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A Study of Subcutaneously Administered Tocilizumab in Participants With Systemic Juvenile Idiopathic Arthritis

Primary Purpose

Juvenile Idiopathic Arthritis

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
Tocilizumab
Sponsored by
Hoffmann-La Roche
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Juvenile Idiopathic Arthritis

Eligibility Criteria

1 Year - 17 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Diagnosis of sJIA according to the International League of Associations for Rheumatology (ILAR) classification
  • History of inadequate clinical response (in the opinion of the treating physician) to Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and corticosteroids
  • If a participant has received previous treatment with any biologic agents other than tocilizumab, these must have been discontinued according to the timelines defined by protocol prior to the baseline visit
  • Participants currently receiving tocilizumab by the intravenous (IV) route of administration and with well-controlled disease do not require a period of discontinuation of IV tocilizumab and should have their first dose of SC tocilizumab administered on the date that their next IV tocilizumab infusion would be due
  • Concurrent treatment with Disease Modifying Anti-Rheumatic Drugs (DMARDs) including methotrexate (MTX), NSAIDs, and oral corticosteroids are permitted at the discretion of the investigator
  • Participants of reproductive potential must be willing to use highly effective contraceptive methods

Exclusion Criteria:

  • Prior discontinuation of IV tocilizumab because of inadequate clinical response or safety events (including hypersensitivity)
  • Participants with poorly controlled disease (in the opinion of the treating physician) despite current treatment with IV tocilizumab
  • sJIA that is well controlled by any treatment agent other than tocilizumab (Juvenile Arthritis Disease Activity Score of 71 Joints [JADAS-71] less than or equal to [<=] 3.8 with no fever)
  • Participants who are wheelchair-bound or bedridden
  • Any other auto-immune, rheumatic disease, or overlapping syndrome other than sJIA
  • Lack of recovery from recent surgery or an interval of <6 weeks since surgery at the time of the screening visit
  • Females who are pregnant, lactating, or intending to become pregnant during study conduct
  • Any significant concurrent medical or surgical condition that would jeopardize the participant's safety or ability to complete the study
  • Known Human Immunodeficiency Virus (HIV) infection or other acquired forms of immune compromise or inborn conditions characterized by a compromised immune system
  • History of alcohol, drug, or chemical abuse within 6 months of screening
  • Any active acute, subacute, chronic, or recurrent bacterial, viral, or systemic fungal infection or any major episode of infection requiring hospitalization or treatment during screening or treatment with IV antibiotics completed within 4 weeks of the screening visit or oral antibiotics completed within 2 weeks of the screening visit
  • History of atypical tuberculosis (TB) or active TB requiring treatment within 2 years prior to screening visit
  • Positive TB test at screening unless treated with anti-TB therapy for at least 4 weeks prior to receiving study drug
  • History of reactivation or new onset of a systemic infection such as herpes zoster or Epstein-Barr virus within 2 months of the screening visit
  • Hepatitis B surface antigen or hepatitis C antibody positivity or chronic viral or autoimmune hepatitis
  • History of concurrent serious gastrointestinal disorders such as ulcer or inflammatory bowel disease, Crohn's disease, ulcerative colitis, or other symptomatic lower gastrointestinal conditions
  • History of or current cancer or lymphoma
  • Uncontrolled diabetes mellitus with elevated glycosylated hemoglobin
  • Macrophage activation syndrome (MAS) within 3 months of the screening visit
  • Inadequate hematologic, renal or liver function

Sites / Locations

  • Arkansas Children's Hospital Research Institute
  • Connecticut Children's Medical Center; 5E Clinical Trials Unit
  • Ann & Robert H. Lurie Children's Hospital of Chicago; Division of Rheumatology
  • The University of Chicago;Department of Pediatrics
  • Hackensack University Medical Center; Pediatric Rheumatology
  • Levine Children's Hospital; Divison of Pediatric Rheumatology; Department of Pediatrics
  • Duke University
  • Cincinnati Children'S Hospital Medical Center; Division of Rheumatology
  • Cleveland Clinic Fndn
  • University of Utah; Immunology/Rheumatology/Allergy
  • Seattle Children's Hospital
  • Hospital Gral de Niños Pedro Elizalde
  • Hospital de Ninos de la Santisima Trinidad; Reumatologia Infantil
  • Westmead Hospital; Paediatric Rheumatology
  • Royal Children'S Hospital; Paediatric Rheumatology
  • Hospital das Clinicas - FMUSP Ribeirao Preto; Pediatria - Imunologia e Reumatologia
  • Hospital das Clinicas - FMUSP; Instituto da Crianca - Reumatologia
  • Universidade Federal de Sao Paulo - UNIFESP
  • Alberta Children'S Hospital
  • Children'S Hospital of Eastern Ontario
  • Hospital For Sick Children
  • CH de Bicêtre; Pediatrie Generale
  • Charité Campus; Virchow Klinikum Berlin
  • Uniklinikum Freiburg Zentrum für Kinder- und Jugendmedizin; Pädiatrische Infektio- u. Rheumatologie
  • Asklepios Klinik; Zentrum fuer Allgemeine Paediatrie und Neonatologie
  • Irccs Ospedale Pediatrico Bambin Gesu - Dip. Di Medicina
  • Istituto Giannina Gaslini-Ospedale Pediatrico IRCCS
  • Nuovo Ospedale Pediatrico Meyer; Reumatologia - Clinica Pediatrica 1°
  • Hospital Infantil de México "Federico Gomez"; Rheumatology
  • Cliditer SA de CV
  • Hospital Universitario Dr. Jose Eleuterio Gonzalez; Pediatria
  • FSBI "Scientific Research Institute of Rheumatology" of russian Academy of Medical Sciences
  • SI Sceintific children health center RAMS
  • Hospital Sant Joan De Deu; Servicio de Reumatologia Pediatrica
  • Hospital Infantil Universitario Niño Jesus, Servicio Reumatologia
  • Hospital Ramon y Cajal ; Servicio de Reumatologia
  • Hospital de La Paz; Unidad de Reumatologia Pediatrica
  • Hospital Universitario la Fe: Servicio de Reumatologia Pediatrica
  • Bristol Royal Hospital For Children
  • Alder Hey Children's NHS Foundation Trust
  • Great Ormond Street Hospital; Somers Clinical Research Facility
  • Nottingham Children's Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Tocilizumab

Arm Description

Participants will receive SC dose of tocilizumab based on body weight; participants with <30 kg will receive 162 milligrams (mg) of tocilizumab Q2W and those participants =>30 kg will receive 162 mg of tocilizumab QW, for 52 weeks.

Outcomes

Primary Outcome Measures

Pharmacokinetics: Area Under the Concentration-Time Curve (AUC) of Tocilizumab
Pharmacokinetics: Maximum Plasma Concentration (Cmax) of Tocilizumab
Pharmacokinetics: Minimum Plasma Concentration (Cmin) of Tocilizumab

Secondary Outcome Measures

Pharmacodynamics: Serum Interleukin-6 (IL6) Levels
Pharmacodynamics: Soluble IL-6 Receptor (sIL-6R) Levels
Pharmacodynamics: Serum C-Reactive Protein (CRP) Levels
Pharmacodynamics: Serum Erythrocyte Sedimentation Rate (ESR)
Pharmacodynamics: Percentage of Participants with Anti-Tocilizumab Antibodies
Safety: Percentage of Participants with At Least 1 Adverse Event

Full Information

First Posted
June 14, 2013
Last Updated
November 16, 2017
Sponsor
Hoffmann-La Roche
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1. Study Identification

Unique Protocol Identification Number
NCT01904292
Brief Title
A Study of Subcutaneously Administered Tocilizumab in Participants With Systemic Juvenile Idiopathic Arthritis
Official Title
A Phase Ib, Open-Label, Multicenter Study to Investigate the Pharmacokinetics, Pharmacodynamics, and Safety of Tocilizumab Following Subcutaneous Administration to Patients With Systemic Juvenile Idiopathic Arthritis
Study Type
Interventional

2. Study Status

Record Verification Date
November 2017
Overall Recruitment Status
Completed
Study Start Date
August 15, 2013 (Actual)
Primary Completion Date
June 13, 2017 (Actual)
Study Completion Date
June 13, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Hoffmann-La Roche

4. Oversight

5. Study Description

Brief Summary
This open-label, multicenter study will evaluate the pharmacokinetics, pharmacodynamics, and safety of subcutaneously administered tocilizumab in participants with Systemic Juvenile Idiopathic Arthritis (sJIA). Participants with body weight less than (<) 30 kilograms (kg) will receive subcutaneous (SC) tocilizumab dose every 2 weeks (Q2W) and participants with body weight greater than or equal to (>=) 30 kg will receive weekly (QW), for 52 weeks. Tocilizumab was administered every 10 days until pre-planned interim analysis was performed and changed to Q2W in participants with body weight <30 kg.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Juvenile Idiopathic Arthritis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
52 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Tocilizumab
Arm Type
Experimental
Arm Description
Participants will receive SC dose of tocilizumab based on body weight; participants with <30 kg will receive 162 milligrams (mg) of tocilizumab Q2W and those participants =>30 kg will receive 162 mg of tocilizumab QW, for 52 weeks.
Intervention Type
Drug
Intervention Name(s)
Tocilizumab
Other Intervention Name(s)
RoActemra/Actemra
Intervention Description
Subcutaneous 162 mg dose QW or Q2W for 52 weeks
Primary Outcome Measure Information:
Title
Pharmacokinetics: Area Under the Concentration-Time Curve (AUC) of Tocilizumab
Time Frame
Age <2 years: 0 hours(h) on Days(D) 0,84; on D5,14,42,70,85,88,98,182,266, 364. Weight <30kg, Age>=2 years: 0,6,12h on D0,84; on D2,5,14,42,56,70,86,87,88,90,98,182,266,364. Weight >=30kg: 0,6,12h on D0, 91; on D2,4,7,14,28,56,92,93,95,96,98,182,266, 364
Title
Pharmacokinetics: Maximum Plasma Concentration (Cmax) of Tocilizumab
Time Frame
Age <2 years: 0h on D0,84; on D5,14,42,70,85,88,98,182,266,364. Weight <30 kg, Age >=2 years: 0,6,12h on D0,84; on D2,5,14,42,56,70,86,87,88,90,98,182,266,364. Weight >=30 kg: 0,6,12h on D0, 91; on D2,4,7,14,28,56,92,93,95,96,98,182,266,364
Title
Pharmacokinetics: Minimum Plasma Concentration (Cmin) of Tocilizumab
Time Frame
Weight <30 kg: predose (0h) on Days 0 and 84. Weight >= 30 kg: predose (0h) on Days 0 and 91
Secondary Outcome Measure Information:
Title
Pharmacodynamics: Serum Interleukin-6 (IL6) Levels
Time Frame
Age<2 years: 0h on Days 0,84; Days 5,14,42,70,85,88,98,182,266,364. Weight <30 kg, Age >=2 years: 0,6,12h on Days 0,84; Days 2,5,14,42,56,70,86,87,88,90,98,182,266,364. Weight >=30kg: 0,6,12h on Days 0,91;Days 2,4,7,14,28,56,92,93,95,96,98,182,266,364
Title
Pharmacodynamics: Soluble IL-6 Receptor (sIL-6R) Levels
Time Frame
Age<2 years: 0h on Days 0,84; Days 5,14,42,70,85,88,98,182,266,364. Weight <30 kg, Age >=2 years: 0,6,12h on Days 0,84; Days 2,5,14,42,56,70,86,87,88,90,98,182,266,364. Weight >=30kg: 0,6,12h on Days 0,91;Days 2,4,7,14,28,56,92,93,95,96,98,182,266,364
Title
Pharmacodynamics: Serum C-Reactive Protein (CRP) Levels
Time Frame
Age <2years: Days 0,14,28,42,70,84,98,126, 154,182,210,238,266,294,322,350,364. Weight <30 kg, Age >=2years: Days 0,14,28,42,70, 98,126,154,182,210,238,266,294,322,350,364. Weight >=30kg: Days 0,7,14,21,28,42, 56,70,84,91,95,96,98,182,266,294,322,350,364
Title
Pharmacodynamics: Serum Erythrocyte Sedimentation Rate (ESR)
Time Frame
Age <2years: Days 0,14,28,42,70,84,98,126, 154,182,210,238,266,294,322,350,364. Weight <30 kg, Age >=2years: Days 0,14,28,42,70, 98,126,154,182,210,238,266,294,322,350,364. Weight >=30kg: Days 0,7,14,21,28,42, 56,70,84,91,95,96,98,182,266,294,322,350,364
Title
Pharmacodynamics: Percentage of Participants with Anti-Tocilizumab Antibodies
Time Frame
Age <2 years: Days 0, 84, 182, 266, 364. Weight <30 kg, Age >=2 years: Days 0, 84, 182, 266, 364. Weight >=30 kg: Days 0, 91, 182, 266, 364
Title
Safety: Percentage of Participants with At Least 1 Adverse Event
Time Frame
57 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
1 Year
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnosis of sJIA according to the International League of Associations for Rheumatology (ILAR) classification History of inadequate clinical response (in the opinion of the treating physician) to Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and corticosteroids If a participant has received previous treatment with any biologic agents other than tocilizumab, these must have been discontinued according to the timelines defined by protocol prior to the baseline visit Participants currently receiving tocilizumab by the intravenous (IV) route of administration and with well-controlled disease do not require a period of discontinuation of IV tocilizumab and should have their first dose of SC tocilizumab administered on the date that their next IV tocilizumab infusion would be due Concurrent treatment with Disease Modifying Anti-Rheumatic Drugs (DMARDs) including methotrexate (MTX), NSAIDs, and oral corticosteroids are permitted at the discretion of the investigator Participants of reproductive potential must be willing to use highly effective contraceptive methods Exclusion Criteria: Prior discontinuation of IV tocilizumab because of inadequate clinical response or safety events (including hypersensitivity) Participants with poorly controlled disease (in the opinion of the treating physician) despite current treatment with IV tocilizumab sJIA that is well controlled by any treatment agent other than tocilizumab (Juvenile Arthritis Disease Activity Score of 71 Joints [JADAS-71] less than or equal to [<=] 3.8 with no fever) Participants who are wheelchair-bound or bedridden Any other auto-immune, rheumatic disease, or overlapping syndrome other than sJIA Lack of recovery from recent surgery or an interval of <6 weeks since surgery at the time of the screening visit Females who are pregnant, lactating, or intending to become pregnant during study conduct Any significant concurrent medical or surgical condition that would jeopardize the participant's safety or ability to complete the study Known Human Immunodeficiency Virus (HIV) infection or other acquired forms of immune compromise or inborn conditions characterized by a compromised immune system History of alcohol, drug, or chemical abuse within 6 months of screening Any active acute, subacute, chronic, or recurrent bacterial, viral, or systemic fungal infection or any major episode of infection requiring hospitalization or treatment during screening or treatment with IV antibiotics completed within 4 weeks of the screening visit or oral antibiotics completed within 2 weeks of the screening visit History of atypical tuberculosis (TB) or active TB requiring treatment within 2 years prior to screening visit Positive TB test at screening unless treated with anti-TB therapy for at least 4 weeks prior to receiving study drug History of reactivation or new onset of a systemic infection such as herpes zoster or Epstein-Barr virus within 2 months of the screening visit Hepatitis B surface antigen or hepatitis C antibody positivity or chronic viral or autoimmune hepatitis History of concurrent serious gastrointestinal disorders such as ulcer or inflammatory bowel disease, Crohn's disease, ulcerative colitis, or other symptomatic lower gastrointestinal conditions History of or current cancer or lymphoma Uncontrolled diabetes mellitus with elevated glycosylated hemoglobin Macrophage activation syndrome (MAS) within 3 months of the screening visit Inadequate hematologic, renal or liver function
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Clinical Trials
Organizational Affiliation
Hoffmann-La Roche
Official's Role
Study Director
Facility Information:
Facility Name
Arkansas Children's Hospital Research Institute
City
Little Rock
State/Province
Arkansas
ZIP/Postal Code
72202
Country
United States
Facility Name
Connecticut Children's Medical Center; 5E Clinical Trials Unit
City
Hartford
State/Province
Connecticut
ZIP/Postal Code
06106
Country
United States
Facility Name
Ann & Robert H. Lurie Children's Hospital of Chicago; Division of Rheumatology
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
The University of Chicago;Department of Pediatrics
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60649
Country
United States
Facility Name
Hackensack University Medical Center; Pediatric Rheumatology
City
Hackensack
State/Province
New Jersey
ZIP/Postal Code
07601
Country
United States
Facility Name
Levine Children's Hospital; Divison of Pediatric Rheumatology; Department of Pediatrics
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28203
Country
United States
Facility Name
Duke University
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27710
Country
United States
Facility Name
Cincinnati Children'S Hospital Medical Center; Division of Rheumatology
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45229-3039
Country
United States
Facility Name
Cleveland Clinic Fndn
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
University of Utah; Immunology/Rheumatology/Allergy
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84109
Country
United States
Facility Name
Seattle Children's Hospital
City
Seattle
State/Province
Washington
ZIP/Postal Code
98105
Country
United States
Facility Name
Hospital Gral de Niños Pedro Elizalde
City
Buenos Aires
ZIP/Postal Code
1270
Country
Argentina
Facility Name
Hospital de Ninos de la Santisima Trinidad; Reumatologia Infantil
City
Cordoba
ZIP/Postal Code
5000
Country
Argentina
Facility Name
Westmead Hospital; Paediatric Rheumatology
City
Westmead
State/Province
New South Wales
ZIP/Postal Code
2145
Country
Australia
Facility Name
Royal Children'S Hospital; Paediatric Rheumatology
City
Parkville
State/Province
Victoria
ZIP/Postal Code
3052
Country
Australia
Facility Name
Hospital das Clinicas - FMUSP Ribeirao Preto; Pediatria - Imunologia e Reumatologia
City
Ribeirao preto.
State/Province
SP
ZIP/Postal Code
14048-900
Country
Brazil
Facility Name
Hospital das Clinicas - FMUSP; Instituto da Crianca - Reumatologia
City
Sao Paulo
State/Province
SP
ZIP/Postal Code
05403-000
Country
Brazil
Facility Name
Universidade Federal de Sao Paulo - UNIFESP
City
Sao Paulo
State/Province
SP
ZIP/Postal Code
22793-080
Country
Brazil
Facility Name
Alberta Children'S Hospital
City
Calgary
State/Province
Alberta
ZIP/Postal Code
T3B 6A8
Country
Canada
Facility Name
Children'S Hospital of Eastern Ontario
City
Ottawa
State/Province
Ontario
ZIP/Postal Code
K1H 8L1
Country
Canada
Facility Name
Hospital For Sick Children
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 1X8
Country
Canada
Facility Name
CH de Bicêtre; Pediatrie Generale
City
Le Kremlin Bicêtre
ZIP/Postal Code
94275
Country
France
Facility Name
Charité Campus; Virchow Klinikum Berlin
City
Berlin
ZIP/Postal Code
13353
Country
Germany
Facility Name
Uniklinikum Freiburg Zentrum für Kinder- und Jugendmedizin; Pädiatrische Infektio- u. Rheumatologie
City
Freiburg
ZIP/Postal Code
79106
Country
Germany
Facility Name
Asklepios Klinik; Zentrum fuer Allgemeine Paediatrie und Neonatologie
City
Sankt Augustin
ZIP/Postal Code
53757
Country
Germany
Facility Name
Irccs Ospedale Pediatrico Bambin Gesu - Dip. Di Medicina
City
Roma
State/Province
Lazio
ZIP/Postal Code
00165
Country
Italy
Facility Name
Istituto Giannina Gaslini-Ospedale Pediatrico IRCCS
City
Genova
State/Province
Liguria
ZIP/Postal Code
16147
Country
Italy
Facility Name
Nuovo Ospedale Pediatrico Meyer; Reumatologia - Clinica Pediatrica 1°
City
Firenze
State/Province
Toscana
ZIP/Postal Code
50139
Country
Italy
Facility Name
Hospital Infantil de México "Federico Gomez"; Rheumatology
City
Mexico
ZIP/Postal Code
06720
Country
Mexico
Facility Name
Cliditer SA de CV
City
Miexico City
ZIP/Postal Code
06700
Country
Mexico
Facility Name
Hospital Universitario Dr. Jose Eleuterio Gonzalez; Pediatria
City
Monterrey
ZIP/Postal Code
64460
Country
Mexico
Facility Name
FSBI "Scientific Research Institute of Rheumatology" of russian Academy of Medical Sciences
City
Moscow
ZIP/Postal Code
115522
Country
Russian Federation
Facility Name
SI Sceintific children health center RAMS
City
Moscow
ZIP/Postal Code
119991
Country
Russian Federation
Facility Name
Hospital Sant Joan De Deu; Servicio de Reumatologia Pediatrica
City
Esplugas DE Llobregat
State/Province
Barcelona
ZIP/Postal Code
08950
Country
Spain
Facility Name
Hospital Infantil Universitario Niño Jesus, Servicio Reumatologia
City
Madrid
ZIP/Postal Code
28009
Country
Spain
Facility Name
Hospital Ramon y Cajal ; Servicio de Reumatologia
City
Madrid
ZIP/Postal Code
28034
Country
Spain
Facility Name
Hospital de La Paz; Unidad de Reumatologia Pediatrica
City
Madrid
ZIP/Postal Code
28046
Country
Spain
Facility Name
Hospital Universitario la Fe: Servicio de Reumatologia Pediatrica
City
Valencia
ZIP/Postal Code
46026
Country
Spain
Facility Name
Bristol Royal Hospital For Children
City
Bristol
ZIP/Postal Code
BS2 8BJ
Country
United Kingdom
Facility Name
Alder Hey Children's NHS Foundation Trust
City
Liverpool
ZIP/Postal Code
L12 2AP
Country
United Kingdom
Facility Name
Great Ormond Street Hospital; Somers Clinical Research Facility
City
London
ZIP/Postal Code
WC1N 3JH
Country
United Kingdom
Facility Name
Nottingham Children's Hospital
City
Nottingham
ZIP/Postal Code
NG7 2UH
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
33506875
Citation
Ruperto N, Brunner HI, Ramanan AV, Horneff G, Cuttica R, Henrickson M, Anton J, Boteanu AL, Penades IC, Minden K, Schmeling H, Hufnagel M, Weiss JE, Pardeo M, Nanda K, Roth J, Rubio-Perez N, Hsu JC, Wimalasundera S, Wells C, Bharucha K, Douglass W, Bao M, Mallalieu NL, Martini A, Lovell D, Benedetti F; Paediatric Rheumatology INternational Trials Organisation (PRINTO) and the Paediatric Rheumatology Collaborative Study Group (PRCSG). Subcutaneous dosing regimens of tocilizumab in children with systemic or polyarticular juvenile idiopathic arthritis. Rheumatology (Oxford). 2021 Oct 2;60(10):4568-4580. doi: 10.1093/rheumatology/keab047.
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A Study of Subcutaneously Administered Tocilizumab in Participants With Systemic Juvenile Idiopathic Arthritis

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