Qu /ID# 152913
- 1st Aff Hosp of Bengbu Med Col /ID# 162974
- The 1st Aff Hosp Xiamen Univ /ID# 162076
- 1st Aff Hosp of Shantou Univ /ID# 162968
- Centro de Investigacion en Reumatologia y Especialidades Medicas- CIREEM SAS /ID# 143214
- Ctr Int de Reum del Caribe SAS /ID# 143211
- Riesgo de Fractura S.A - CAYRE /ID# 143212
- Simedics IPS SAS /ID# 152572
- Fund Inst de Reum F. Chalem /ID# 159544
- Medicity S.A.S. /ID# 143213
- Klinicki bolnicki centar Split /ID# 143216
- Clinical Hospital Dubrava /ID# 143217
- Medical Center Kuna-Peric /ID# 143218
- Poliklinika Bonifarm /ID# 143215
- L.K.N. Arthrocentrum, s.r.o /ID# 143224
- CTCenter MaVe, s.r.o. /ID# 143226
- Nuselská poliklinika, Revmatologie /ID# 143232
- Nuselská poliklinika, Revmatologie /ID# 143233
- Thomayerova nemocnice /ID# 143228
- PV MEDICAL Services s.r.o. /ID# 143234
- RHEUMA s.r.o. /ID# 143230
- Revmatologie, s.r.o. /ID# 143223
- Revmatologie Bruntal, s.r.o /ID# 143220
- Nemocnice Slany /ID# 143221
- Medical Plus, s.r.o. /ID# 143219
- Center of Clinical and Basic Research /ID# 143239
- Paernu Hospital /ID# 143238
- East Tallinn Central Hospital /ID# 143240
- North Estonian Medical Centre /ID# 145456
- Rheumazentrum Ruhrgebiet /ID# 145652
- Uniklinik Koln /ID# 143248
- Praxis Walter, Rendsburg /ID# 143250
- Rheumaforschungszentrum II /ID# 143247
- Schoen Klinikum Hamburg Eilbek /ID# 143251
- LMU Klinikum der Universität München /ID# 143249
- University General Hospital Attikon /ID# 143252
- Clinicas Hospital Herrera Ller /ID# 153715
- Creer /Id# 153713
- Clin Especializada Med Interna /ID# 153716
- Clinica Medica Reumatologia /ID# 153714
- Clinica Medica Reumatologia /ID# 153931
- Queen Mary Hospital /ID# 143255
- Tuen Mun Hospital /ID# 143256
- CRU Hungary Egeszsegugyi és Szolgaltato Kft. /ID# 143258
- Qualiclinic Kft. /ID# 143259
- Markusovszky Egyetemi Oktatókórház /ID# 143261
- Hevizgyogyfurdo es Szent Andra /ID# 143257
- Pest Megyei Flor Ferenc Korhaz /ID# 143260
- Fejer Megyei Szent Gyorgy Korh /ID# 144724
- St Vincent's University Hosp /ID# 143262
- Barzilai Medical Center /ID# 144725
- Rambam Health Care Campus /ID# 143263
- Sheba Medical Center /ID# 145975
- Istituto Clinico Humanitas /ID# 147531
- Azienda Ospedaliera Luigi Sacc /ID# 143270
- Fondazione IRCCS Policlinico /ID# 143265
- A.O.U.I. di Verona Policlinico /ID# 143266
- Nagoya University Hospital /ID# 148031
- NHO Toyohashi Medical Center /ID# 161033
- Teikyo University Chiba Medical Center /ID# 159618
- NHO Kyushu Medical Center /ID# 148263
- NHO Kyushu Medical Center /ID# 148264
- National Hospital Organization Asahikawa Medical Center /ID# 148021
- Katayama Orthopedic Rheumatology Clinic /ID# 148029
- Kobe University Hospital /ID# 153461
- National Hospital Organization Sagamihara National Hospital /ID# 148019
- NHO Osaka Minami Med Ctr /ID# 148042
- Bay Side Misato Medical Center /ID# 148256
- Center for Arthritis and Clinical Rheumatology Matsubara Clinic /ID# 148254
- Kumamoto Orthopaedic Hospital /ID# 148054
- Kumamoto Shinto General Hospital /ID# 148266
- Sasebo Chuo Hospital /ID# 148261
- Nagaoka Red Cross Hospital /ID# 148018
- Japanese Red Cross Okayama Hospital /ID# 159619
- Kansai Medical University Hospital /ID# 159622
- Osaka Medical College Hospital /ID# 159624
- Saitama Medical Center, Saitama Medical University /ID# 148015
- Jichi Medical University Hospital /ID# 159620
- Juntendo University Hospital /ID# 148050
- St.Luke's International Hospital /ID# 148041
- Toho University Ohashi Medical Center /ID# 148027
- Keio University Hospital /ID# 148057
- Tokito Clinic Rheumatology and Orthopaedics Surgery /ID# 148052
- National Hospital Organization Beppu Medical Center /ID# 161058
- NHO Chiba-East-Hospital /ID# 148035
- Sugimoto Rheumatology and Internal Medicine Clinic /ID# 148047
- Shono Rheumatism Clinic /ID# 148046
- Matsubara Mayflower Hospital /ID# 148033
- St. Mary's Hospital /ID# 148038
- Kagawa University Hospital /ID# 148016
- Yu Family Clinic /ID# 148048
- Daido Hospital /ID# 160868
- Kondo Clinic for Ortho & Rheum /ID# 148032
- Shirahama Hamayu Hospital /ID# 148253
- Oribe Clinic of Rheumatology and Internal Medicine /ID# 156035
- Osaka City General Hospital /ID# 159617
- Sanuki Municipal Hospital /ID# 158842
- Sagawa Akira Rheumatology Clin /ID# 148043
- Sapporo City General Hospital /ID# 148037
- Hokkaido University Hospital /ID# 148262
- Hokkaido Medical Center for Rheumatic Diseases /ID# 148259
- Azuma Rheumatology Clinic /ID# 161050
- Hikarigaoka Spellman Hospital /ID# 148020
- Takaoka Rheumatic Orthopedic Clinic /ID# 148022
- National Hospital Organization Tokyo Medical Center /ID# 148040
- National Hospital Organization Shimoshizu National Hospital /ID# 148258
- JSC Nat Scientific Med Res Ctr /ID# 143272
- Karaganda State Medical Univ /ID# 153431
- Semey State Medical University /ID# 152661
- Regional Clinical Hospital /ID# 147173
- LTD M+M Centers /ID# 143279
- Hosp Lithuanian Univ Health Sc /ID# 143582
- Klaipeda University Hospital /ID# 143583
- Vilnius University Hospital /ID# 143584
- Clinstile, S.A. de C.V. /ID# 143591
- CINTRE, Centro de Investigación y Tratamiento Reumatológico SC /ID# 153562
- Invest y Biomed de Chihuahua /ID# 143595
- RM Pharma Specialists, S.A de C.V /ID# 143593
- Unidad de Investigacion de las Enfermedades Reumatologicas SA de CV /ID# 143592
- Centro Especializado en Diabetes, Obesidad y Prevención de Enfermedades Cardiova /ID# 143589
- Centro Reumatologico de Queret /ID# 149493
- Waikato Hospital /ID# 143602
- Middlemore Clinical Trials /ID# 143600
- Porter Rheumatology Ltd /ID# 143601
- Timaru Medical Specialists Ltd /ID# 143599
- WroMedica I. Bielicka, A. Strzalkowska s.c. /ID# 143606
- Centrum Medyczne AMED /ID# 143604
- Centrum Medyczne Pratia Warszawa /ID# 143608
- Centrum Medyczne Pratia Gdynia /ID# 143607
- Silmedic Sp z o.o /ID# 143605
- NZOZ Centrum Reumatologiczne /ID# 143603
- Medyczne Centrum Hetmanska /ID# 144726
- Instituto Portugues De Reumatologia /ID# 148313
- Centro Hospitalar Lisboa Ocidental, EPE /ID# 151009
- Centro Hospitalar De Vila Nova /ID# 143615
- Centro Hospitalar Lisboa Norte, EPE /ID# 143613
- Centro Hospitalar Baixo Vouga /ID# 153726
- Centro Hospitalar de Sao Joao, EPE /ID# 153575
- Unidade Local De Saude Do Alto Minho /ID# 143611
- Centro Hosp de Tondela-Viseu /ID# 143612
- Ponce School of Medicine /ID# 145657
- GCM Medical Group /ID# 143618
- School of Medicine University of Puerto Rico-Medical Sciences Campus /ID# 143619
- Spitalul Clinic Dr. I. Cantacuzino /ID# 143622
- Spitalul Clinic Sf. Maria /ID# 143623
- Spitalul Clinic Sf. Maria /ID# 143625
- Spitalul Clinic Sf. Maria /ID# 143627
- Spitalul Clinic de Recuperare /ID# 143620
- Ecomed SRL /ID# 143629
- Family Outpatient clinic#4,LLC /ID# 151010
- Clinical Hospital No.1 n.a. N.I.Pirogov /ID# 143641
- LLC Medical Center /ID# 143647
- LLC Novaya Klinika /ID# 143631
- Kazan State Medical University /ID# 143645
- Tver Regional Clinical Hosp. /ID# 143639
- Russian National Research Medi /ID# 143642
- Orenburg Regional Clinical Hos /ID# 143630
- Republican Clin Hos n.a. Baran /ID# 143634
- Ryazan State Medical Universit /ID# 143646
- Samara Regional Clinical Hosp /ID# 150928
- Reg Clin Hosp n.a. Kuvatova G. /ID# 143632
- Ulyanovsk Regional Clin Hosp /ID# 143644
- Voronezh State Medical Univers /ID# 150926
- Clinical Center Serbia /ID# 143649
- Clinical Center Serbia /ID# 143650
- Special Hospital for Rheuma /ID# 143648
- MEDMAN s.r.o. /ID# 143661
- Reumatologická ambulancia Reum.hapi s.r.o. /ID# 143657
- REUMACENTRUM s.r.o. /ID# 143653
- Slovak research center Team Member, Thermium s.r.o. /ID# 143663
- Slovak Research Center /ID# 143659
- TIMMED spol. s r.o. /ID# 143664
- Reumatologicka ambulancia, LER /ID# 143660
- MEDEOS s.r.o. /ID# 143656
- REUMA-GLOBAL, s.r.o. /ID# 143655
- ALBAMED s.r.o. /ID# 143654
- Reuma -MUDr. Maria Palasthyova /ID# 143662
- Univ Medical Ctr Ljubljana /ID# 143667
- Jakaranda Hosp, Emmed Research /ID# 143668
- Jakaranda Hosp, Emmed Research /ID# 145976
- Arthritis Clinical Research Tr /ID# 143670
- Winelands Medical Research Ctr /ID# 143669
- H. Un. Marques de Valdecilla /ID# 143671
- Comple Hosp Univ de A Coruna /ID# 143672
- Hospital Univ Vall d'Hebron /ID# 143675
- Hospital Clin Univ San Carlos /ID# 143674
- Clinica Gaias /ID# 143673
- Hosp Nuestra Senora Esperanza /ID# 143677
- HFR Fribourg - Hopital Canton /ID# 143700
- China Medical University Hosp /ID# 143703
- National Taiwan Univ Hosp /ID# 143702
- Dalin Tzu Chi General Hospital /ID# 153535
- Hopital Mongi Slim /ID# 152870
- Institut Mohamed Kassab /ID# 152869
- Hopital Farhat Hached /ID# 152868
- Charles Nicolle Univ Hosp /ID# 152866
- Hospital La Rabta /ID# 152867
- Uludag Universitesi Ataturk Rehabilitasyon ve Uygulama Merkezi /ID# 143705
- Izmir Tepecik Training and Research Hospital /ID# 157863
- Izmir Katip Celebi Ataturk Training & Research Hospital /ID# 143704
- Lviv Regional Clinical Hospita /ID# 154449
- Vinnytsia Regional Clinical Hospital n.a. M.I.Pyrogov /ID# 143714
- Regional Clinical Hospital /ID# 152029
- NSC-Strazhesko Ist Cardiology /ID# 152026
- LLC Revmocentr /ID# 143710
- MNCE "Lviv City Clinical Hospital #4" /ID# 143711
- Odessa National Medical Univ /ID# 143715
- Zaporizhzhia Regional Clinical /ID# 143712
- Leicester Royal Infirmary /ID# 143718
- Whipps Cross Univ Hospital /ID# 143721
- Western General Hospital /ID# 144431
- Chapel Allerton Hospital /ID# 143717
- Queen Alexandra Hospital /ID# 143722
- Southampton General Hospital /ID# 143716
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Active Comparator
Experimental
Experimental
Experimental
Methotrexate
Upadacitinib 7.5 mg (Japan-only)
Upadacitinib 15 mg
Upadacitinib 30 mg
Period 1: Participants will receive placebo to upadacitinib once daily and methotrexate once weekly for 48 weeks. Period 2: Participants will continue on placebo to upadacitinib once daily and methotrexate once weekly until the study is unblinded, after which participants will receive open-label methotrexate up to Week 260.
Period 1: Participants will receive upadacitinib 7.5 mg once daily and placebo to methotrexate once weekly for 48 weeks. Period 2: Participants will continue on upadacitinib 7.5 mg once daily and placebo to methotrexate once weekly until the study is unblinded, after which participants will receive open-label upadacitinib 7.5 mg up to Week 260.
Period 1: Participants will receive upadacitinib 15 mg once daily and placebo to methotrexate once weekly for 48 weeks. Period 2: Participants will continue on upadacitinib 15 mg once daily and placebo to methotrexate once weekly until the study is unblinded, after which participants will receive open-label upadacitinib 15 mg up to Week 260.
Period 1: Participants will receive upadacitinib 30 mg once daily and placebo to methotrexate once weekly for 48 weeks. Period 2: Participants will continue on upadacitinib 30 mg once daily and placebo to methotrexate once weekly until the study is unblinded, after which participants will receive open-label upadacitinib 30 mg once daily. After implementation of Protocol Amendment 6 participants will receive upadacitinib 15 mg once daily up to Week 260.