Ulcerative colitis (UC) is a type of inflammatory bowel disease that causes inflammation and bleeding from the lining of the rectum and colon (large intestine). This study will assess how safe and effective Upadacitinib is in treating pediatric participants with UC. Adverse events and change in disease activity will be assessed. Upadacitinib (RINVOQ) is a drug approved in adults for moderate- to severely active UC and is being developed for moderate- to severely active UC in pediatric participants. This study is conducted in 2 periods: Period 1 is comprised of two phases: an 8-week open-label induction phase which means that the study doctor and patients know that participants will receive UPA Dose-A (or the adult equivalent based on body weight) followed by a 44-week double-blind maintenance phase meaning that neither the participants nor the study doctors will know which dose of upadacitinib will be given(UPA Dose B or Dose C). Period 2 is a 260 week open-label extension (OLE) of Period 1. Approximately 110 pediatric participants with moderate to severely active UC will be enrolled at up to 100 sites worldwide. Participants will receive upadacitinib oral tablets once daily or oral solution twice daily at approximately the same time each day, with or without food. Participants will be followed up for 30 days after each phase (i.e. after induction, maintenance, OLE) and only if a participant doesn't continue into the next phase. There may be higher treatment burden for participants in this trial compared to their standard of care. Participants will attend regular visits during the study at a hospital or clinic. The effect of the treatment will be checked by medical assessments, blood tests, checking for side effects and completing questionnaires.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
122
Oral Solution/ Tablets
Phoenix Children's Hospital /ID# 250135
Phoenix, Arizona, United States
Arkansas Children's Hospital /ID# 250106
Little Rock, Arkansas, United States
Kindred Medical Institute - Corona /ID# 255484
Corona, California, United States
UCSF Benioff Children's Hospital - Oakland /ID# 255067
Oakland, California, United States
Lucile Packard Children's Hospital /ID# 258430
Palo Alto, California, United States
Percentage of Participants Achieving Adapted Mayo score (AMS) Clinical Remission (Period 1)
The Mayo score is a tool designed to measure disease activity for ulcerative colitis. The AMS is a composite of the following subscores: stool frequency subscore (SFS), rectal bleeding subscore (RBS) and endoscopy subscore (MES). AMS ranges from 0 to 9 where higher scores represent more severe disease. Clinical remission is defined as an AMS \< or = 2, with SFS \< or = 1 and not higher than baseline, RBS of 0, and MES \< or = 1.
Time frame: Week 8
Percentage of Participants Achieving AMS Clinical Remission Among Week 8 Responders per AMS (Period 1)
The Mayo score is a tool designed to measure disease activity for ulcerative colitis. AMS ranges from 0 to 9 where higher scores represent more severe disease. Clinical remission is defined as an AMS ≤ 2, with SFS ≤ 1 and not higher than Baseline, RBS of 0, and MES ≤ 1.
Time frame: Week 52
Percentage of Participants Achieving Endoscopic Improvement (Period 1)
Endoscopic Improvement is defined as MES \< or = 1.
Time frame: Week 8
Percentage of Participants Achieving Partial Mayo Score (PMS) Clinical Remission (Period 1)
The Mayo score is a tool designed to measure disease activity for ulcerative colitis. The PMS is a composite of the following subscores: SFS, RBS and physician's global assessment (PGA). The PMS ranges from 0 to 9 with higher scores representing more severe disease. PMS clinical remission is defined as a PMS \< or = 2 and no individual subscore \> 1.
Time frame: Week 8
Percentage of Participants Achieving AMS Clinical Response (Period 1)
The adapted mayo score (AMS) is a composite of the following subscores: SFS, RBS and MES. AMS clinical response is defined as decrease in AMS by \> or = 2 points and \> or = 30% from baseline with a decrease in RBS of \> or = 1 or an absolute RBS of 0 or 1.
Time frame: Week 8
Percentage of Participants Achieving Endoscopic Improvement Among Week 8 Responders per AMS (Period 1)
Endoscopic Improvement is defined as MES of \< or = 1. The AMS is a composite of the following subscores: SFS, RBS and MES.
Time frame: Week 52
Percentage of Participants Achieving PMS Clinical Remission Among Week 8 Responders per AMS (Period 1)
The Mayo score is a tool designed to measure disease activity for ulcerative colitis. The PMS ranges from 0 to 9 with higher scores representing more severe disease. PMS clinical remission is defined as a PMS \< or = 2 and no individual subscore \> 1. The AMS is a composite of the following subscores: SFS, RBS and MES.
Time frame: Week 52
Percentage of Participants Achieving AMS Clinical Response Among Week 8 Responders per AMS (Period 1)
The AMS is a composite of the following subscores: SFS, RBS and MES. AMS clinical response is defined as decrease in AMS by \> or = 2 points and \> or = 30% from baseline with a decrease in RBS of \> or = 1 or an absolute RBS of 0 or 1.
Time frame: Week 52
Percentage of Participants Achieving PMS Clinical Response Among Week 8 Clinical Responders per AMS (Period 1)
The AMS is a composite of the following subscores: SFS, RBS and endoscopy MES. PMS clinical response is defined as decrease in PMS by \> or = 2 points and \> or = 30% from baseline with a decrease in RBS \> or = 1 or an absolute RBS of 0 or 1.
Time frame: Week 52
Percentage of Participants Achieving Corticosteroid-Free AMS Clinical Remission Among Week 8 Responders per AMS (Period 1)
Corticosteroid-free AMS clinical remission is defined as being in AMS clinical remission and free of corticosteroids for \>= 90 days immediately preceeding the timepoint of endpoint assessment. The AMS is a composite of the following subscores: SFS, RBS and MES.
Time frame: Week 52
Percentage of Participants Achieving AMS Clinical Remission Among Week 8 Remitters per AMS (Period 1)
The AMS is a composite of the following subscores: SFS, RBS and MES. Adapted Mayo score ranges from 0 to 9 where higher scores represent more severe disease. Clinical remission is defined as an AMS \< or = 2, with SFS \< or = 1 and not higher than baseline, RBS of 0, and MES \< or = 1.
Time frame: Week 52
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Children's Hospital Colorado - Aurora /ID# 250110
Aurora, Colorado, United States
Nemours/Alfred duPont Hospital for Children /ID# 255483
Wilmington, Delaware, United States
Childrens Healthcare of Atlanta - Center for Advanced Pediatrics /ID# 255069
Atlanta, Georgia, United States
Ann & Robert H. Lurie Children's Hospital of Chicago /ID# 254505
Chicago, Illinois, United States
OSF St. Francis Medical Center /ID# 256968
Peoria, Illinois, United States
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