Clinical trial NCT02885181
Conditions: Rheumatoid Arthritis
Sponsor: Gilead Sciences
Start date: 2016-09-21; Completion date: 2017-09-20
Enrollment: 83 participants; Allocation: RANDOMIZED; Intervention model: PARALLEL

Brief summary:
The primary objective of this study is to evaluate the effect of GS-9876 versus placebo for the treatment of signs and symptoms of rheumatoid arthritis (RA) in participants with active RA as measured by change from baseline in Disease Activity Score for 28 joint count using C-reactive protein (CRP) (DAS28 (CRP)) at Week 12.

Detailed description:

Arms: arm 1: GS-9876 30 mg + filgotinib placebo for 12 weeks arm 2: GS-9876 10 mg + filgotinib placebo for 12 weeks arm 3: Filgotinib + GS-9876 placebo for 12 weeks arm 4: GS-9876 placebo + filgotinib placebo for 12 weeks
Interventions: intervention 1: GS-9876 intervention 2: Filgotinib intervention 3: GS-9876 placebo intervention 4: Filgotinib placebo intervention 5: Methotrexate
Intervention descriptions: intervention 1: One tablet administered orally once daily intervention 2: Two tablets administered orally once daily intervention 3: One tablet administered orally once daily intervention 4: Two tablets administered orally once daily intervention 5: Background therapy with methotrexate administered orally or parenterally once weekly

Protocol documents:
Prot_002.pdf: 
Study Title: 
Sponsor: 
INDNumber: 
EudraCT Number: 
Clinical Trials.gov 
Identifier: 
Indication: 
Protocol ID: 
~ GILEAU 
CLINICAL STUDY PROTOCOL 
A Randomized, Double-Blind, Placebo-Controlled, Multicenter, 
Phase 2 Proof-of-Concept Study to Evaluate Safety, Tolerability, and 
Efficacy of GS-9876 in Subjects with Active Rheumatoid Althritis on 
Backgrmmd Therapy with Methotrexate 
Gilead Sciences, Inc. 
333 Lakeside Drive 
Foster City, CA 94404 
IND 123903 
2016-001496-75 
TBD 
Rheumatoid Arthritis 
GS-US-379-1582 
Gilead Clinical 
Name: 
TomDoan 
Program Manager: 
Telephone: 
Gilead Medical 
Name: 
Monitor: 
Telephone: 
Fax: 
Mobile: 
Protocol Version/Date: 
Original: 
Amendment 1: 
Amendment 2: 
PPD 
Franziska Matzkies 
PPD 
PPD 
PPD 
08 April 2016 
27 Jlme 2016 
11 July 2016 
CONFIDENTIALITY STATEMENT 
The infonnation contained in this document, patticularly lmpublished data, is the property or 
under control of Gilead Sciences, Inc., and is provided to you in confidence as an investigator, 
potential investigator, or consultant, for review by you, your staff, and an applicable Institutional 
Review Board or Independent Ethics Committee. The infonnation is only to be used by you in 
com1ection with authorized clinical studies of the investigational dmg described in the protocol. 
You will not disclose any of the inf01mation to others without written authorization from 
Gilead Sciences, Inc., except to the extent necessaty to obtain inf01med consent from those 
persons to whom the dmg may be administered. 


GS-9876
Protocol GS-US-379-1582
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
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TABLE OF CONTENTS
TABLE OF CONTENTS ..............................................................................................................................................2
LIST OF IN-TEXT TABLES........................................................................................................................................5
LIST OF IN-TEXT FIGURES ......................................................................................................................................5
PROTOCOL SYNOPSIS ..............................................................................................................................................6
GLOSSARY OF ABBREVIATIONS AND DEFINITION OF TERMS....................................................................12
1.
INTRODUCTION ..............................................................................................................................................16
1.1.
Background ............................................................................................................................................16
1.2.
GS-9876 .................................................................................................................................................17
1.2.1.
General Information .............................................................................................................17
1.2.2.
Nonclinical Pharmacology and Toxicology .........................................................................17
1.2.3.
Clinical Trials of GS-9876 ...................................................................................................20
1.3.
Filgotinib................................................................................................................................................20
1.3.1.
General Information .............................................................................................................20
1.3.2.
Nonclinical Pharmacology, Absorption, Distribution, Metabolism, and 
Excretion (ADME) and Toxicology.....................................................................................20
1.3.3.
Clinical Trials of Filgotinib..................................................................................................22
1.4.
Information about Methotrexate.............................................................................................................23
1.5.
Rationale for Current Study ...................................................................................................................23
1.6.
Rationale for Dose Selection..................................................................................................................24
1.7.
Risk/Benefit Assessment for the Study..................................................................................................24
1.8.
Compliance ............................................................................................................................................26
2.
OBJECTIVES.....................................................................................................................................................27
3.
STUDY DESIGN................................................................................................................................................28
3.1.
Endpoints ...............................................................................................................................................28
3.2.
Study Design..........................................................................................................................................28
3.3.
Study Treatments ...................................................................................................................................29
3.4.
Duration of Treatment............................................................................................................................29
3.5.
Criteria for Interruption and Discontinuation Criteria............................................................................30
3.5.1.
Study drug interruption considerations ................................................................................30
3.5.2.
Study drug discontinuation considerations...........................................................................30
3.6.
End of Study...........................................................................................................................................32
3.7.
Post Study Care......................................................................................................................................32
3.8.
Pharmacokinetic (PK) Assessments.......................................................................................................32
3.9.
Biomarker Testing..................................................................................................................................32
3.9.1.
Biomarker Samples for Optional Future Research...............................................................33
3.9.2.
Optional Genomic Research.................................................................................................33
4.
SUBJECT POPULATION..................................................................................................................................34
4.1.
Number of Subjects and Subject Selection ............................................................................................34
4.2.
Inclusion Criteria....................................................................................................................................34
4.3.
Exclusion Criteria...................................................................................................................................35
5.
INVESTIGATIONAL MEDICINAL PRODUCTS ...........................................................................................38
5.1.
Randomization, Blinding and Treatment Codes ....................................................................................38
5.1.1.
Procedures for Breaking Treatment Codes...........................................................................38
5.2.
Description of GS-9876 and PTM GS-9876 ..........................................................................................38


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5.2.1.
Formulation of GS-9876 and PTM GS-9876 .......................................................................38
5.2.2.
Packaging and Labeling of GS-9876 and PTM GS-9876 ....................................................39
5.3.
Description of Filgotinib and PTM Filgotinib........................................................................................39
5.3.1.
Formulation of Filgotinib and PTM Filgotinib.....................................................................39
5.3.2.
Packaging and Labeling of Filgotinib and PTM Filgotinib..................................................39
5.4.
Storage and Handling of Study Drugs....................................................................................................40
5.5.
Dosage and Administration of Study Drugs...........................................................................................40
5.6.
Other Medication Administered.............................................................................................................41
5.7.
Prior and Concomitant Medications.......................................................................................................41
5.8.
Investigational Medicinal Product Accountability and Disposal or Return ...........................................44
6.
STUDY PROCEDURES ....................................................................................................................................45
6.1.
Subject Enrollment and Treatment Assignment.....................................................................................45
6.2.
Pretreatment Assessments......................................................................................................................45
6.2.1.
Screening Visit (within 28 days prior to randomization) .....................................................45
6.3.
Randomization (Day 1)..........................................................................................................................47
6.4.
Treatment Assessments..........................................................................................................................47
6.4.1.
Day 1 ....................................................................................................................................47
6.4.2.
Week 2 (+ 3 days) ................................................................................................................49
6.4.3.
Week 4 (+ 3 days) ................................................................................................................49
6.4.4.
Week 8 (+ 3 days) ................................................................................................................51
6.4.5.
Week 12 (+ 3 days) ..............................................................................................................52
6.5.
Early Termination (+ 3 days) .................................................................................................................53
6.6.
Post-Treatment Assessments (+ 5 days).................................................................................................54
6.7.
Sample Storage.......................................................................................................................................55
7.
ADVERSE EVENTS AND TOXICITY MANAGEMENT...............................................................................56
7.1.
Definitions of Adverse Events, Adverse Reactions, and Serious Adverse Events.................................56
7.1.1.
Adverse Events.....................................................................................................................56
7.1.2.
Serious Adverse Events........................................................................................................56
7.1.3.
Clinical Laboratory Abnormalities and Other Abnormal Assessments as 
Adverse Events or Serious Adverse Events .........................................................................57
7.2.
Assessment of Adverse Events and Serious Adverse Events.................................................................57
7.2.1.
Assessment of Causality for Study Drugs and Procedures...................................................57
7.2.2.
Assessment of Severity ........................................................................................................58
7.3.
Investigator Requirements and Instructions for Reporting Adverse Events and Serious 
Adverse Events to Gilead.......................................................................................................................58
7.3.1.
Requirements for collection prior to study drug initiation: ..................................................58
7.4.
Gilead Reporting Requirements.............................................................................................................60
7.5.
Clinical Laboratory Abnormalities and Other Abnormal Assessments as Adverse Events or 
Serious Adverse Events..........................................................................................................................60
7.5.1.
Grades 1 and 2 Laboratory Abnormality or Clinical Event..................................................60
7.5.2.
Grade 3 Laboratory Abnormality or Clinical Event.............................................................60
7.5.3.
Grade 4 Laboratory Abnormality or Clinical Event.............................................................61
7.6.
Toxicity Management ............................................................................................................................61
7.7.
Special Situations Reports......................................................................................................................61
7.7.1.
Definitions of Special Situations..........................................................................................61
7.7.2.
Instructions for Reporting Special Situations.......................................................................62
8.
STATISTICAL CONSIDERATIONS................................................................................................................64
8.1.
Analysis Objectives and Endpoints........................................................................................................64
8.1.1.
Analysis Objectives..............................................................................................................64
8.1.2.
Primary Endpoint .................................................................................................................64
8.1.3.
Secondary Endpoint .............................................................................................................64


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8.1.4.
Exploratory Endpoints..........................................................................................................64
8.2.
Analysis Conventions.............................................................................................................................65
8.2.1.
Analysis Sets ........................................................................................................................65
8.3.
Data Handling Conventions ...................................................................................................................65
8.4.
Demographic Data and Baseline Characteristics ...................................................................................66
8.5.
Efficacy Analysis ...................................................................................................................................66
8.6.
Safety Analysis.......................................................................................................................................66
8.6.1.
Extent of Exposure...............................................................................................................67
8.6.2.
Adverse Events.....................................................................................................................67
8.6.3.
Laboratory Evaluations ........................................................................................................67
8.6.4.
Other Safety Evaluations......................................................................................................68
8.7.
Pharmacokinetic Analysis......................................................................................................................68
8.8.
Biomarker Analysis................................................................................................................................68
8.9.
Sample Size............................................................................................................................................68
9.
RESPONSIBILITIES..........................................................................................................................................69
9.1.
Investigator Responsibilities ..................................................................................................................69
9.1.1.
Good Clinical Practice..........................................................................................................69
9.1.2.
Institutional Review Board (IRB)/Independent Ethics Committee (IEC) 
Review and Approval...........................................................................................................69
9.1.3.
Informed Consent.................................................................................................................69
9.1.4.
Confidentiality......................................................................................................................70
9.1.5.
Study Files and Retention of Records ..................................................................................70
9.1.6.
Case Report Forms...............................................................................................................71
9.1.7.
Investigational Medicinal Product Accountability and Return.............................................72
9.1.8.
Inspections............................................................................................................................72
9.1.9.
Protocol Compliance............................................................................................................72
9.2.
Sponsor Responsibilities ........................................................................................................................73
9.2.1.
Protocol Modifications.........................................................................................................73
9.2.2.
Study Report and Publications .............................................................................................73
9.3.
Joint Investigator/Sponsor Responsibilities ...........................................................................................73
9.3.1.
Payment Reporting...............................................................................................................73
9.3.2.
Access to Information for Monitoring..................................................................................74
9.3.3.
Access to Information for Auditing or Inspections ..............................................................74
9.3.4.
Study Discontinuation..........................................................................................................74
10.
REFERENCES ...................................................................................................................................................75
11.
APPENDICES ....................................................................................................................................................77
Appendix 1.
Investigator Signature Page....................................................................................................78
Appendix 2.
Study Procedures Tables ........................................................................................................79
Appendix 3.
Laboratory Assessments Table...............................................................................................82
Appendix 4.
Common Terminology Criteria for Adverse Events (CTCAE) v4.03....................................83
Appendix 5.
Pregnancy Precautions, Definition for Female of Childbearing Potential, and 
Contraceptive Requirements...................................................................................................84
Appendix 6.
The 2010 American College of Rheumatology –European League Against 
Rheumatism Collaborative Initiative Classification Criteria for Rheumatoid 
Arthritis {Aletaha et al 2010}.................................................................................................86
Appendix 7.
American College of Rheumatology Response Evaluations/ Preliminary Definition 
of Improvement in Rheumatoid Arthritis {Felson et al 1995} ...............................................88
Appendix 8.
Disease Activity Score for 28 Joint Count (DAS28) {Prevoo et al 1995} .............................90
Appendix 9.
Procedures and Specifications................................................................................................91


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Gilead Sciences, Inc.
Amendment 2
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LIST OF IN-TEXT TABLES
Table 1-1.
Margins for GS-9876 Based on Systemic Exposure Relative to the Observed 
Human Exposure at 30 mg once daily (AUC)........................................................................19
Table 5-1.
Examples of Disallowed Medications ....................................................................................44
LIST OF IN-TEXT FIGURES
Figure 3-1.
Study Schema.........................................................................................................................29


GS-9876 
Protocol GS-US-379-1582 
Gilead Sciences, Inc. 
Study Title: 
IND Number: 
EudraCT Number: 
Clinical Trials.gov 
Identifier: 
Study Centers 
Planned: 
Objectives: 
CONFIDENTIAL 
PROTOCOL SYNOPSIS 
Gilead Sciences, Inc. 
333 Lakeside Drive 
Foster City, CA 94404 
Final 
Amendment2 
A Randomized, Double-Blind, Placebo-Controlled, Multicenter, 
Phase 2 Proof-of-Concept Study to Evaluate Safety, Tolerability, and 
Efficacy of GS-9876 in Subjects with Active Rheumatoid Arthritis 
on Background Therapy with Methotrexate 
IND 123903 
2016-001496-75 
TBD 
Approximately 60 centers globally 
The primmy objective of this study is as follows: 
• 
To evaluate the effect ofGS-9876 versus placebo for the 
treatment of signs and symptoms of rheumatoid mihritis (RA) in 
subjects with active RA as measmed by change from baseline in 
Disease Activity Score for 28 joint count using C-reactive protein 
(CRP) (DAS28 [CRP]) at Week 12 
The secondmy objective of this study is as follows: 
• 
To evaluate the safety and tolerability of GS-9876 in subjects 
withRA 
• 
To explore the effect of GS-9876 on other disease-specific 
outcomes in RA 
The explorat01y objectives of this study are: 
IT 
I 
I 
Page 6 
11 July 2016 


GS-9876
Protocol GS-US-379-1582
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 7
11 July 2016
Study Design:
This is a randomized, double-blind, placebo-controlled, multicenter, 
Phase 2 proof-of-concept (POC) study evaluating the safety, 
tolerability, and efficacy of GS-9876 in adult male and female 
subjects with active RA despite MTX therapy who had an inadequate 
response to MTX (either alone or in combination with biological 
disease modifying anti-rheumatic drug [bDMARDs]).
Approximately 80 subjects will be randomized in a 1:1:1:1 ratio to 
receive daily doses of 30 mg GS-9876, 10 mg GS-9876, 200 mg 
filgotinib, or placebo-to-match (PTM) in addition to background 
therapy with MTX for up to 12 weeks:

GS-9876 30 mg: GS-9876 (1 x 30 mg tablet QD) + PTM 
filgotinib (2 x placebo tablets QD) (N=20)

GS-9876 10 mg: GS-9876 (1 x 10 mg tablet QD) + PTM 
filgotinib (2 x placebo tablets QD) (N=20)

Filgotinib 200 mg: filgotinib (2 x 100 mg tablets QD) + PTM 
GS-9876 (1 x placebo tablet QD) (N=20)

Placebo only: PTM GS-9876 (1 x placebo tablet QD) + PTM 
filgotinib (2 x placebo tablets QD) (N=20)
Randomization will be stratified by prior inadequate response to 
biologic therapy and geographic region.
Subjects will be followed for 4 weeks after their last dose of study 
drug. 
Number of Subjects 
Planned:
Approximately 80 subjects
Target Population:
Subjects with active RA on background MTX therapy who had an 
inadequate response to MTX (either alone or in combination with
bDMARDs). 
Duration of 
Treatment:
Up to 12 weeks
Diagnosis and Main 
Eligibility Criteria:
For a complete list of inclusion and exclusion criteria, please refer to 
Section 4 of the protocol.
Male or non-pregnant female subjects with active RA, between 
18 and 75 years of age (inclusive)
Key Inclusion Criteria include:
1) Active RA disease as defined by: a tender joint count (TJC) 
of ≥6 (out of 68), a swollen joint count (SJC) of ≥6 
(out of 66) at Screening and Day 1
2) Inadequate response to treatment with oral or parenteral MTX 
7.5 to 25 mg/week continuously for at least 12 weeks, with at 
least 6 weeks at a stable dose (defined as no change in 
prescription) prior to the first dose of study drug


GS-9876
Protocol GS-US-379-1582
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
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3) Subjects must be receiving a folic or folinic acid 
supplementation at a stable dose. Subjects who are not taking 
folic or folinic acid at Screening, should be initiated on an 
adequate dose of folic acid (≥5 mg/week total dose or as per 
local practice) or equivalent and maintained throughout the 
study.
4) Use of oral corticosteroids of no more than 10 mg prednisone 
or its equivalent per day is allowed if the dose is stable 
(defined as no change in prescription) for at least 28 days 
prior to the first dose of study drug 
5) Nonsteroidal Anti-inflammatory Drugs (NSAIDs) or other 
analgesics (including aspirin ≤ 100 mg daily) are allowed if 
doses are stable (defined as no change in prescription) for at 
least 14 days prior to the first dose of study drug; pro re nata 
(PRN) use for other indications is allowed.
6) No evidence of active or latent TB as demonstrated by a
negative QuantiFERON® TB-Gold In-Tube test at Screening. 
Tests with inconclusive results may be repeated one time. If 
an inconclusive test is repeated and is returned with 
inconclusive results a second time, the subject will be 
excluded from the study. Any prior history of active or latent
TB (regardless of treatment) is exclusionary.
Key Exclusion Criteria include:
1) Prior treatment with B-cell depleting agents (eg, rituximab), 
unless more than 6 months prior to the first dose of study drug 
and documented return of CD19+ cells at Screening 
2) Prior treatment with any commercially available or 
investigational SYK inhibitor 
3) Concurrent treatment at Screening with any other
conventional synthetic DMARD (csDMARD) other than 
MTX and/or hydroxychloroquine (HCQ) (prior csDMARD 
treatment allowed if appropriate wash out as defined in 
Section 5.7)
4) Concurrent treatment at Screening with any bDMARD 
(prior bDMARD treatment allowed if appropriate wash out as 
defined in Section 5.7). Prior failure to treatment with 
bDMARDs is not an exclusion criterion.
5) QT interval corrected for heart rate using the Fridericia 
formula (QTcF) > 450 msec determined by the average of 
values at the Screening visit


GS-9876
Protocol GS-US-379-1582
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
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6) History of any major bleeding event defined as Grade 3 
severity and above (as defined by modified the Common 
Terminology Criteria for Adverse Events [CTCAE] 4.03
[Appendix 4]) within the last year or personal or family 
history of bleeding disorder
OR
Current use of chronic anticoagulant, not including daily 
aspirin for cardiac prophylaxis
7) Treatment with moderate or strong CYP3A inducers or 
inhibitors within 2 weeks prior to the first dose of study drug 
(examples are provided in Section 5.7)
Study Procedures/
Frequency:
All subjects will complete the following study visits: Screening, 
Day 1 (first dose), and on-treatment visits at Weeks 2, 4, 8, and 12. 
All subjects will be followed for safety for an additional 4 weeks 
after their last dose of study drug. 
Screening assessments will be completed no more than 28 days prior 
to the Day 1 visit and will include a complete physical examination
(PE), joint count assessment, medical history, vital signs, height and 
weight, electrocardiogram (ECG), adverse events (AEs) related to 
screening procedures, concomitant medications, safety laboratory 
tests (including hematology, chemistry, coagulation, and lipid panel), 
CRP, serology (HIV, HCV, HBV), QuantiFERON® TB-Gold 
In-Tube test, urinalysis, urine drug screen, thyroid-stimulating 
hormone (TSH), HbA1c, and CD19 count as applicable and as 
outlined in the protocol . Serum pregnancy testing will be performed 
for females of childbearing potential (as defined per protocol).
On-treatment assessments include a symptom driven PE, joint count 
assessment, disease-specific questionnaires and activity scales, vital 
signs, ECGs, AEs, concomitant medications, safety laboratory tests 
(including hematology, chemistry, coagulation, and lipid panel 
[fasting on Day 1 and Week 12]), B and T cell  panels (Day 1, 
Week 4, and Week 12 ), immunoglobulins (Day 1 and Week 12 or 
ET), RNA (Day 1, Week 4, and Week 12 or ET), RF/CCP (Day 1
and Week 12 or ET), CRP, urine pregnancy test, inflammation and 
pathway biomarkers (Day 1, Week 4, and Week 12 or ET), whole 
blood samples for mechanism of action (MoA) studies (Day 1, 
Week 4 and Week 12), and urine bone marker samples (Day 1
[fasting], Week 4, and Week 12 [fasting]). Additional testing will 
include PK sampling (Weeks 2, 4, 8 and 12 or ET).  


GS-9876 
Protocol GS-US-379-1582 
Gilead Sciences, Inc. 
Test Product, Dose, 
and Mode of 
Administration: 
Reference Therapy, 
Dose, and Mode of 
Administration 
Required Background 
Therapy 
Criteria for 
Evaluation: 
Safety: 
Efficacy: 
Phannacokinetics: 
CONFIDENTIAL 
Final 
Amendment2 
Post-treatment assessments include symptom driven PE, vital signs, 
ECGs, AEs, concomitant medications, safety laboratmy tests 
(including hematology, chemistry, and coagulation), CRP, and urine 
pregnancy test where applicable. 
For subjects who provide their additional and s ecific consent, 
PPD 
For subjects who rovide their additional and s ecific consent, PO 
GS-9876 30 mg (1 x 30 mg tablet), administered orally once daily 
GS-9876 10 mg (1 x 10 mg tablet), administered orally once daily 
Filgotinib 200 mg (2 x 100 mg tablets), administered orally 
once daily 
PTM GS-9876 (1 x placebo tablet), administered orally once daily 
PTM filgotinib (2 x placebo tablets), administered orally once daily 
MTX 7.5 to 25 mg, administered orally or parenterally once a week 
and folic acid supplementation 
Safety will be assessed through the reporting of AEs, clinical 
laboratmy tests, PEs, vital sign assessments, and ECGs at various 
time points during the study. Concomitant medication usage will 
also be documented throughout the study. 
The primaty endpoint is change from baseline in DAS28 (CRP) at 
Week 12. 
The secondaty endpoints include: 
• 
The propotiion of subjects who achieve ACR 20/50/70 at 
Week 12 
• 
Change from baseline in Heath Assessment 
Questionnaire - Disability Index (HAQ-DI) score at Week 12 
Plasma concenu·ations ofGS-9876, filgotinib and the active 
metabolite of filgotinib (GS-829845) will be detetmined. 
Page 10 
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GS-9876 
Protocol GS-US-379-1582 
Gilead Sciences, Inc. 
Explorat01y: 
Statistical Methods: 
PPD 
Final 
Amendment2 
The primaty endpoint is change from baseline in DAS28 (CRP) at 
Week 12. The primaty analysis will consist of a superiority test of 
each of the GS-9876 doses compared to placebo based on the change 
from baseline in DAS28 (CRP) at Week 12. 
All continuous endpoints will be summm·ized using an 8-number 
summaty [n, mean, standard deviation (SD), median, 1st quatiile 
(Q1), 3rd quartile (Q3), minimum, maximmn] by treatment group. All 
categorical endpoints will be summarized by the number and 
percentage of subjects who meet the endpoint defmition. 
Safety endpoints will be analyzed by the number and percent of 
subjects with events or abn01malities for categorical values or 
8-number surnmaty (n, mean, SD, median, Q1, Q3, minimum, 
maximum) for continuous data by treatment group. 
Sample sizes for GS-9876 and placebo groups are detennined based 
on the superiority test of one dose of GS-9876 compm·ed to placebo 
based on the change from baseline in DAS28 (CRP) at Week 12. 
When assuming a difference of 1.2 between the two groups and a 
common standm·d deviation of 1.35, 20 subjects in each of the 
GS-9876 groups and 20 in the placebo~ are re uired to obtain 
78% power at a 2-sided 0.05-level. 1fPPD 
Therefore, the total sample size will be 80 (20 per treatment group). 
This study will be conducted in accordance with the guidelines of Good Clinical Practice (GCP) 
including archiving of essential docurnents. 
CONFIDENTIAL 
Page 11 
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GS-9876
Protocol GS-US-379-1582
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 12
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GLOSSARY OF ABBREVIATIONS AND DEFINITION OF TERMS
°C
degrees Celsius
°F
degrees Fahrenheit 
β-hCG
beta-human chorionic gonadotropin
μM
micromolar
ACPA
anti-citrullinated protein antibody
ACR
American College of Rheumatology
ACR 20/50/70 
American College of Rheumatology 20/50/70%  improvement
ADP
adenosine di-phosphate
AE
adverse event
AhR
aryl hydrocarbon receptor
AKT
protein kinase B
ALT
alanine aminotransferase
APC
antigen-presenting cell
APTT
activated partial thromboplastin time
AST
aspartate aminotransferase
ATP
adenosine triphosphate
AUC
area under the curve
AUC0-last
area under the plasma/serum concentration versus time curve from time zero to 
the last quantifiable concentration
BCR
B-cell receptor
BCRP
breast cancer resistance protein
BDC
bile duct-cannulated
bDMARD
biological disease modifying anti-rheumatic drug
BLNK
B-cell linker protein
BLQ
below the limit of quantitation
BTK
Bruton’s tyrosine kinase
BUN
blood urea nitrogen
CBC
complete blood count
CCP
cyclic citrullinated peptide
CDAI
Clinical Disease Activity Index
CES
carboxylesterase
CFR
Code of Federal Regulations
CG
Cockcroft-Gault
CIA
collagen-induced arthritis 
Cmax
the maximum observed serum/plasma/peripheral blood mononuclear cell 
concentration of drug
CMH
Cochran–Mantel–Haenszel
CNS
central nervous system
CPK
creatine phosphokinase


GS-9876
Protocol GS-US-379-1582
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 13
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CRO
contract research organization
CRP
C-reactive protein
csDMARD
conventional synthetic disease modifying anti-rheumatic drug
CTCAE
Common Toxicity Criteria for Adverse Events
CYP
cytochrome P450 
DAS28
Disease Activity Score for 28 joint count
DMARD
disease modifying anti-rheumatic drug
DSPH
Drug Safety and Public Health
DSS
dextran sulphate sodium
EC50
half maximal effective concentration 
ECG
electrocardiogram
eCRF
electronic case report form
EDC
electronic data capture
ERK
extracellular signal-regulated kinase
eSAE
electronic serious adverse event
ESR
erythrocyte sedimentation rate
ET
early termination
EU
European Union
FAS
Full Analysis Set
FDA
(United States) Food and Drug Administration
g
gram
GCP
Good Clinical Practice
Gilead
Gilead Sciences, Inc.
GLP
Good Laboratory Practice
GFR
glomerular filtration rate
HAQ-DI
Health Assessment Questionnaire – Disability Index
HBV
hepatitis B virus
HCQ
hydroxychloroquine
HCV
hepatitis C virus
HDL
high-density lipoprotein
HDPE
high density polyethylene
hERG
human ether-a-go-go-related gene
HIV
human immunodeficiency virus
HLGT
high-level group term
HLT
high-level term
IB
Investigator’s Brochure 
IC
immune complex
IC50
concentration that results in 50% inhibition
ICH
International Conference on Harmonization 
ICH E3
ICH Guideline for Structure and Content of Clinical Study Reports


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ie
id est (that is)
IEC
Independent Ethics Committee
Ig
immunoglobulin
IL
interleukin
INR
International Normalized Ratio of prothrombin time
IR
inadequate response
IRB
Institutional Review Board
IU
international units
IUD
intrauterine device
IV
intravenous
IXRS
Interactive Web and Mobile Response System
JAK
Janus kinase
kg
kilogram
L
liter
LAM
lactational amenorrhea method
LDL
low-density lipoprotein
LLT
lower-level term
MAPK
mitogen-activated protein kinase
MCV
mean corpuscular volume 
MedDRA
Medical Dictionary for Regulatory Activities
MEK
MAPK/ERK kinase
mg
milligram
MMRM
mixed model repeated measures
MoA
mechanism of action
msec
millisecond
MTX
methotrexate
ng
nanogram
nM
nanomolar
NOAEL
no-observed-adverse-effect-level 
NSAID
nonsteroidal anti-inflammatory drug
OATP
organic anion transporting polypeptide
PAR-1
protease-activated receptor
PD
pharmacodynamics
PE
physical examination
P-gp
P-glycoprotein
PK
pharmacokinetics
PKC
protein kinase C
POC
proof-of-concept
PRN
pro re nata (as needed)
PT
preferred term or prothrombin time


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PTM
placebo-to-match
PTT
partial thromboplastin time
PXR
pregnane X receptor
Q1
first quartile
Q3
third quartile
QD
quaque die (each day)
QT
electrocardiographic interval between the beginning of the Q wave and 
termination of the T wave, representing the time for both ventricular 
depolarization and repolarization to occur
QTc
corrected QT interval
QTcF
QT interval corrected for heart rate using the Fridericia formula
RA
rheumatoid arthritis
RBC
red blood cell
RF
rheumatoid factor
RNA
ribonucleic acid
s
second
SADR
serious adverse drug reaction
SAE
serious adverse event
SD
standard deviation 
SDAI
Simplified Disease Activity Index
SJC
swollen joint count
SLE
systemic lupus erythematosus
SOC
system organ class
SOP
standard operating procedure
SS
Sjogren’s syndrome
STAT
signal transducer and activator of transcription
SUSAR
suspected unexpected serious adverse reaction
SYK
spleen tyrosine kinase
TB
tuberculosis
TEAE
treatment-emergent adverse event
TJC
tender joint count
TNF
tumor necrosis factor
TSH
thyroid-stimulating hormone
UGT
uridine disphosphate glucuronosyltransferase
ULN
upper limit of normal
US, USA
United States, United States of America
VAS
visual analog scale
WBC
white blood cell


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1.
INTRODUCTION
1.1.
Background
Rheumatoid Arthritis is a chronic, systemic inflammatory disease that affects approximately 
1.3 million adults in the United States (US) {Helmick et al 2008}. Rheumatoid Arthritis manifests 
principally as an attack on peripheral joints and may lead to marked destruction and deformity of 
joints, with considerable disability and impact on quality of life. It is characterized by the 
production of autoantibodies, synovial inflammation with formation of pannus tissue, and 
erosion of underlying cartilage and bone. Although people of any age can be affected, the onset 
of RA is most frequent between the age of 40 and 50 years, and women are affected 3 times 
more often than men. While the cause of RA is still not completely understood, aberrant B-cell 
activation, T-cell co-stimulation, osteoclast differentiation, and cytokine release all have been 
implicated in its pathogenesis. Subjects with RA experience a high risk of disability and 
mortality {Arthritis Foundation 2008}.
Despite the currently available treatment options for RA, there is still a need for new treatments 
because not all subjects respond adequately (or maintain response) to current therapies and some 
subjects experience toxicities and/or intolerance that limit the use of such therapies. All currently 
available treatments have safety considerations that can develop during chronic use that may 
require a change to a different therapy. The unmet medical need for new therapeutic options with 
a favorable efficacy and safety profile that do not require injection/infusion have prompted 
efforts to develop oral small molecule inhibitors of protein kinases involved in cellular signaling 
associated with the underlying RA disease pathology. 
GS-9876 is a potent and selective inhibitor of SYK and is being developed by Gilead Sciences, 
Inc. (Gilead) as an oral agent for the treatment of inflammatory diseases. Spleen tyrosine kinase 
is a nonreceptor cytoplasmic tyrosine kinase primarily expressed in cells of hematopoietic 
lineage, where it functions as a key signaling molecule mediating immunoreceptor signaling in a 
range of cells involved in inflammatory disease. Given its central role in immune cell signaling, 
inhibition of SYK is expected to affect multiple steps in the pathogenesis of RA resulting in 
pleiotropic anti-inflammatory effects.
Filgotinib (GS-6034, formerly GLPG0634) is being developed by Gilead as an oral agent, and is 
a potent and selective inhibitor of JAK1. While the pan JAK inhibitor tofacitinib (Xeljanz®) has 
shown an early onset of action and long-term efficacy in RA as monotherapy and in combination 
with background csDMARD therapy, dose levels were limited by side effects potentially 
mediated by its effect on JAK 2 and JAK 3. This highlights the need for more selective and 
targeted therapies with improved immunomodulatory and hematologic effects.  JAK1 is thought 
to be an integral part of RA pathogenesis due its role in transmitting inflammatory cytokine 
signaling. Hence, targeted inhibition of JAK1 has great potential for the treatment of RA with an 
improved safety and side effect profile.


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1.2.
GS-9876
1.2.1.
General Information
For further information on GS-9876, refer to the current Investigator’s Brochure (IB).
1.2.2.
Nonclinical Pharmacology and Toxicology
1.2.2.1.
Nonclinical Pharmacology and Safety Pharmacology
GS-9876 is a selective and potent adenosine triphosphate (ATP)-competitive inhibitor of SYK
with an IC50 value of 9.5 nM. Overall, GS-9876 is at least 7-fold more selective biochemically 
for SYK relative to all other protein kinases assayed. Functionally, GS-9876 inhibited 
anti-IgM-induced BCR/SYK-mediated phosphorylation and activation of multiple downstream
signaling pathways in primary human B-cells, suppressed anti-IgM mediated CD69 and CD86 
activation marker expression on B-cells, and proliferation of peripheral B cells.  GS-9876 
showed a 12-fold selectivity for B-cell proliferation versus anti-CD3/anti-CD28 costimulation of 
T-cell proliferation.  Furthermore, GS-9876 inhibited immune-complex stimulated TNFand 
IL-1release from primary human monocytes. In human blood, GS-9876 inhibited SYK
autophosphorylation, anti-IgD/BCR-induced CD69 expression on B-cells, and
anti-FceRI-stimulated CD63 expression on basophils with geometric mean EC50 values ranging 
from 171 nM to 301 nM.
In two independent rat collagen-induced arthritis (CIA) models in animals with established 
disease, treatment with GS-9876 caused significant and dose-dependent amelioration of clinical 
and histopathology parameters when dosed either early (at initiation of ankle swelling) or late 
(at time of peak ankle swelling) after disease onset. Histological evaluation of joints in the 
animals from the study demonstrated that GS-9876 treatment reduced pannus formation, 
cartilage damage, bone resorption, and periosteal bone formation with an effective dose inducing 
a 50% inhibitory effect (ED50) of < 6.25 mg/kg, QD and 11.6 mg/kg, QD in the early and late 
CIA models, respectively.  Significant efficacy was seen with GS-9876 doses that produced 
Cave exposures that were calculated to inhibit SYK phosphorylation by 50% (EC50).  GS-9876 
was well tolerated at all doses and there were no treatment-related adverse effects on body 
weight, food and drink intake, in-life observations or clinical pathology parameters.  
Safety pharmacology studies were conducted to examine the potential effects of GS-9876 on the
cardiovascular system, respiratory system, and central nervous system (CNS). There were no 
clinically-relevant effects on the respiratory, and CNS systems after single oral doses up to 
300 mg/kg. Cardiovascular effects in telemetered cynomolgus monkeys at ≥20 mg/kg included 
prolonged QTc interval from 5 through 25 hours postdose, slightly higher systolic, diastolic, and 
mean arterial pressure with lower heart rate through 6 hours postdose, and higher heart rate from 
9 through 25 hours postdose. While differences in QTc interval were generally small, the 
changes were of sufficient magnitude to be considered biologically relevant. There were no 
inhibitory effects on the hERG potassium current when GS-9876 was tested up to a free drug 
concentration of 30 μM, approximately 207-fold above the observed steady state Cmax at a 30 mg 
QD clinical dose. Further, no cardiovascular effects were observed in telemetered cynomolgus 


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monkeys administered GS-9876 for 13 weeks at doses up to 15 mg/kg/day. The potential for 
GS-9876 to prolong the QTc interval was assessed with intensive time matched ECG monitoring 
in Gilead studies GS-US-379-1372 and GS-US-379-1900 (cohorts 1 and 2), and no clinical 
significant change in time matched QTc intervals was observed. No clinical significant changes 
in vital signs during serial vital sign measurements were observed.
1.2.2.2.
Nonclinical Toxicology
In the repeat-dose studies, the toxicity profile of GS-9876 was assessed in rats and monkeys 
administered GS-9876 orally for up to 26 weeks. Dose-dependent effects on lymphocytes in both 
rats and monkeys were consistent with the expected pharmacology of SYK inhibition. Effects on 
hemostasis were observed in rats and monkeys, with increased erythrocyte turnover in rats at 
≥10 mg/kg/day, and hemorrhage and thrombosis in monkeys at ≥20 mg/kg/day. At higher doses 
in rats (≥30 mg/kg/day), mortality associated with bacterial infections, likely resulting from the 
immunomodulatory activity of GS-9876, was seen. Additional findings included lymphoid 
depletion in the thymus, changes in the pancreas, with secondary effects related to the 
immunomodulatory activity of GS-9876, and likely opportunistic bacterial infection, observed in 
several tissues. The no-observed-adverse-effect level (NOAEL) in rats was 10 mg/kg/day after 
26 weeks dosing. For the highest proposed dose 30 mg dose, estimated exposure margins are 
2.4-/5.9- fold based on exposures at the NOAELs in the 26 week study in male/female rats.  
Subjects will be closely monitored for any infection and changes in the differential CBC.
In monkeys, the NOAEL in the 28-day study was identified at 10 mg/kg/day, which was 
associated with AUC0-24hr of 4290 ng•hr/mL. In the 13-week monkey study, there were no effects 
on hemostasis, and the NOAEL was the high dose of 15 mg/kg/day. However in the ongoing 
39-week study, one 15 mg/kg/day monkey was euthanized moribund during Week 22 with 
persistent fecal changes, weight loss, deteriorating clinical condition, and large bowel 
inflammation. All other animals survived to their scheduled necropsy after 39-weeks dosing. For 
the highest proposed dose 30 mg dose, the estimated exposure margin is 2.7-fold based on 
exposures at the 15 mg/kg/day NOAEL in the 13-week monkey study. Although the relationship 
of the moribund animal to GS-9876 treatment is uncertain, Gilead considers it prudent to limit 
exposures to mean exposures achieved in monkeys at the 10 mg/kg/day mid-dose at Week 13 of 
the 39-week study (6750 ng•h/mL), which were 1.8-fold above estimated exposures at the 
highest proposed dose 30 mg dose.
In GLP range-finding developmental toxicity studies in pregnant rats and rabbits, no 
Caesarean-sectioning, litter parameters, or gross external or visceral alterations were affected by 
GS-9876 at dose levels up to 100 mg/kg/day in rats, or up to 30 mg/kg/day in rabbits. In rabbits 
at 100 mg/kg/day, mortality, clinical observations, reduced body weights and food consumption
in does were associated with increased resorptions and reduced fetal body weights.  In rats, the 
maternal no-observed-effect level (NOEL) was 30 mg/kg/day, and the embryo-fetal development 
NOEL was 100 mg/kg/day. In rabbits, the maternal and embryo-fetal development NOEL was 
30 mg/kg/day.
GS-9876 was negative in the bacterial reverse mutation (Ames) assay, in vitro chromosomal
aberration assay, and in vivo rat micronucleus assay and is therefore considered to be
nongenotoxic. In the in vitro chromosome aberration assay in human lymphocytes, slight, but


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statistically significant increases in the number of polyploid cells was observed at the highest
GS-9876 dose level evaluated. GS-9876 did not induce structural chromosome breakage when
evaluated in the in vitro assay. 
Table 1-1.
Margins for GS-9876 Based on Systemic Exposure Relative to the 
Observed Human Exposure at 30 mg once daily (AUC)
Species
Duration
Route
NOAEL
(mg/kg/day)
AUC0-24
(ng•h/mL)a
Margin b
Rat
Once daily 
x 26 weeks
Oral
10
8800/21,800
(male/female)
2.4/5.9
(male/female)
Cynomolgus Monkey
Once daily 
x 13 weeks
Oral
15c
10,100
2.7
a
NOAEL, no observed adverse effect level. Week 4 male and female rat AUC and week 13 Cynomolgus monkey AUC
(combined sex)
b
Margins of exposure were calculated using observed steady-state exposure (AUCtau) in humans of 3708 ng•h/mL at 30 mg 
once daily in study GS-US-379-1900.
c
One animal was euthanized moribund during Week 22 at the 15 mg/kg/day dose level.
1.2.2.3.
Nonclinical Drug Metabolism and Pharmacokinetics
GS-9876 exhibits high absorption in rats, dogs and monkeys. Plasma protein binding is moderate 
in all species with the mean free fraction in humans being of 20.4%.
After oral dosing to albino and pigmented rats, [14C]GS-9876-derived radioactivity was rapidly 
distributed to most tissues and concentrations of radioactivity were below the limit of 
quantitation by 168 hours postdose. The lowest levels of radioactivity were observed in the 
brain, bone, adipose, and testis. Melanin containing tissues exhibited higher concentrations than 
their non-pigmented counterparts but binding was reversible.  Recovery of radioactivity was high 
(≥ 97.8%) and the main route of elimination of GS-9876 was hepatobiliary with ≤5.1% orally 
dosed radioactivity found in urine and 69.4% in bile.
In vitro, GS-9876 exhibits high metabolic stability with human hepatocytes, liver fractions and 
individual metabolizing enzymes.  GS-9876 had little inhibitory effect on the activities of the 
major human drug metabolizing CYP enzymes and was a weak inhibitor of human UGT1A1.   
GS-9876 is a weak inhibitor of P-gp and BCRP and is a substrate for those efflux transports.  It is 
a weak inhibitor of the hepatic uptake transporters OATP1B1 and OATP1B3 but is a substrate 
for neither. Drug-drug interactions in vivo are unlikely through inhibition of human CYP 
enzymes, UGT1A1, or efflux or uptake transporters.  The potential of GS-9876 to cause 
drug-drug interactions through induction is low as there is little activation of PXR or AhR in 
vitro.


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1.2.3.
Clinical Trials of GS-9876
As of 12 February 2016, 62 healthy volunteers have been dosed with GS-9876 in two clinical 
studies.
Completed Clinical Trial
GS-US-379-1372: This was a first-in-human, Phase 1, single-dose ranging study of GS-9876 in 
healthy adult volunteers to evaluate the safety, tolerability, PK, PD, food effect, and drug-drug 
interaction potential using a representative acid reducing agent (omeprazole). No risks were 
identified and no grade 3 or 4 AEs were reported. There were no clinically significant changes in 
vital signs, physical findings, bleeding times, or ECGs. For further information, refer to the 
current IB.
Ongoing Clinical Trial
GS-US-379-1900: This is a single- and multiple-dose Phase 1 study of GS-9876 in healthy 
volunteers to evaluate the safety, tolerability, PK and PD of GS-9876.
1.3.
Filgotinib
1.3.1.
General Information
For further information on filgotinib, refer to the current IB.
1.3.2.
Nonclinical Pharmacology, Absorption, Distribution, Metabolism, and 
Excretion (ADME) and Toxicology
Filgotinib and its metabolite, GS-829845 have been extensively characterized in nonclinical 
studies. This program includes cellular assays demonstrating potency and selectivity of the 
compound against JAK1, efficacy studies in rats and mice, repeat dose toxicity studies (up to 
26 weeks in the rat and 39 weeks in the dog), in vitro and in vivo safety pharmacology and 
genetic toxicology studies, and reproductive toxicology studies in rats and rabbits. Additional 
toxicology studies conducted include phototoxicity studies and dose-range finding studies in 
support of a definitive rat juvenile toxicity study and a 6 month carcinogenicity study in 
transgenic (TgrasH2) mice. A 2 year rat oral carcinogenicity study is ongoing.
1.3.2.1.
Primary and Secondary Pharmacology
Filgotinib is an ATP-competitive inhibitor of JAK1. It is highly selective for inhibition of JAK1 
over 451 other kinases evaluated in vitro. In cellular assays, it inhibits JAK/STAT-driven 
processes with half maximal inhibitory concentration (IC50) values from 179 nM onwards.  In 
human whole blood, JAK1 is inhibited by filgotinib with an IC50 of 629 nM and exhibits 
approximately 30-fold selectivity over JAK2. Filgotinib demonstrated significant efficacy in the 
rat CIA model as well as in the mouse dextran sulphate sodium (DSS)-induced colitis model.
Metabolite GS-829845 exhibits a similar JAK1 selectivity profile but is approximately 10 to 
20-fold less potent than the parent filgotinib in in vitro assays. GS-829845 was as effective as 
filgotinib in the rat CIA model, but at doses that required a 10-fold higher exposure.


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1.3.2.2.
Safety Pharmacology
Filgotinib and GS-829845 had no effects on the respiratory system and CNS up to respectively 
40- and 5-fold the exposure in RA subjects given filgotinib 200 mg QD.
Filgotinib and GS-829845 had no relevant effects on cardiovascular parameters (hERG and dog 
telemetry studies), apart from a slight non-adverse increase in heart rate and arterial pressure 
with GS-829845 at exposures 7-fold that of the Cmax in subjects with RA dosed with 200 mg QD
filgotinib. There were no relevant effects on ECG and QT.
1.3.2.3.
Nonclinical ADME
Filgotinib demonstrates good oral bioavailability in mice, rats, dogs, and mini-pigs but less in 
monkeys.  Plasma protein binding is low (< 70%) in all species, including humans.
The PK of filgotinib is generally dose proportional without gender differences.  No accumulation 
occurs with repeated dosing. The mean terminal half-life after oral administration is 4 and 
5 hours in rats and dogs, respectively.
In the rat, filgotinib showed a rapid and even distribution throughout the body.  High 
concentrations were observed only in the gastrointestinal tract and urinary bladder. Filgotinib 
does not penetrate into CNS tissues.  The distribution of filgotinib indicates some affinity for 
melanin-containing tissues.
Excretion is nearly complete within 24 hours (rat) and 48 hours (dog) post-dosing.  In the rat, 
fecal and urinary excretion accounted for 40% and 53% of the administered dose, respectively, 
with a bile secretion of about 15%.  In the dog, fecal excretion was the primary route of 
excretion, accounting for 59% of the administered dose, with urinary excretion accounting for 
25%.
In vitro metabolism studies in all species revealed one major metabolite (GS-829845). The 
formation of GS-829845 is mediated by carboxylesterases (CES) and is not dependent on CYP.
In vitro experiments have shown that drug-drug interactions with filgotinib and GS-829845 are 
unlikely.  There is no inhibition or induction of CYPs or UGTs, and no relevant inhibition of key 
drug transporters, including the organic anion transporters involved in the renal elimination of 
MTX, by filgotinib or GS-829845.
1.3.2.4.
Nonclinical Toxicology
In repeat oral dose toxicity studies in both rats and dogs, the primary target tissues identified for 
filgotinib were the lymphoid tissues which are expected based on the pharmacology of JAK 
inhibition. Additional filgotinib-related findings were observed in the male reproductive organs 
of both species, and in the incisor teeth of rats only. Effects on the lymphoid system were fully 
reversible. Testicular toxicity demonstrated partial reversibility, however sperm counts remained 
low. A dose of 200 mg/day of filgotinib results in an estimated mean clinical AUC of
2.80 μg∙h/mL, which represents an exposure margin of 2.3, 1.8, and 3.4-fold when considering
the mean AUC in male dogs at the no-observed-effect-levels (NOELs) in the 26 week and
39 week chronic toxicity studies, and the 39 week targeted exposure toxicity study, respectively.


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GS-829845-related findings in general repeat dose toxicity studies were similar to those of the 
parent filgotinib, however no testicular toxicity was noted following administration of 
GS-829845.
Filgotinib and GS-829845 were non-genotoxic when evaluated in the bacterial mutagenicity 
assay, the in vitro mouse lymphoma mutagenicity assay, and the rat bone marrow micronucleus 
assay.
In embryofetal development studies, filgotinib and GS-829845 caused embryolethality and 
teratogenicity in rats and rabbits at exposures similar to the human exposure at 200 mg/day of 
filgotinib in subjects with RA.  Administration of filgotinib did not affect female fertility but 
impaired fertility was observed in male rats at exposures approximately 15-fold the human 
exposure at 200 mg of filgotinib in subjects with RA. GS-829845 did not have any effects on 
fertility parameters in either male or female rats.
In an in vitro phototoxicity study in 3T3 cells, the metabolite GS-829845 was positive for 
phototoxic potential and results with filgotinib were equivocal. A follow-up in vivo rat 
phototoxicity assay revealed a lack of phototoxic potential for both compounds.
1.3.3.
Clinical Trials of Filgotinib
As of January 2016, filgotinib has been administered to more than 150 healthy subjects, more 
than 1000 RA subjects, and more than 150 subjects with Crohn’s disease. The main Phase 2b 
studies are listed below. A detailed description of all clinical studies can be found in the IB. 
GLPG0634-CL-203: In this study, subjects with active RA on stable dose of MTX were 
randomized to receive either placebo or one of three total daily doses of filgotinib (50 mg,
100 mg, or 200 mg) on a once or twice daily schedule for 24 weeks. The primary objective of the
study was to evaluate the efficacy of different doses and dose regimens of filgotinib compared to 
placebo at Week 12.
GLPG0634-CL-204: This study evaluated filgotinib administered as a monotherapy in RA 
subjects. The primary objective of study GLPG0634-CL-204 was to evaluate the efficacy of 
three doses of daily filgotinib compared to placebo at Week 12.
In both 24-week, Phase 2b, randomized, double-blind, placebo-controlled studies in 
594 (Study GLPG0634-CL-203) and 283 subjects (Study GLPG0634-CL-204) with moderately 
to severely active RA who had insufficient response to MTX, filgotinib added to a stable dose of 
background MTX or administered as monotherapy was efficacious in a dose-dependent manner 
in treating the signs and symptoms of active RA. In Study GLPG0634-CL-203, an ACR20 
response was achieved by a statistically significantly higher percentage of subjects in the 100-mg 
once-daily, 200-mg once-daily and 100-mg filgotinib twice-daily groups (63.5%, 68.6%, and 
78.6%, respectively) compared with placebo (44.2%) (p = 0.0435, 0.0068, and < 0.0001, 
respectively). In Study GLPG0634-CL-204, an ACR20 response at Week 12 was achieved by a 
statistically significantly higher percentage of subjects in all filgotinib dose groups compared 
with placebo (66.7%, 65.7%, and 72.5% in the 50-mg once-daily, 100-mg once-daily, and 


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200-mg filgotinib once-daily groups, respectively, compared with 29.2% on placebo) 
(p < 0.0001 for all comparisons). In both studies, the ACR20 appeared to plateau at Week 8 and 
was maintained through Week 24. In addition, at Week 12, filgotinib showed a beneficial effect 
across the following secondary efficacy parameters: ACR50, ACR70, ACR-N, DAS28 (CRP), 
CDAI, and SDAI. A dose-dependent fast onset of efficacy was reported, and the responses were 
maintained or continued to improve through 24 weeks. No significant difference in efficacy was 
observed between 100-mg and 200-mg once-daily dosing regimens.
1.4.
Information about Methotrexate 
Subjects will continue to receive stable weekly doses of MTX. Further information regarding
side effects, dosage and administration is available in the current local prescribing information.
1.5.
Rationale for Current Study
Over the last decade, changes in RA treatment strategies accompanied by advances in drug 
development and the addition of targeted biological therapies have greatly improved the 
outcomes for subjects with RA. Despite these developments, therapeutic challenges remain. The 
current conventional and biological DMARDs may be ineffective, produce only partial responses 
or loose therapeutic response over time due to development of neutralizing antibodies in some 
subjects and are associated with significant safety and tolerability concerns. There is an unmet 
medical need for simple, orally administered therapies with novel and targeted mechanisms of 
action that can effectively improve the disease course while being safe and well tolerated.
Given its central role in immune cell signaling, inhibition of SYK is expected to have pleiotropic
anti-inflammatory effects and affect multiple steps in RA pathogenesis. B cells have been
implicated as playing a critical role in the pathogenesis of RA as demonstrated by the clinical
activity of the anti-CD20 monoclonal antibody, rituximab, in RA subjects {Leandro et al 2006, 
Navarro-Millan et al 2013}. B cells contribute to the pathogenesis of RA through their ability to act 
as antigen presenting cells (APCs) presenting self-antigens to auto-reactive T cells {Shlomchik 
2008}, and through the production of autoantibodies and pro-inflammatory cytokines {Martin et al 
2006, Song et al 2010}. As a critical mediator of BCR signaling, SYK inhibition suppresses 
BCR-stimulated proliferation, co-stimulatory molecule expression, and autoantibody production 
in B cells {Braselmann et al 2006, Coffey et al 2012}. 
Additionally, SYK inhibition suppresses IC-stimulated cytokine release from 
monocytes/macrophages and prevents osteoclastogenesis {Liao et al 2013}. Spleen tyrosine 
kinase is expressed in the rheumatoid synovium {Cha et al 2006} and SYK inhibition reduces 
cellular infiltrates into synovial tissue {Coffey et al 2012}. Pharmacologic inhibition of SYK has 
been shown to inhibit disease progression and reduce inflammation in multiple animal models of 
RA, and has demonstrated disease modifying anti-rheumatic drug (DMARD) activity on 
endpoints such as cartilage destruction and bone erosion {Coffey et al 2012, Liao et al 2013, Pine et 
al 2007}.  A consistent finding in these nonclinical studies is that significant efficacy can be 
achieved with minimum plasma concentrations (Cmin) that result in target coverage less 
than 50% {Liao et al 2013}.


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Taken together, the in vitro and in vivo data suggest that inhibition of SYK may decrease several 
pathologically active mechanisms implicated in RA including B-cell activation, T -cell 
costimulation, and cytokine release. 
Filgotinib is an orally administered, small molecule inhibitor of JAK1, an intracellular tyrosine 
kinase dysregulated in subjects with inflarmnat01y disorders including RA. Filgotinib has 
demonstrated clinical activity and a favorable safety and tolerability profile in Phase 2 studies in 
subjects with moderately to severely active RA. 
This study is designed to evaluate the efficac , safety, tolerability, PK, and PPD 
of GS-9876 in subjects with RA. PPD 
1.6. 
Rationale for Dose Selection 
In the rat CIA model, predicted GS-9876 exposure at the 30 mg and 10 mg QD doses are 
estimated to provide 75% and 37% of the maximal treatment response observed with GS-9876, 
respectively. The maximal treatment response observed with GS-9876 in this model was similar 
to the positive control dexamethasone. In the multiple ascending dose study (GS-US-379-1900), 
doses up to 30 mg QD of GS-9876 for 7 days were well tolerated in healthy volunteers. 
Therefore both doses (10 mg QD and 30 mg QD) are expected to be safe and have the potential 
to be efficacious in RA. 
Results from Phase 2a studies (GLPG-CL-201 and GLPG-CL-202) and Phase 2b studies 
(GLPG-CL-203 and GLPG-CL-204) showed that 200 mg QD filgotinib was well tolerated and 
demonstrated promising clinical efficacy (ACR20/50/70 and DAS28[CRP]) in subjects with RA. 
Exposure-response analysis based on data from all Phase 2 studies indicated a dose-dependent 
increase in efficacy (ACR20/50/70, DAS28[CRP]), with a plateau at the 200 mg total daily dose 
on the dose-response curve. These results are consistent with the relationship observed between 
filgotinib exposures and pSTAT1 activation (ex-vivo) following single and multiple filgotinib 
doses, where maximal inhibition ofpSTAT1 (~78%) was achieved at or above 200 mg total 
daily dose {Namour et al 2015}. Based on the overall risk-benefit observed in Phase 2b studies, 
200 mg QD filgotinib is expected to be safe and efficacious in subjects with RA, and is 
considered an appropriate dose to investigate the mechanism of action of a JAK inhibitor in 
compm·ison to a SYK inhibitor. 
1.7. 
Risk/Benefit Assessment for the Study 
Rheumatoid mthritis (RA) is a chronic, systemic inflammat01y disease that affects approximately 
1% of the population {Helmick et al2008}. Despite the cunently available medications for RA, 
there is still a need for new treatments because not all patients respond adequately (or maintain 
response) to cunent therapies and some experience toxicities and/or intolerance that limit the use 
of such therapies. The need for new, non-injectable therapeutic options with a favorable efficacy 
and safety profile have prompted efforts to develop orally administered, small molecules. The 
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development of these drugs is important because in addition to RA, other inflammatory diseases, 
such as systemic lupus erythematosus (SLE) and Sjogren’s syndrome (SS), also have a need for 
additional therapeutic options. 
GS-9876 is a highly selective spleen tyrosine kinase (SYK) inhibitor with once daily dosing; 
SYK is a key signaling molecule involved in innate and adaptive immune system responses. It is
important in various cell types, including platelets, phagocytes, fibroblasts, and osteoclasts, and 
in the generation of the inflammasome. Nonclinical studies show that SYK inhibition may have 
therapeutic value in the treatment of RA, SLE, SS, autoimmune cytopenias, and allergic and 
autoinflammatory diseases. Clinical trials with fostamatinib (an experimental SYK inhibitor) 
have demonstrated responses in RA and in idiopathic thrombocytopenic purpura.
In repeat dose toxicity studies of GS-9876 (in rats for up to 26 weeks and in cynomolgus 
monkeys for up to 39 weeks), the primary observed effects were reversible, dose-dependent 
decreases in circulating lymphocytes, and decreased lymphocytes in various tissues (spleen, 
lymph nodes, thymus, and/or bone marrow), consistent with the expected pharmacology of SYK 
inhibition {Barr et al 2012}. Additionally, effects on erythrocyte turnover were seen in rats, and 
effects on hemostasis (hemorrhage and thrombosis) were seen in monkeys. In clinical studies of 
GS-9876 in healthy volunteers (GS-US-379-1372, single ascending dose, completed, and 
GS-US-379-1900, multiple ascending dose, ongoing), no risks were identified and no 
grade 3 or 4 AEs were reported. There were no clinically significant changes in vital signs, 
physical findings, or ECGs. Given the role of SYK in platelet activation and aggregation, 
bleeding time was evaluated in the study subjects; no prolongation was noted. 
In addition to GS-9876, filgotinib, a once-daily, oral, and potent JAK-1 inhibitor, has the 
potential to address the medical needs of RA. As of January 2016, filgotinib has been 
administered to more than 1000 subjects with RA and more than150 subjects with Crohn’s 
disease (CD) at daily doses ranging from 50 to 200 mg. Dose-dependent decreases in mean 
neutrophil counts and platelet counts were observed in the RA Phase 2b studies (but mean levels 
of both remained within normal laboratory reference ranges), and there were no decreases in 
mean lymphocytes or lymphocyte subsets. However, a potential increased risk of infection may 
be considered consistent with the mechanism of JAK inhibition. In the filgotinib RA program, 
three deaths have been reported, all due to infectious etiologies. One subject in the Phase 2b 
study died of community acquired pneumonia and septic shock; two subjects had entered the 
open-label extension study, one died of meningococcal meningitis, and the other of pneumonia.
Nonclinical studies in rats and dogs identified lymphoid tissues and testes as target organs for 
filgotinib; microscopic findings in the testes included germ cell depletion and degeneration in 
both species, with reduced sperm content and reduced fertility in male rats. A male safety study 
is planned to assess the effects, if any, of filgotinib on semen parameters.
Both GS-9876 and filgotinib are contraindicated in pregnancy; highly effective contraception is 
to be used across all clinical studies to mitigate this risk. Measures to minimize other potential 
risks to subjects will include site/investigator training regarding monitoring for infection, and 
collection of AEs of special interest, including major adverse cardiac events, malignancies, 
infections, and specific laboratory abnormalities. 


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Preclinical and clinical data support the further clinical development of GS-9876 and filgotinib 
due to their potential benefit as novel therapies in inflammatory diseases, with an acceptable 
level of risk consistent with immunomodulation in these patient populations. Controlled trials 
will be utilized to minimize risk to subjects, while gaining understanding of the lowest effective 
doses of these drugs. With respect to GS-9876 and filgotinib, given the early clinical data, as 
well as the beneficial findings in nonclinical models and overall safety, tolerability, and PK 
characteristics of these drugs, there is a favorable benefit:risk profile for continued development 
as treatments for autoimmune/inflammatory diseases. The development of GS-9876 and 
filgotinib are expected to provide a valuable addition and alternative to existing treatments for 
RA, SLE, SS, and related diseases.
1.8.
Compliance
This study will be conducted in compliance with this protocol, GCP, and all applicable 
regulatory requirements.


GS-9876 
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2. 
OBJECTIVES 
The primaty objective of this study is: 
Final 
Amendment2 
• 
To evaluate the effect of GS-987 6 versus placebo for the treatment of signs and symptoms of 
RAin subjects with active RA as measured by change from baseline in DAS28 (CRP) at 
Week 12 
The secondruy objectives of this study ru·e: 
• 
To evaluate the safety and tolerability of GS-9876 in subjects with RA 
• 
To explore the effect of GS-9876 on other disease-specific outcomes in RA 
The explorat01y objectives of this study are: 
IT 
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3. 
STUDY DESIGN 
3.1. 
Endpoints 
The primary endpoint of this study is: 
• 
Change from baseline in DAS28 (CRP) at Week 12 
The secondmy endpoints of the study are: 
• 
The proportion of subjects who achieve ACR 20/50170 at Week 12 
• 
Change from baseline in HAQ-DI score at Week 12 
The explorat01y endpoints include: 
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3.2. 
Study Design 
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This is a randomized, double-blind, placebo-controlled, Phase 2 POC study evaluating the safety, 
tolerability, and efficacy of GS-9876 in adult male and female subjects with active RA despite 
MTX therapy who had an inadequate response to MTX (either alone or in combination with 
bDMARDs). In addition, the effect ofGS-9876 and filgotinib on disease and/or pathway mm·kers 
relevm1t to RA and/or the SYK and JAK pathways will be assessed. 
A total of approximately 80 subjects will be randomized in this study. 
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Figure 3-1.
Study Schema
3.3.
Study Treatments
Following completion of Screening assessments, eligible subjects will be randomized in a 
blinded fashion in a 1:1:1:1 ratio as follows (all groups will continue to take MTX):

GS-9876 30 mg: GS-9876 (1 x 30 mg tablet QD) + PTM filgotinib (2 x placebo tablets QD) 
(N=20)

GS-9876 10 mg: GS-9876 (1 x 10 mg tablet QD) + PTM filgotinib (2 x placebo tablets QD) 
(N=20)

Filgotinib 200 mg: Filgotinib (2 x100 mg tablets QD) + PTM GS-9876 (1 x placebo tablets 
QD) (N=20)

Placebo only: PTM GS-9876 (1 x placebo tablet QD) + PTM filgotinib (2 x placebo tablets 
QD) (N=20)
Randomization will be stratified by prior inadequate response to biologic therapy and geographic 
region.  
3.4.
Duration of Treatment
Subjects will be dosed for up to 12 weeks and then followed for 4 weeks after their last dose of 
study drug. 


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3.5.
Criteria for Interruption and Discontinuation Criteria
3.5.1.
Study drug interruption considerations
The Gilead Medical Monitor should be consulted prior to study drug interruption when 
medically feasible. 
Study drug interruption should be considered in the following circumstances; prior to resumption 
of study drug, the investigator should discuss the case with the Gilead medical monitor:

Intercurrent illness that would, in the judgment of the investigator, affect assessments of 
clinical status to a significant degree.   

Subject is scheduled for emergency surgery (excluding minor skin procedures under local or 
no anesthesia); timing of study drug pausing should be determined in consultation with the 
Gilead medical monitor.  Elective surgery should not be planned during the 12 week study 
period. 

If the subject has any signs or symptoms suggestive of infection (regardless of severity), 
study drug dosing should be immediately interrupted, and the medical monitor notified. Any 
subject who develops a new infection during the study should undergo prompt and complete 
diagnostic testing appropriate for an immunocompromised individual, and the subject should 
be closely monitored. Study drug should continue to be paused until the subject’s event has 
resolved, per judgment of the investigator. Prior to resuming study drug dosing, the 
investigator should discuss these cases with the sponsor or its designee

NOTE: During the time of study drug interruption for any of the above, the subject may 
continue to have study visits and to take part in procedures and assessments, if deemed 
medically appropriate by the investigator.
3.5.2.
Study drug discontinuation considerations
The Gilead Medical Monitor should be consulted prior to study drug discontinuation when 
medically feasible. 
Study medication should be permanently discontinued in the following instances:

Any opportunistic infection

Any serious infection that requires antimicrobial therapy or hospitalization, or any infection 
that meets SAE reporting criteria. 

Complicated herpes zoster infection (with multi-dermatomal, disseminated, ophthalmic, or 
CNS involvement)

Unacceptable toxicity, or toxicity that, in the judgment of the investigator, compromises the 
subject’s ability to continue study-specific procedures or is considered to not be in the 
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
Subject request to discontinue for any reason

Subject noncompliance

Discontinuation of the study at the request of Gilead, a regulatory agency or an institutional 
review board or independent ethics committee (IRB/IEC)

Subjects use of non-permitted concurrent therapy

Pregnancy during the study; refer to Appendix 5

Investigator discretion
After becoming aware of any of the below described abnormal laboratory changes at any one 
time, an unscheduled visit (ie, second sequential) to retest must occur within 3 to 5 days. If the 
laboratory abnormality is confirmed by the retest, study medication should be discontinued.

2 sequential total WBCs <2000 cells/mm3 (SI: <2.0x109 cells/L)

2 sequential neutrophil counts <1000 neutrophils/mm3 (SI: <1.0x109 cells/L)

2 sequential lymphocyte counts <750 lymphocytes/mm3 (SI: <0.75x109 cells/L)

2 sequential hemoglobin values <8.0 g/dL (SI: <80 g/L)

2 sequential platelet counts <75,000 platelets/mm3 (SI: <75.0x109 cells/L)

2 sequential AST or ALT elevations >3xULN with ≥1 total bilirubin value >2xULN1

2 sequential AST or ALT elevations >3xULN accompanied by elevated international 
normalized ratio (INR)1

2 sequential AST or ALT elevations >5xULN, regardless of total bilirubin or accompanying 
symptoms1

2 sequential values for estimated creatinine clearance <40 mL/min based on the 
Cockroft Gault formula
Subjects who stop study medication for any reason will not be replaced. Subjects withdrawing 
from the study should complete the ET and Post-Treatment Week 4 visits. Subjects may
withdraw from the study at any time without providing reason(s) for withdrawal and without 
prejudice to further treatment. The reason(s) for withdrawal will be documented in the electronic 
case report form (eCRF).
                                                
1 In each case, there is a need for additional investigations, such as review of ethanol, recreational drug and dietary 
supplement consumption; testing for acute hepatitis A, B or C infection and biliary tract imaging should be promptly 
discussed with the study Medical Monitor.


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Reasonable efforts will be made to contact subjects who are lost to follow-up. All contacts and 
contact attempts must be documented in the subject's file. 
The sponsor has the right to tenninate the study at any time in case of safety concems or if 
special circumstances conceming the study medication or the company itself occur, making 
fmther tTeatment of subjects impossible. In this event, the investigator(s) and relevant authorities 
will be infonned of the reason for study te1mination. 
3.6. 
End of Study 
End of Study is defined as when the last subject has completed up to 12 weeks of treatment and 
4 weeks of follow-up. 
3.7. 
Post Study Care 
Subjects may be offered the opp01tunity to emoll into an open-label extension study at a future 
date. At this time there are no confi1med post study care options to subjects that have 
pmiicipated on this study a11d the long te1m care of subjects will remain the responsibility of their 
prima1y treating physician. 
3.8. 
Pharmacokinetic (PK) Assessments 
Plasma concentrations ofGS-9876, filgotinib and the metabolite offilgotinib (GS-829845) will 
be measured and PK pm·ameters dete1mined. Plasma concentrations of GS-9876 metabolites may 
be dete1mined and PK parameters may be explored, as applicable. PK sampling will occur 
relative to study dmg dosing at Weeks 2, 8, and 12 or ET, conesponding to a trough 
concentration taken approximately 24 hours after the previous dose of GS-9876 or filgotinib, but 
prior to the next dose of GS-9876 or filgotinib. At Week 4, PK sampling will occur at 
approximately 2 hours postdose. The samples will be used to evaluate PK of GS-9876 or 
filgotinib and may also be used to measure protein binding of GS-9876 or filgotinib. Plasma 
concentrations of GS-9876 metabolites, other filgotinib metabolite(s), and/or MTX may be 
dete1mined. 
PD 
3.9. 
Biomarker Testing 
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Sampling for markers relevant to inflammation (including but not limited to disease-associated 
markers ofRA and/or the SYK and JAK pathways) may be perf01med at Day 1, Week 4, and 
Week 12 or ET. Blood and urine samples will also be collected for assessments of 
immunoglobulins (Day 1 and Week 12 or ET), BandT cell panels (Day 1, Week 4, and 
Week 12), whole blood samples for MoA studies (Day 1, Week 4 and Week 12), and bone 
markers (Day 1 [fasting], Week 4, and Week 12 [fasting]). Sampling time points may be 
modified by the Sponsor based upon emerging data and assay feasibility. Samples for CRP will 
be drawn at every visit. 
The testing outlined in this protocol is based upon the cunent state of scientific knowledge. It 
may be modified during or after the end of the study to remove tests no longer indicated and/or 
to add new tests based upon the growing state of knowledge. Samples may be stored at 
Gilead Sciences for a period of up to 15 years after the end of the study. 
3.9.1. 
Biomarker Samples for Optional Future Research 
PPD 
3.9.2. 
Optional Genomic Research 
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4.
SUBJECT POPULATION
4.1.
Number of Subjects and Subject Selection
Approximately 80 subjects will be enrolled in this study with active RA who have an inadequate 
response to MTX (either alone or in combination with bDMARDs). In order to manage the total 
study enrollment, Gilead, at its sole discretion, may suspend screening and/or enrollment at any 
site or study-wide at any time.
4.2.
Inclusion Criteria
Subjects must meet all of the following inclusion criteria to be eligible for participation in this 
study.
1) Male or female subjects who are between 18 and 75 years of age, inclusive, on the day of 
signing informed consent
2) Have a diagnosis of RA as defined by the 2010 American College of 
Rheumatology - European League Against Rheumatism Collaborative Initiative 
Classification Criteria for Rheumatoid Arthritis (Appendix 6)
3) Active RA disease as defined by: a TJC of ≥6 (out of 68), an SJC of ≥6 (out of 66) at 
Screening and Day 1
4) Inadequate response to treatment with oral or parenteral MTX 7.5 to 25 mg/week 
continuously for at least 12 weeks, with at least 6 weeks at a stable dose (defined as no 
change in prescription) prior to the first dose of study drug
5) Subjects must be receiving a folic or folinic acid supplementation at a stable dose. Subjects 
who are not taking folic or folinic acid at Screening should be initiated on an adequate dose 
of folic acid (>5 mg/week total dose or as per local practice) or equivalent and maintained 
throughout the study.
6) Use of oral corticosteroids of no more than 10 mg prednisone or its equivalent per day is 
allowed if the dose is stable (defined as no change in prescription) for at least 28 days prior to 
the first dose of study drug  
7) NSAIDs or other analgesics (including aspirin ≤ 100 mg daily) are allowed if doses are stable 
(defined as no change in prescription) for at least 14 days prior to the first dose of study drug; 
PRN use for other indications is allowed.
8) No evidence of active or latent TB as demonstrated by a negative QuantiFERON® TB-Gold 
In-Tube test at Screening. Tests with inconclusive results may be repeated one time. If an 
inconclusive test is repeated and is returned with inconclusive results a second time, the 
subject will be excluded from the study. Any prior history of active or latent TB 
(regardless of treatment) is exclusionary.


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9) Able and willing to sign the informed consent as approved by the IRB/IEC. Written consent 
must be provided before initiating any Screening evaluations. Subjects must have read and 
understood the informed consent form (ICF), must fully understand the requirements of the 
study, and must be willing to comply with all study visits and assessments.
10) A negative serum pregnancy test is required for female subjects of childbearing potential, as 
defined in Appendix 5
11) Lactating females must agree to discontinue nursing before the study drug is administered
and for the duration of the study.
12) Male subjects and female subjects of childbearing potential who engage in heterosexual 
intercourse must agree to use protocol specified method(s) of contraception as described in 
Appendix 5.
13) Male subject agrees to refrain from sperm donation throughout the study period and for at 
least 90 days following their last dose of study drug.
14) Female subject agrees to refrain from egg donation/harvest throughout the study period and 
for at least 35 days after their last dose of study drug.
4.3.
Exclusion Criteria
1) Prior treatment with B-cell depleting agents (eg, rituximab), unless more than 6 months prior 
to the first dose of study drug and documented return of CD19+ cells at Screening
2) Prior treatment with any commercially available or investigational SYK inhibitor 
3) Concurrent treatment at Screening with any other csDMARD other than MTX and/or HCQ
(prior csDMARD treatment allowed if appropriate wash out as defined in Section 5.7)
4) Concurrent treatment at Screening with any bDMARD (prior bDMARD treatment allowed if 
appropriate wash out as defined in Section 5.7). Prior failure to treatment with bDMARDs is 
not an exclusion criterion.
5) QT interval corrected for heart rate using the Fridericia formula (QTcF) > 450 msec 
determined by the average of values at the Screening visit
6) History of any major bleeding event defined as Grade 3 severity and above (as defined by the 
modified CTCAE 4.03[Appendix 4]) within the last year or personal or family history of 
bleeding disorder
OR
Current use of chronic anticoagulant, not including daily aspirin for cardiac prophylaxis
7) Treatment with moderate or strong CYP3A inducers or inhibitors within 2 weeks prior to the 
first dose of study drug (examples are provided in Section 5.6)


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8) Joint injections within 4 weeks prior to the first dose of study drug
9) Known hypersensitivity or allergy to GS-9876, filgotinib or MTX, and their metabolites, or 
their formulation excipients
10) Administration of a live or attenuated vaccine within 30 days of Screening or planned for 
during the study.
11) Participation in any investigational drug/device clinical study within 4 weeks or 5 half-lives 
prior to Screening, whichever is longer. Exposure to investigational biologics should be 
discussed with the sponsor. 
12) Have a diagnosis of any generalized musculoskeletal disorder that would interfere with study 
procedures or assessments per the discretion of the investigator (eg, generalized 
osteoarthritis, or systemic inflammatory condition other than RA such as, but not limited to: 
juvenile idiopathic arthritis, Felty’s syndrome, ankylosing spondylitis, reactive arthritis, 
psoriatic arthritis, inflammatory bowel disease associated arthropathies, systemic lupus 
erythematosus, scleroderma, inflammatory myopathy, mixed connective tissue disease, an 
overlap syndrome, systemic vasculitis or gout [participants with secondary Sjogren's 
syndrome or secondary limited cutaneous vasculitis with RA are not excluded]).
13) History of or current moderate to severe congestive heart failure (New York Heart 
Association [NYHA] class III or IV), or within the last 6 months prior to Screening: a 
cerebrovascular accident, myocardial infarction, unstable angina, unstable arrhythmia or any 
other cardiovascular condition which, in the opinion of the investigator, would put the 
subject at risk by participating in the study.
14) History of malignancy within the past 5 years prior to Screening (except for adequately 
treated basal cell carcinoma or non-metastatic squamous cell carcinoma of the skin or 
cervical carcinoma in situ with no evidence of recurrence). 
15) History of lymphoproliferative disease or possible current lymphoproliferative disease
16) History of organ or bone marrow transplant.
17) Positive serology at Screening for human immunodeficiency virus (HIV) 1 or 2, hepatitis B 
virus (ie, surface antigen [Ag] or core antibody [Ab] positive) or hepatitis C virus 
(ie, HCV Ab positive) or any history of infectious hepatitis from any cause with the 
exception of hepatitis A.
18) History of opportunistic infection or immunodeficiency syndrome which would put the
subject at risk, as per investigator judgment.
19) Known active infection of any kind (excluding fungal infections of nail beds) or any major 
episode of infection requiring hospitalization or treatment with intravenous (IV) or oral 
anti-infectives within 4 weeks of Screening.


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20) History of symptomatic herpes zoster or herpes simplex infection within 12 weeks prior to 
Screening or history of disseminated/complicated herpes zoster infection (multi-dermatomal 
involvement, ophthalmic zoster, central nervous system involvement or postherpetic 
neuralgia).
21) History of an infected joint prosthesis or other implanted device with the prosthesis or device
still in situ.
22) History within the previous 2 years prior to Screening or current drug or alcohol abuse, or 
heavy tobacco use, per the investigator judgment.
23) Any condition or circumstances (such as fibromyalgia or others) which in the opinion of the 
investigator or sponsor may make a subject unlikely or unable to complete the study or 
comply with study procedures and requirements. 
24) Have any chronic, uncontrolled medical condition, which would put the subject at increased 
risk during study participation, such as uncontrolled: diabetes, hypertension, morbid obesity, 
thyroid, adrenal, pulmonary, hepatic, renal, neurologic or psychiatric disease, or other disease 
of concern, as per investigator judgment
25) Significant blood loss (>450 mL) or transfusion of any blood product within 12 weeks prior 
to the first dose of study drug
26) Subject has donated blood within 56 days of the first dose of study drug or plasma within 
7 days of the first dose of study drug or does not agree to refrain from blood donation 
throughout the study period and for at least 30 days following the last dose of study drug.
27) The results of the following laboratory tests performed at the central laboratory at Screening 
meet any of the criteria below (out of range lab values may be rechecked one time, per
investigator judgment, before subject is considered a screen-failure):
a) Hemoglobin <8.0 g/dL (International System of Units [SI]: <80 g/L);
b) White blood cells <3.0 x 103 cells/mm3 (SI: <3.0 x 109 cells/L); 
c) Neutrophils <1.5 x 103 cells/mm3 (SI: <1.5 x 109 cells/L);
d) Lymphocytes <0.5 x 103 cells/mm3 (SI: <0.5 x 109 cells/L);
e) Platelets <100 x 103 cells/mm3 (SI: <100 x 109 cells/L);
f)
Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) ≥1.5x ULN;
g) Total bilirubin level ≥2x ULN unless the subject has been diagnosed with Gilbert’s  
disease and this is clearly documented;
h) Creatinine clearance (estimated GFR) < 60 mL/min based on the Cockcroft-Gault (CG) 
formula


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5.
INVESTIGATIONAL MEDICINAL PRODUCTS
5.1.
Randomization, Blinding and Treatment Codes
An Interactive Web and Mobile Response System (IXRS) will be employed to manage subject 
randomization and treatment assignments. It is the responsibility of the investigator to ensure that 
the subject is eligible for the study prior to enrollment. Subjects will be assigned a Screening 
number at the time of consent.
5.1.1.
Procedures for Breaking Treatment Codes
In the event of a medical emergency where breaking the blind is required to provide medical care 
to the subject, the investigator or qualified designee may obtain treatment assignment directly 
from the IXRS system for that subject. Gilead recommends but does not require that the 
investigator contact the Gilead medical monitor before breaking the blind. Treatment assignment 
should remain blinded unless that knowledge is necessary to determine subject emergency 
medical care. The rationale for unblinding must be clearly explained in source documentation 
and on the eCRF, along with the date on which the treatment assignment was obtained. The 
investigator is advised to contact the Gilead medical monitor promptly in case of any treatment 
unblinding.
Blinding of study treatment is critical to the integrity of this clinical trial and therefore, if a 
subject’s treatment assignment is disclosed to the investigator, the subject must discontinue study 
drug. All subjects will be followed until study completion unless consent to do so is specifically 
withdrawn by the subject.
Gilead Drug Safety and Public Health (DSPH) may independently unblind cases for expedited 
reporting of suspected unexpected serious adverse reactions (SUSARs).
5.2.
Description of GS-9876 and PTM GS-9876
5.2.1.
Formulation of GS-9876 and PTM GS-9876
GS-9876 will be supplied as 10 or 30 mg tablets that are identical in appearance, round, 
biconvex, plain-faced and film-coated blue. Each tablet contains either 10 mg or 30 mg of
GS-9876 free base as the succinate form (GS-9876-02). The GS-9876 tablets contain commonly
used excipients including microcrystalline cellulose, mannitol, croscarmellose sodium, 
magnesium stearate, polyvinyl alcohol, polyethylene glycol, titanium dioxide, talc, and 
FD&C blue #2/indigo carmine aluminum lake. 
Matching placebo tablets will be supplied that are identical in physical appearance to the 
10 and 30 mg GS-9876 tablets and contain the following inactive ingredients: 
microcrystalline cellulose, lactose monohydrate, croscarmellose sodium, magnesium stearate, 
polyvinyl alcohol, polyethylene glycol, titanium dioxide, talc, and FD&C blue #2/indigo carmine 
aluminum lake.


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5.2.2.
Packaging and Labeling of GS-9876 and PTM GS-9876
GS-9876 tablets, 10 mg or 30 mg, and PTM GS-9876 tablets are packaged in white, high-density
polyethylene (HDPE) bottles. Each bottle contains 30 tablets, silica gel desiccant and polyester 
packing material. Each bottle is enclosed with a white, continuous thread, child-resistant 
polypropylene screw cap with an induction-sealed and aluminum-faced liner.
Study drug(s) to be distributed to centers in the US and other participating countries will be 
labeled to meet applicable requirements of the United States Food and Drug Administration 
(FDA), European Union (EU) Guideline to Good Manufacturing Practice – Annex 13 
(Investigational Medicinal Products), and/or other local regulations.
5.3.
Description of Filgotinib and PTM Filgotinib
5.3.1.
Formulation of Filgotinib and PTM Filgotinib
Filgotinib will be provided as 100 mg tablets that are capsule-shaped, biconvex, and film-coated 
beige tablets debossed with “GSI” on one side and “100” on the other. Each tablet contains the 
equivalent of 100 mg filgotinib free base in the form of filgotinib maleate. In addition to the 
active ingredient, filgotinib tablets contain the following inactive ingredients: microcrystalline 
cellulose, lactose monohydrate, fumaric acid, pregelatinized starch, silicon dioxide, magnesium 
stearate, macrogol/PEG 3350, polyvinyl alcohol, talc, titanium dioxide, iron oxide yellow, and 
iron oxide red.
Placebo-to-match filgotinib tablets are identical in appearance to the active filgotinib tablets. 
Placebo-to-match filgotinib tablets contain the following inactive ingredients: microcrystalline 
cellulose, lactose monohydrate, croscarmellose sodium, magnesium stearate, 
macrogol/PEG 3350, polyvinyl alcohol, talc, titanium dioxide, iron oxide yellow, and iron oxide 
red.
5.3.2.
Packaging and Labeling of Filgotinib and PTM Filgotinib
Filgotinib 100 mg tablets and PTM filgotinib tablets are packaged in white, HDPE bottles. Each 
bottle contains 30 tablets, silica gel desiccant and polyester packing material. Each bottle is 
enclosed with a white, continuous thread, child-resistant polypropylene screw cap fitted with an 
induction-sealed, aluminum-faced liner.
Study drugs to be distributed to participating centers will be labeled to meet applicable 
requirements of the United States Food and Drug Administration (FDA), the EU Guideline to 
Good Manufacturing Practice - Annex 13 (Investigational Medicinal Products) and/or other local 
regulations, as applicable. 


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5.4.
Storage and Handling of Study Drugs
GS-9876 tablets, PTM GS-9876 tablets, filgotinib tables, and PTM filgotinib tablets should be 
stored at controlled room temperature of 25ºC (77ºF); excursions are permitted between 15ºC 
and 30ºC (59ºF and 86ºF). Storage conditions are specified on the label. 
Until dispensed to the subjects, all drug products should be stored in a securely locked area, 
accessible only to authorized site personnel. To ensure the stability of the study drugs and to 
ensure proper product identification, the drug products should not be stored in a container other 
than the containers in which they are supplied. Consideration should be given to handling, 
preparation, and disposal through measures that minimize drug contact with the body. 
Appropriate precautions should be followed to avoid direct eye contact or exposure when 
handling.
5.5.
Dosage and Administration of Study Drugs
Subjects will receive study drugs according to their randomization assignment to one of the 
following 4 arms:

GS-9876 30 mg: GS-9876 (1 x 30 mg tablet QD) + PTM filgotinib (2 x placebo tablets QD) 
(N=20)

GS-9876 10 mg: GS-9876 (1 x 10 mg tablet QD) + PTM filgotinib (2 x placebo tablets QD) 
(N=20)

Filgotinib 200 mg: Filgotinib (2 x100 mg tablets QD) + PTM GS-9876 (1 x placebo tablet 
QD) (N=20)

Placebo only: PTM GS-9876 (1 x placebo tablet QD) + PTM filgotinib (2 x placebo tablets
QD) (N=20)
The study drugs should be administered orally once daily with water, with or without food. The 
study drugs should be swallowed whole and administered together. Subjects will be instructed to 
take study drug at approximately the same time each morning. On Day 1, subjects will be 
instructed to take their dose in clinic as the last in-clinic study procedure (after all other 
procedures for that visit have been completed). At Weeks 2, 8 and 12, subjects will be instructed 
to take their dose after predose assessments have been completed (eg, PK sample collection). At 
Week 4, subjects will be instructed to take their dose in clinic as the first study procedure prior to 
any others scheduled for that visit.
For missed dose(s) of study medication, subjects should be instructed to take the missed dose(s) 
of study medication as soon as possible during the same day. If more than 12 hours has elapsed 
since the scheduled time of the missed dose, the subject should be instructed to wait and take the 
next dose at the regularly scheduled time. Subjects should be cautioned never to double the next 
dose with a missed dose of study drug under any circumstances. In those cases, the missed dose 
should be returned to the study drug bottle.


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5.6.
Other Medication Administered
Methotrexate should be administered weekly at a dose of 7.5 to 25 mg, orally or parenterally. 
Subjects must also receive folic acid supplementation.
5.7.
Prior and Concomitant Medications
At Screening, all medication taken up to 30 days prior to the Screening visit and all prior and 
current RA medication will be recorded on the eCRF. At each study visit, the site will capture 
any and all medications taken by the subject since the last visit or during the visit (as applicable). 
Concomitant medications include prescription, non-prescription medications, therapies, dietary 
supplements, and minerals.
Allowed Medications:

Subjects must have taken oral or parenteral MTX 7.5 to 25 mg/week continuously for at least 
12 weeks, with at least 6 weeks of stable dose (defined as no change in prescription) prior to 
first study dose and throughout the duration of the study. Subjects will continue to receive 
stable weekly doses of MTX. Further information regarding side effects, dosage and 
administration is available in the current local prescribing information.

Subjects are allowed to remain on HCQ, with at least 8 weeks of stable dose (defined as no 
change in prescription) prior to first study dose and maintained at a stable dose throughout 
the study.

Oral steroids ≤10 mg/day prednisone or equivalent, with at least 28 days of stable dose 
(defined as no change in prescription) prior to the first dose of study drug and maintained at a 
stable dose throughout the study.

NSAIDs or other analgesics (including aspirin ≤100 mg) are allowed if doses are stable
(defined as no change in prescription) for at least 14 days prior to first study dose and 
maintained at a stable dose throughout the study. Pro re nata use for other indications is 
allowed.

For pain while on study, the subject may take acetaminophen or other non-NSAID pain 
medications as directed by the treating physician.  Any scheduled or PRN pain medications, 
including chronic NSAIDs, should be held on study visit days until after the visit procedures 
have been completed.

Dose adjustments for management of toxicity of the above medications are allowed and 
should be documented, along with documentation of the AE which led to the change in the 
medication.
Prohibited Medications:

Any herbal/natural supplements, unless approved by the investigator

Any and all illegal or illicit drug use, including use of prescription drugs outside the care of 
the prescribing physician


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
Changes in the doses of background MTX, anti-malarial therapy, corticosteroids and/or 
NSAIDS (except for adverse events and toxicities per the discretion of the investigator)

Moderate or strong CYP3A4 inhibitors or inducers within 2 weeks prior to the first dose of 
study drug and while on study drug 

The following medications are prohibited within 4 weeks prior to the first dose of study drug 
and throughout the study: 
minocycline, penicillamine, sulfasalazine, anakinra, etanercept, azathioprine, 
cyclosporine, tacrolimus, sirolimus, everolimus, mycophenolate mofetil, tofacitinib or 
biosimilar versions of these drugs, where applicable

The following medications are prohibited within 10 weeks of the first dose of study drug and 
throughout the study: 
infliximab, golimumab, certolizumab pegol, abatacept, tocilizumab, adalimumab or 
biosimilar versions of these drugs, where applicable

Treatment with IV antibiotics for a clinical infection or other medical condition within 
30 days prior to first dose of study drug and throughout the study. If subject acquires an 
infection during the course of the study that requires antibiotic treatment, study drug should
be paused until discontinuation of the antibiotic treatment, clearance of the infection and 
discussion of the case with the medical monitor.

Treatment with B-cell depleting agents (ie, rituximab) within 6 months prior to the first dose 
of study drug and throughout the study 

Treatment with any other investigational study drug within 4 weeks or 5 half-lives prior to 
Screening (whichever is longer) and throughout the study

Prior treatment with any commercially available or investigational SYK inhibitor and 
throughout the study

Joint injections within 4 weeks prior to the first dose of study drug and throughout the study.
If a joint injection has been administered within 6 weeks of the first dose of study drug, the 
joint will be considered unevaluable throughout the study.

Concurrent therapy with any anti-coagulant (eg, coumadin [warfarin], any Vitamin K 
antagonist, any novel oral anticoagulant, any heparin or low molecular heparins, inhibitors of 
factor Xa) 

Concurrent therapy with any anti-platelet therapy (eg, adenosine diphosphate [ADP] receptor 
inhibitors, phosphodiesterase inhibitors, PAR-1 antagonists, Glycoprotein 2b/3a inhibitors) 
with the exception of ≤ 100 mg daily of aspirin and other NSAIDs


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Vaccine Guidelines:

Prior to study participation, it is recommended that the subject’s vaccinations be brought up 
to date according to local vaccination standards.

Live or attenuated vaccines (including, but not limited to varicella and inhaled flu vaccine) 
are prohibited within 30 days of Day 1, throughout the study, and for 6 weeks after the last 
dose of study drug.

Subjects should be advised to avoid routine household contact with persons vaccinated with 
live/attenuated vaccine components. General guidelines suggest that a study subject’s 
exposure to household contacts should be avoided for the below stated time periods:
Varicella or attenuated typhoid fever vaccination – avoid contact for 4 weeks following 
vaccination
Oral polio vaccination -- avoid contact for 6 weeks following vaccination
Attenuated rotavirus vaccine -- avoid contact for 10 days following vaccination
Inhaled flu vaccine -- avoid contact for 1 week following vaccination

Inactivated vaccines (such as inactivated flu vaccines) should be administered according to 
local vaccination standards whenever medically appropriate; however, there are no available 
data on the concurrent use of GS-9876 or filgotinib and their respective impact on immune 
responses following vaccination.
Examples of representative medications which are prohibited are listed below: 


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Table 5-1.
Examples of Disallowed Medications
Drug Class
Agents Disallowed
Strong CYP3A4 Inhibitorsa
clarithromycin, conivaptan,  itraconazole, ketoconazole, nefazodone, 
posaconazole, telithromycin, voriconazole, ritonavir, cobicistat, telaprevir, 
boceprevir, grapefruit juice, idelalisib
Strong CYP3A4 Inducersb
carbamazepine, phenytoin, rifampin, fosphenytoin, pentobarbital, primidone, 
rifabutin, rifapentine, phenobarbital, mitotane, avasimibe, St. John’s Wort
Moderate CYP3A4 Inhibitorsa
fluconazole, erythromycin, diltiazem, dronedarone, aprepitant, imatinib, 
verapamil, tofisopam, ciprofloxacin, cimetidine, cyclosporine, Schisandra 
sphenanthera
Moderate CYP3A4 Inducersb
efavirenz, tipranavir/ritonavir, bosentan, thioridazine, nafcillin, talviraline, 
lopinavir, modafinil, etravirine, lersivirine, semagacestat, genistein
Immunosuppressants
mycophenolate mofetil, azathioprine, quinacrin, gold, leflunomide
Calcineurin inhibitor
cyclosporine, tacrolimus
mTOR inhibitor
sirolimus, everolimus
Herbal/Natural Supplementsd
grapefruit juicea, St. John’s Wortb, fish oil, borage oil, Schisandra 
sphenanthera
Anti-plateletc
adenosine diphosphate (ADP) receptor inhibitors, phosphodiesterase 
inhibitors, PAR-1 antagonists, Glycoprotein 2b/3a inhibitors
Anti-coagulant
warfarin, any Vitamin K antagonist, any novel oral anticoagulant, any heparin 
or low molecular heparins, inhibitors of factor Xa
a
In vitro data indicate GS-9876 is a substrate of CYP3A4. Co-administration of CYP3A4 inhibitors may increase GS-9876
exposure. These agents are prohibited while subject is on study drug and 2 weeks prior to study drug administration.
b
In vitro data indicate GS-9876 is a substrate of CYP3A4. Co-administration of CYP3A4 inducers may decrease GS-9876
exposure. These agents are prohibited while subject is on study drug and 2 weeks prior to study drug administration.
c
≤ 100 mg aspirin and NSAIDs are permitted 
d
Herbal/Natural supplements not listed require investigator review and approval.
5.8.
Investigational Medicinal Product Accountability and Disposal or Return
The investigator is responsible for ensuring adequate accountability of all used and unused study 
drugs. This includes acknowledgement of receipt of each shipment of study drugs (quantity and 
condition). All used and unused study drugs dispensed to subjects must be returned to the site.
Accountability records will be maintained by each study site to:

Record the date received and quantity of study drugs; 

Record the date, subject number, subject initials, and the study drugs number dispensed; and

Record the date, quantity of used and unused study drugs returned, along with the initials of 
the person recording the information.
For additional information about study drug accountability and return, refer to Section 9.1.7.


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Amendment 2
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6.
STUDY PROCEDURES
The study procedures to be conducted for each subject enrolled are presented in tabular form in 
Appendix 2 and described in the text that follows. The investigator must document any 
deviation from protocol procedures and notify the sponsor or contract research organization 
(CRO).
The study center will not initiate dosing until:

The IRB and IEC and other applicable regulatory agencies have reviewed and approved the 
study and the informed consent document;

All requested regulatory documents have been submitted to and approved by Gilead;

A Master Services Agreement and/or Study Agreement is executed;

The study initiation meeting has been conducted by the Gilead (or designee).
The initiation meeting will include but is not limited to a review of the protocol, the IB, study 
drugs, and investigator responsibilities.
Documentation of the personally signed and dated informed consent of each subject, using the 
study-specific, IRB-approved Informed Consent Forms (ICF), is required before initiating the 
screening process. 
6.1.
Subject Enrollment and Treatment Assignment
It is the responsibility of the investigator to ensure that subjects are eligible to participate in the 
study prior to enrollment and continue to remain eligible throughout the study.
Once informed consent has been obtained, all screening tests and procedures have been assessed, 
and study eligibility has been confirmed, eligible subjects will be randomized to study treatment
as described in Section 5.1.
6.2.
Pretreatment Assessments
6.2.1.
Screening Visit (within 28 days prior to randomization)
Written informed consent must be obtained from each subject before initiation of any visit 
procedures. After a subject has provided informed consent, the investigator will determine if the 
subject is eligible for participation in the study.  Subjects will be screened within 28 days before 
randomization (first dose of study drug) to determine eligibility for participation in the study.
The assessment will include a review of the Inclusion/Exclusion criteria and completion of all 
Screening Visit procedures as outlined in Appendix 2. A sufficient number of subjects will be 
screened to enroll approximately 80 subjects.


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The following will be performed and documented at Screening:

Obtain written informed consent

Obtain medical history including but not limited to RA, prior RA medication history any 
personal or family histories of bleeding disorders and cardiovascular disease

Perform complete physical examination (refer to Appendix 9)

Obtain vital signs (refer to Appendix 9)

Obtain height and weight (refer to Appendix 9)

Complete 12-lead ECG (refer to Appendix 9)

Perform 66 swollen and 68 tender joint count assessment (refer to Appendix 7 and 
Appendix 9)

Obtain blood samples for (refer to Appendix 3):
Hematology, Chemistry and Coagulation
Lipid Panel
CRP
TSH
HbA1c
Serology (HIV, HCV, and HBV)
Serum pregnancy test for females of childbearing potential only
QuantiFERON® TB-Gold
CD19 count, as applicable (refer to exclusion criteria)

Obtain urine for urinalysis and urine drug screen (refer to Appendix 3)

Record any serious adverse events (SAEs) and all AEs related to protocol mandated 
procedures occurring after signing of the consent form (refer to Section 7).

Record any prior and concomitant medications
Subjects meeting all of the inclusion criteria and none of the exclusion criteria may return to the 
clinic after Screening for randomization into the study.


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Amendment 2
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Subjects who do not meet the eligibility criteria will be considered screen failures and excluded 
from randomization. Screen failures may be considered for rescreening one time for the study in 
consultation with the Sponsor or its designee.
From the time of obtaining informed consent through the first administration of study drug, 
record all SAEs, as well as any AEs related to protocol-mandated procedures on the adverse 
events eCRF. All other untoward medical occurrences observed during the screening period, 
including exacerbation or changes in medical history are to be captured on the medical history 
eCRF. See Section 7 Adverse Events and Toxicity Management for additional details.
Screening labs may be repeated once within 28 days prior to administration of study drug to rule 
out laboratory error.
6.3.
Randomization (Day 1)
Subjects who meet all inclusion and exclusion criteria and complete screening will return for 
randomization into one of the 4 treatments as described in Section 3.3. The 66 swollen and 
68 tender joint count assessments must be performed prior to all other study procedures on Day 1 
and prior to randomization to confirm subject eligibility. Randomization will be completed as 
described in Section 5.1.
6.4.
Treatment Assessments
6.4.1.
Day 1
Study procedures and assessments are outlined in Appendix 2. The 66 swollen and 68 tender 
joint count assessments must be performed prior to all other study procedures on Day 1 and prior 
to randomization to confirm subject eligibility. The HAQ-DI including Patient’s Assessment of 
Pain, and Patient’s Global Assessment of Disease Activity are recommended to be done prior to 
any invasive study procedures. Blood draws should be the last study assessment prior to dosing 
and dosing should be the last study procedure on Day 1.
The following will be performed and documented on Day 1:

Confirm study eligibility

Perform symptom driven physical examination 

Obtain vital signs 

Obtain weight

Perform 12-lead ECG (predose)

Assess AEs and concomitant medications

Subject completes disease specific questionnaires and activity scales (refer to Appendix 9): 
HAQ-DI including Patient’s Assessment of Pain
Patient’s Global Assessment of Disease Activity   


GS-9876 
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Gilead Sciences, Inc. 
• 
Perf01m 66 swollen and 68 tender joint cmmt assessment (refer to Appendix 9) 
Final 
Amendment 2 
• 
Investigator completes Physician's Global Assessment of Disease Activity (refer to 
Appendix 9) 
• 
Obtain blood samples for: 
-
Hematology, Chemistty and Coagulation 
-
Lipid Panel (Fasting) 
-
CRP 
-
RF/CCP 
-
Inflammation and Pathway Biomarkers 
-RNA 
-
Imrrumoglobulins 
-
Whole Blood Sample for MoA Studies 
-
B and T Cell Panels 
• 
Obtain urine sample for urine pregnancy test for females of childbearing potential only 
• 
Obtain urine sample for bone maTker (fasting) 
• PPD 
• 
Dmg Administration 
-
Dispense study dtugs as directed by the IXRS. 
-
Instruct the subject on the packaging, storage and adtninistration of all study dtugs. 
-
Instmct the subject to document their daily dose administr·ation. 
-
Observe the subject taking the first dose of study dt11g and record the time of the 
first dose. Study dtug should be administered as the last study procedure on Day 1. 
-
Instr11ct the subject to bring their study dtug to all study visits and not to take study dtug 
until after predose assessments at Week 2, Week 8, and Week 12 visits. Instruct the 
subject not to take study dt11g until in clinic and instmcted to do so at Week 4. 
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6.4.2. 
Week 2 (± 3 days) 
Final 
Amendment 2 
Study procedures and assessments are outlined in Appendix 2. The following will be performed 
and documented at Week 2, within a± 3-day window: 
• 
Perform symptom driven physical examination 
• 
Obtain vital signs 
• 
Obtain weight 
• 
Perform 12-lead ECG 
• 
Assess AEs and concomitant medications 
• 
Subject completes disease specific questionnaires and activity scales: 
-
HAQ-DI including Patient's Assessment of Pain 
-
Patient's Global Assessment of Disease Activity 
• 
Perform 66 swollen and 68 tender joint count assessment 
• 
Investigator completes Physician's Global Assessment of Disease Activity 
• 
Obtain blood samples for: 
-
Hematology, Chemistry and Coagulation 
-
Lipid Panel 
-
CRP 
• 
Obtain urine sample for urine pregnancy test for females of childbearing potential only 
(obtain blood for serum pregnancy test if urine pregnancy test is positive) 
• 
Collect PK sample (predose) 
• 
Study drug administration after predose assessments completed (eg, PK sample collection). 
• 
Complete medication pill count 
• 
Review study drug compliance and drug administration instructions with subject. 
6.4.3. 
Week 4 (± 3 days) 
Study procedures and assessments are outlined in Appendix 2. The following will be performed 
and documented at Week 4, within a± 3-day window: 
• 
Study drug administration Qrior to other study procedures ~PPD 
~----------------------~ 
• 
Perform symptom driven physical examination 
CONFIDENTIAL 
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Gilead Sciences, Inc. 
• 
Obtain vital signs 
• 
Obtain weight 
• 
Perf01m 12-lead ECG 
• 
Assess AEs and concomitant medications 
• 
Subject completes disease specific questionnaires and activity scales: 
-
HAQ-DI including Patient's Assessment of Pain 
-
Patient's Global Assessment of Disease Activity 
• 
Perf01m 66 swollen and 68 tender joint count assessment 
• 
Investigator completes Physician's Global Assessment of Disease Activity 
• 
Obtain blood samples for: 
-
Hematology, Chemistly and Coagulation 
-
Lipid Panel 
-
CRP 
-
Inflammation and Pathway Biomarkers 
-
RNA 
-
Whole Blood Sample for MoA Studies 
-
B and T Cell Panels 
Final 
Amendment2 
• 
Obtain mine sample for mine pregnancy test for females of childbearing potential only 
(obtain blood for sennn pregnancy test if mine pregnancy test is positive) 
• 
Obtain mine sample for bone marker 
• 
Collect PK sample (2 homs postdose) 
• PPD 
• 
Study dmg will be dispensed as directed by IXRS. 
• 
Complete medication pill count 
• 
Review study dmg compliance and dmg administt·ation instluctions with subject. 
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Gilead Sciences, Inc. 
6.4.4. 
Week 8 (± 3 days) 
Final 
Amendment 2 
Study procedmes and assessments are outlined in Appendix 2. The following will be perfmmed 
and documented at Week 8, within a± 3-day window: 
• 
Perfmm symptom driven physical examination 
• 
Obtain vital signs 
• 
Obtain weight 
• 
Perfmm 12-lead ECG 
• 
Assess AEs and concomitant medications 
• 
Subject completes disease specific questionnaires and activity scales: 
-
HAQ-DI including Patient's Assessment of Pain 
-
Patient's Global Assessment of Disease Activity 
• 
Perfmm 66 swollen and 68 tender joint count assessment 
• 
Investigator completes Physician's Global Assessment of Disease Activity 
• 
Obtain blood samples for: 
-
Hematology, Chemistiy and Coagulation 
-
Lipid Panel 
-
CRP 
• 
Obtain mine sample for mine pregnancy test for females of childbearing potential only 
(obtain blood for serum pregnancy test if mine pregnancy test is positive) 
• 
Collect PK sample (predose) 
• PPD 
• 
Study drug administration after predose assessments completed (eg, PK sample collection). 
• 
Study dmg will be dispensed as directed by IXRS. 
• 
Complete medication pill cmmt 
• 
Review study drug compliance and dmg administration instiu ctions with subject. 
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6.4.5.
Week 12 (+ 3 days)
Study procedures and assessments are outlined in Appendix 2. The HAQ-DI including Patient’s 
Assessment of Pain, and Patient’s Global Assessment of Disease Activity are recommended to 
be done prior to the 66 swollen and 68 tender joint count assessments and before any invasive 
study procedures. Blood draws should be done at the end of the study visit.
The following will be performed and documented on Day 1, within a + 3-day window:

Perform symptom driven physical examination 

Obtain vital signs 

Obtain weight

Perform 12-lead ECG

Assess AEs and concomitant medications

Subject completes disease specific questionnaires and activity scales: 
HAQ-DI including Patient’s Assessment of Pain 
Patient’s Global Assessment of Disease Activity

Perform 66 swollen and 68 tender joint count assessment (prior to Physician’s Global 
Assessment of Disease Activity)

Investigator completes Physician’s Global Assessment of Disease Activity

Obtain blood samples for:
Hematology, Chemistry and Coagulation
Lipid Panel (Fasting)
CRP
RF/CCP
Inflammation and Pathway Biomarkers
RNA
Immunoglobulins
Whole Blood Sample for MoA Studies
B and T Cell Panels

Obtain urine sample for urine pregnancy test for females of childbearing potential only
(obtain blood for serum pregnancy test if urine pregnancy test is positive)


GS-9876 
Protocol GS-US-379-1582 
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• 
Obtain mine sample for bone marker (fasting) 
• 
Collect PK sample (predose) 
• PPD 
Final 
Amendment2 
• 
Study dmg administration after predose assessments completed (eg, PK sample collection). 
• 
All study dmg must be retumed by subject. Study dmg not previously retumed by the subject 
should also be collected. 
• 
Complete medication pill count. 
6.5. 
Early Termination(± 3 days) 
If a subject discontinues study dosing (for example, as a result of an AE), evety attempt should 
be made to perf01m the required study-related follow-up and procedmes (see Section 3.5, 
Discontinuation Criteria). 
Evaluations indicating abn01mal results believed to be possibly or probably related to study 
dosing at the ET visit should be repeated weekly or as often as deemed appropriate by the 
investigator tmtil the abn01mality resolves, retums to baseline visit levels, or is othetwise 
explained. 
If the subject discontinues prematmely from the study, the ET evaluations and/or procedmes 
should be completed as outlined in Appendix 2 within 72 homs of subject's early tetmination 
from the study. The following will be perf01med and documented at ET, within a± 3-day 
window: 
• 
Perf01m symptom driven physical examination 
• 
Obtain vital signs 
• 
Perf01m 12-lead ECG 
• 
Assess AEs and concomitant medications 
• 
Subject completes disease specific questionnaires and activity scales: 
-
HAQ-DI, including Patient's Assessment of Pain 
-
Patient's Global Assessment of Disease Activity 
• 
Perf01m 66 swollen and 68 tender joint cmmt assessment 
• 
Investigator completes Physician's Global Assessment of Disease Activity 
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
Obtain blood samples for:
Hematology, Chemistry and Coagulation
Lipid Panel
CRP
RF/CCP
Inflammation and Pathway Biomarkers
RNA
Immunoglobulins

Obtain urine sample for urine pregnancy test for females of childbearing potential only
(obtain blood for serum pregnancy test if urine pregnancy test is positive)

Collect PK sample

All study drug must be returned by subject. Study drug not previously returned by the subject 
should also be collected.

Complete medication pill count.
6.6.
Post-Treatment Assessments (+ 5 days)
Study procedures and assessments are outlined in Appendix 2. The Post-Treatment Week 4 Visit 
will occur 28 days (+ 5 days) from the last administration of study drug. The following will be 
performed and documented:

Perform symptom driven physical examination 

Obtain vital signs 

Obtain weight

Perform 12-lead ECG

Assess AEs and concomitant medications

Obtain blood samples for:
Hematology, Chemistry, and Coagulation
Lipid Panel
CRP

Obtain urine sample for urine pregnancy test for females of childbearing potential only
(obtain blood for serum pregnancy test if urine pregnancy test is positive)


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6.7.
Sample Storage
From subjects who provide additional consent, residual samples from blood drawn at all visits 
will be frozen and stored. These stored samples may be used by Gilead or our research partners 
to help answer questions about the RA and related diseases, study drug, or clinical laboratory 
testing to provide additional safety data. No human genetic testing will be performed without 
express consent of the study subjects. At the conclusion of this study, PK samples may be 
retained in storage by Gilead at its research partner facility for a period of up to 2 years. Other
samples and samples collected for RNA may be retained in storage for Gilead for a period of up 
to 15 years.


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7.
ADVERSE EVENTS AND TOXICITY MANAGEMENT
7.1.
Definitions of Adverse Events, Adverse Reactions, and Serious Adverse 
Events
7.1.1.
Adverse Events
An AE is any untoward medical occurrence in a clinical study subject administered a medicinal 
product, which does not necessarily have a causal relationship with the treatment. An AE can 
therefore be any unfavorable and/or unintended sign, symptom, or disease temporally associated 
with the use of a medicinal product, whether or not considered related to the medicinal product.
AEs may also include pre- or post-treatment complications that occur as a result of protocol 
specified procedures, lack of efficacy, overdose, drug abuse/misuse reports, or occupational 
exposure. Preexisting events that increase in severity or change in nature during or as a 
consequence of participation in the clinical study will also be considered AEs.
An AE does not include the following:

Medical or surgical procedures such as surgery, endoscopy, tooth extraction, and transfusion.
The condition that led to the procedure may be an adverse event and must be reported.

Pre-existing diseases, conditions, or laboratory abnormalities present or detected before the 
Screening visit that do not worsen

Situations where an untoward medical occurrence has not occurred (eg, hospitalization for 
elective surgery, social and/or convenience admissions)

Overdose without clinical sequelae (see Section 7.7.2.2)

Any medical condition or clinically significant laboratory abnormality with an onset date 
before the consent form is signed and not related to a protocol-associated procedure is not an 
AE. It is considered to be pre-existing and should be documented on the medical history 
eCRF.
7.1.2.
Serious Adverse Events
An SAE is defined as an event that, at any dose, results in the following:

Death

Life-threatening (Note: The term “life-threatening” in the definition of “serious” refers to an 
event in which the subject was at risk of death at the time of the event; it does not refer to an 
event that hypothetically might have caused death if it were more severe.)

In-patient hospitalization or prolongation of existing hospitalization


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
Persistent or significant disability/incapacity

A congenital anomaly/birth defect

A medically important event or reaction: such events may not be immediately 
life-threatening or result in death or hospitalization but may jeopardize the subject or may 
require intervention to prevent one of the other outcomes constituting SAEs. Medical and 
scientific judgment must be exercised to determine whether such an event is a reportable 
under expedited reporting rules. Examples of medically important events include intensive 
treatment in an emergency room or at home for allergic bronchospasm; blood dyscrasias or 
convulsions that do not result in hospitalization; and development of drug dependency or 
drug abuse. For the avoidance of doubt, infections resulting from contaminated medicinal 
product will be considered a medically important event and subject to expedited reporting 
requirements.
7.1.3.
Clinical Laboratory Abnormalities and Other Abnormal Assessments as 
Adverse Events or Serious Adverse Events
Laboratory abnormalities without clinical significance are not recorded as AEs or SAEs. 
However, laboratory abnormalities (eg, clinical chemistry, hematology, and urinalysis) that 
require medical or surgical intervention or lead to study drug interruption, modification, or 
discontinuation must be recorded as an AE, as well as an SAE, if applicable. In addition, 
laboratory or other abnormal assessments (eg, electrocardiogram, x-rays, vital signs) that are 
associated with signs and/or symptoms must be recorded as an AE or SAE if they meet the 
definition of an AE or SAE as described in Sections 7.1.1 and 7.1.2. If the laboratory 
abnormality is part of a syndrome, record the syndrome or diagnosis (eg, anemia), not the 
laboratory result (ie, decreased hemoglobin).
For specific information on handling of clinical laboratory abnormalities in this study, please
refer to Section 7.5.
7.2.
Assessment of Adverse Events and Serious Adverse Events
The investigator or qualified sub-investigator is responsible for assessing AEs and SAEs for 
causality and severity, and for final review and confirmation of accuracy of event information 
and assessments.
7.2.1.
Assessment of Causality for Study Drugs and Procedures
The investigator or qualified sub-investigator is responsible for assessing the relationship to 
study drug therapy using clinical judgment and the following considerations:

No: Evidence exists that the adverse event has an etiology other than study drug. For SAEs, 
an alternative causality must be provided (eg, pre-existing condition, underlying disease, 
intercurrent illness, or concomitant medication).

Yes: There is reasonable possibility that the event may have been caused by the study drug.


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It should be emphasized that ineffective treatment should not be considered as causally related in 
the context of adverse event reporting. 
The relationship to study procedures (eg, invasive procedures such as venipuncture or biopsy) 
should be assessed using the following considerations:

No: Evidence exists that the adverse event has an etiology other than the study procedure.

Yes: The adverse event occurred as a result of a protocol procedure (eg, venipuncture).
7.2.2.
Assessment of Severity
The severity grading of AEs will be assessed as Grade 1, 2, 3 or 4 using the Common 
Terminology Criteria for Adverse Events (CTCAE) version 4.03. For AEs associated with 
laboratory abnormalities, the event should be graded on the basis of the clinical severity in the 
context of the underlying conditions; this may or may not be in agreement with the grading of 
the laboratory abnormality. 
The only modification to the CTCAE criteria is the addition of a Grade 1 upper respiratory, as 
described in Appendix 4.
7.3.
Investigator Requirements and Instructions for Reporting Adverse Events 
and Serious Adverse Events to Gilead
7.3.1.
Requirements for collection prior to study drug initiation:
After informed consent, but prior to initiation of study medication, the following types of events 
should be reported on the CRF/eCRF: all SAEs and adverse events related to protocol-mandated 
procedures.
7.3.1.1.
Adverse Events
Following initiation of study medication, collect all AEs, regardless of cause or relationship, 
until 30 days after last administration of study drug must be reported to the CRF/eCRF database 
as instructed.
All AEs should be followed up until resolution or until the adverse event is stable, if possible. 
Gilead Sciences may request that certain AEs be followed beyond the protocol defined follow-up 
period.
7.3.1.2.
Serious Adverse Events
All SAEs, regardless of cause or relationship, that occurs after the subject first consents to
participate in the study (ie, signing the informed consent) and throughout the duration of the 
study, including the protocol-required post treatment follow-up period, must be reported to the 
CRF/eCRF database and Gilead DSPH as instructed. This also includes any SAEs resulting from 
protocol-associated procedures performed after informed consent is signed.


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Any SAEs and deaths that occur after the post treatment follow-up visit but within 4 weeks of 
the last dose of study drug, regardless of causality, should also be reported. 
Investigators are not obligated to actively seek SAEs after the protocol defined follow-up period; 
however, if the investigator learns of any SAEs that occur after study participation has concluded 
and the event is deemed relevant to the use of study drug, he/she should promptly document and 
report the event to Gilead DSPH.

All AEs and SAEs will be recorded in the CRF/eCRF database within the timelines outlined 
in the CRF/eCRF completion guideline.
7.3.1.3.
Electronic Serious Adverse Event (eSAE) Reporting Process 

Site personnel record all SAE data in the CRF/eCRF database and from there transmit the 
SAE information to Gilead DSPH within 24 hours of the investigator’s knowledge of the 
event. Detailed instructions can be found in the CRF/eCRF completion guidelines.

If for any reason it is not possible to record the SAE information electronically, 
ie, the CRF/eCRF database is not functioning, record the SAE on the paper serious adverse 
event reporting form and submit within 24 hours to:
Gilead DSPH
Email: Safety_FC@gilead.com
Fax: +1 650-522-5477

As soon as it is possible to do so, any SAE reported via paper must be transcribed into the 
CRF/eCRF Database according to instructions in the CRF/eCRF completion guidelines.

If an SAE has been reported via a paper form because the CRF/eCRF database has been 
locked, no further action is necessary.

All AEs and SAEs will be recorded in the CRF/eCRF database within the timelines outlined 
in the CRF/eCRF completion guideline. 

For fatal or life-threatening events, copies of hospital case reports, autopsy reports, and other 
documents are also to be submitted by e-mail or fax when requested and applicable. 
Transmission of such documents should occur without personal subject identification, 
maintaining the traceability of a document to the subject identifiers.

Additional information may be requested to ensure the timely completion of accurate safety 
reports.

Any medications necessary for treatment of the SAE must be recorded onto the concomitant 
medication section of the subject’s CRF/eCRF and the event description section of the SAE 
form.


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7.4.
Gilead Reporting Requirements
Depending on relevant local legislation or regulations, including the applicable US FDA Code of 
Federal Regulations, the EU Clinical Trials Directive (2001/20/EC) and relevant updates, and 
other country-specific legislation or regulations, Gilead may be required to expedite to 
worldwide regulatory agencies reports of SAEs, serious adverse drug reactions (SADRs), or 
SUSARs. In accordance with the EU Clinical Trials Directive (2001/20/EC), Gilead or a 
specified designee will notify worldwide regulatory agencies and the relevant IEC in concerned 
Member States of applicable SUSARs as outlined in current regulations.
Assessment of expectedness for SAEs will be determined by Gilead using reference safety 
information specified in the IB or relevant local label as applicable. 
All investigators will receive a safety letter notifying them of relevant SUSAR reports associated 
with any study drug. The investigator should notify the IRB/IEC of SUSAR reports as soon as is 
practical, where this is required by local regulatory agencies, and in accordance with the local 
institutional policy. 
7.5.
Clinical Laboratory Abnormalities and Other Abnormal Assessments as 
Adverse Events or Serious Adverse Events
Laboratory abnormalities are usually not recorded as AEs or SAEs. However, laboratory 
abnormalities (eg, clinical chemistry, hematology, and urinalysis) independent of the underlying 
medical condition that require medical or surgical intervention or lead to study drug interruption, 
modification, or discontinuation must be recorded as an AE, as well as an SAE, if applicable. In 
addition, laboratory or other abnormal assessments (eg, electrocardiogram, x-rays, vital signs) 
that are associated with signs and/or symptoms must be recorded as an AE or SAE if they meet 
the definition of an AE or SAE as described in Sections 7.1.1 and 7.1.2, respectively. If the 
laboratory abnormality is part of a syndrome, record the syndrome or diagnosis (i.e., anemia) not 
the laboratory result (i.e., decreased hemoglobin).
Severity should be recorded and graded according to the modified CTCAE Grading Scale as 
described in (Appendix 4). 
For adverse events associated with laboratory abnormalities, the event should be graded on the 
basis of the clinical severity in the context of the underlying conditions; this may or may not be 
in agreement with the grading of the laboratory abnormality.
7.5.1.
Grades 1 and 2 Laboratory Abnormality or Clinical Event
Continue study drug at the discretion of the investigator.
7.5.2.
Grade 3 Laboratory Abnormality or Clinical Event
For Grade 3 clinically significant laboratory abnormality or clinical event, study drug may be 
continued if the event is considered to be unrelated to study drug. 


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For a Grade 3 clinical event, or clinically significant laboratory abnormality confirmed by repeat 
testing, that is considered to be related to study drug, study drug should be withheld until the 
toxicity returns to ≤Grade 2. 
If a laboratory abnormality recurs to ≥Grade 3 following re-challenge with study drug and is 
considered related to study drug, then study drug should be permanently discontinued and the 
subject managed according to local clinical practice. Recurrence of laboratory abnormalities 
considered unrelated to study drug may not require permanent discontinuation.
7.5.3.
Grade 4 Laboratory Abnormality or Clinical Event
For a Grade 4 clinical event or clinically significant Grade 4 laboratory abnormality confirmed 
by repeat testing, study drug should be permanently discontinued and the subject managed 
according to local clinical practice. The subject should be followed as clinically indicated until 
the laboratory abnormality returns to baseline or is otherwise explained, whichever occurs first. 
A clinically significant Grade 4 laboratory abnormality that is not confirmed by repeat testing 
should be managed according to the algorithm for the new toxicity grade. 
Study drug may be continued without dose interruption for a clinically non-significant Grade 4 
laboratory abnormality (eg, Grade 4 CK after strenuous exercise or triglyceride elevation that is 
nonfasting or that can be medically managed) or a clinical event considered unrelated to study 
drug. 
7.6.
Toxicity Management 
Treatment-emergent toxicities will be noted by the investigator and brought to the attention of 
the Gilead Sciences Medical Monitor or designee. Whether or not considered treatment-related, 
all subjects experiencing AEs should be monitored periodically until symptoms subside, any 
abnormal laboratory values have resolved or returned to baseline levels or they are considered 
irreversible, or until there is a satisfactory explanation for the changes observed.
Grade 3 or 4 clinically significant laboratory abnormalities should be confirmed by repeat testing 
as soon as possible, and preferably within 3 calendar days after receipt of the original test results.
Grade 3 or 4 clinically significant laboratory abnormalities should be managed as outlined in 
Sections 7.5.2 and 7.5.3.
Any questions regarding toxicity management should be directed to the Gilead Sciences Medical 
Monitor or designee.
7.7.
Special Situations Reports
7.7.1.
Definitions of Special Situations
Special situation reports include all reports of medication error, abuse, misuse, overdose, reports 
of adverse events associated with product complaints, occupational exposure with an AE, 
pregnancy reports regardless of an associated AE, and an AE in an infant following exposure 
from breastfeeding.  


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Medication error is any unintentional error in the prescribing, dispensing, or administration of a 
medicinal product while in the control of the health care provider, subject, or consumer.
Abuse is defined as persistent or sporadic intentional excessive use of a medicinal product by a 
subject.
Misuse is defined as any intentional and inappropriate use of a medicinal product that is not in 
accordance with the protocol instructions or the local prescribing information.
An overdose is defined as an accidental or intentional administration of a quantity of a medicinal 
product given per administration or cumulatively which is above the maximum recommended 
dose as per protocol or in the product labelling (as it applies to the daily dose of the subject in 
question). In cases of a discrepancy in drug accountability, overdose will be established only 
when it is clear that the subject has taken the excess dose(s). Overdose cannot be established 
when the subject cannot account for the discrepancy except in cases in which the investigator has 
reason to suspect that the subject has taken the additional dose(s).
Product complaint is defined as complaints arising from potential deviations in the manufacture, 
packaging, or distribution of the medicinal product.
Occupational exposure is defined as exposure to a medicinal product as a result of one’s 
professional or non-professional occupation.
7.7.2.
Instructions for Reporting Special Situations
7.7.2.1.
Instructions for Reporting Pregnancies
The investigator should report pregnancies in female study subjects that are identified after 
initiation of study medication and throughout the study, including the post study drug follow-up 
period, to Gilead DSPH using the pregnancy report form within 24 hours of becoming aware of 
the pregnancy.
Refer to Section 7.3 and the CRF/eCRF completion guidelines for full instructions on the 
mechanism of pregnancy reporting.
The pregnancy itself is not considered an AE nor is an induced elective abortion to terminate a 
pregnancy without medical reasons.
Any premature termination of pregnancy (eg, a spontaneous abortion, an induced therapeutic 
abortion due to complications or other medical reasons) must be reported within 24 hours as an 
SAE. The underlying medical reason for this procedure should be recorded as the AE term.
A spontaneous abortion is always considered to be an SAE and will be reported as described in 
Section 7.3. Furthermore, any SAE occurring as an adverse pregnancy outcome post study must 
be reported to Gilead DSPH.


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The subject should receive appropriate monitoring and care until the conclusion of the 
pregnancy. The outcome should be reported Gilead DSPH using the pregnancy outcome report 
form. If the end of the pregnancy occurs after the study has been completed, the outcome should 
be reported directly to Gilead DSPH. Gilead DSPH contact information is as follows: 
Email: Safety_FC@gilead.com and Fax: +1 (650) 522-5477. 
Pregnancies of female partners of male study subjects exposed to Gilead or other study drugs 
must also be reported and relevant information should be submitted to Gilead DSPH using the 
pregnancy and pregnancy outcome forms within 24 hours. Monitoring of the subject should 
continue until the conclusion of the pregnancy. If the end of the pregnancy occurs after the study 
has been completed, the outcome should be reported directly to Gilead DSPH, fax number 
+1 (650) 522-5477 or email Safety_FC@gilead.com.
Refer to Appendix 5 for Pregnancy Precautions, Definition for Female of Childbearing Potential, 
and Contraceptive Requirements.
7.7.2.2.
Reporting Other Special Situations
All other special situation reports must be reported on the special situations report form and 
forwarded to Gilead DSPH within 24 hours of the investigator becoming aware of the situation. 
These reports must consist of situations that involve study drug and/or Gilead concomitant 
medications, but do not apply to non-Gilead concomitant medications. 
Special situations involving non-Gilead concomitant medications does not need to be reported on 
the special situations report form; however, for special situations that result in AEs due to a 
non--Gilead concomitant medication, the AE should be reported on the AE form. 
Any inappropriate use of concomitant medications prohibited by this protocol should not be 
reported as “misuse,” but may be more appropriately documented as a protocol deviation.
Refer to Section 7.3 and the CRF/eCRF completion guidelines for full instructions on the 
mechanism of special situations reporting.
All clinical sequelae in relation to these special situation reports will be reported as AEs or SAEs 
at the same time using the AE CRF/eCRF and/or the SAE report form. Details of the symptoms 
and signs, clinical management, and outcome will be reported, when available.


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8. 
STATISTICAL CONSIDERATIONS 
8.1. 
Analysis Objectives and Endpoints 
8.1.1. 
Analysis Objectives 
The prima1y objective is: 
Final 
Amendment 2 
• 
To evaluate the effect of GS-987 6 versus placebo for the treatment of signs and symptoms of 
RAin subjects with active RA as measured by change from baseline in DAS28 (CRP) at 
Week 12 
The secondaty objectives are: 
• 
To evaluate the safety and tolerability of GS-987 6 in subjects with RA 
• 
To explore the effect of GS-9876 on other disease-specific outcomes in RA 
The explorat01y objectives are: 
[j 
I 
I 
8.1.2. 
Primary Endpoint 
The prima1y endpoint is change from baseline in DAS28 (CRP) at Week 12. 
8.1.3. 
Secondary Endpoint 
The secondmy endpoints include: 
• 
The proportion of subjects who achieve ACR 20/50/70 at Week 12 
• 
Change from baseline in HAQ-DI score at Week 12 
8.1.4. 
Exploratory Endpoints 
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8.2. 
8.2.1. 
8.2.1.1. 
Analysis Conventions 
Analysis Sets 
All Randomized 
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The all randomized analysis set includes all subjects who are randomized in the study. This is the 
primruy analysis set for by-subject listings. 
8.2.1.2. 
Efficacy 
The primaty analysis set for efficacy analyses will be the Full Analysis Set (F AS), which 
includes all randomized subjects who received at least 1 dose of study dmg. 
8.2.1.3. 
Safety 
The primary analysis set for safety analyses will be the Safety Analysis Set, which includes all 
subjects who received at least 1 dose of study dmg. 
8.2.1.4. 
8.2.1.4.1. 
Phrumacokinetics 
PK Substudy Analysis Set 
The primaty analysis set for intensive PK analyses will be the PK substudy analysis set~ which 
includes all subjects in the Safety Analysis Set who have enrolled into the PK substudy, and have 
intensive PK concentration data to provide interpretable results for the specific pru·ameters of 
interest for the analyte under evaluation. 
8.2.1.4.2. 
PK Analysis Set 
The primaty analysis set for general PK analyses will be the PK analysis set, which includes all 
subjects in the Safety Analysis Set who have at least I non-missing PK concentration data for 
GS-9876, filgotinib and/or their metabolite(s). 
8.3. 
Data Handling Conventions 
Phrumacokinetic concentration values and PK pru·ameter values below the limit of quantitation 
(BLQ) will be presented as "BLQ" in the data listings. The BLQ values that occur prior to the 
first dose will be treated as 0, BLQ values at all other time points will be treated as 112 of the 
lower limit of quantitation (LLOQ). 
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Laboratory data that are continuous in nature but are less than the lower limit of quantitation or 
above the upper limit of quantitation will be imputed to the value of the lower or upper limit 
minus or plus one significant digit, respectively (eg, if the result of a continuous laboratory test is 
< 20, a value of 19 will be assigned; if the result of a continuous laboratory test is < 20.0, a value 
of 19.9 will be assigned).
8.4.
Demographic Data and Baseline Characteristics
Demographic and baseline characteristics will be summarized using standard descriptive 
methods including sample size, mean, SD, median, Q1, Q3, minimum, and maximum for 
continuous variables and frequency and percentages for categorical variables.
Demographic data will include sex, race, ethnicity, and age.
Baseline characteristics will include DAS28 (CRP), HAQ-DI, SDAI, and CDAI.
8.5.
Efficacy Analysis
The primary endpoint for the study is change from baseline in DAS28 (CRP) at Week 12. The 
primary analysis will consist of a superiority test of each of the GS-9876 doses compared to 
placebo based on the change from baseline in DAS28 (CRP) at Week 12, which will be analyzed 
using a mixed model repeated measures (MMRM) approach. The model may include the fixed 
effects of treatment, visit, treatment by visit interaction, and baseline value.  Subjects will be 
included as a random effect. 
Secondary endpoints include proportion of subjects who achieve ACR 20/50/70 at Week 12 and 
change from baseline in HAQ-DI score at Week 12. The ACR 20/50/70 response rates between 
each of the 2 GS-9876 dosed groups and the placebo group will be compared using a stratified 
Cochran-Mantel-Haenszel (CMH) Chi-square test adjusting for stratification factor in 
randomization.  The difference in response rates between treatment groups and the 
corresponding 95% confidence intervals will be presented. The difference in change from 
baseline in HAQ-DI between each of the 2 GS-9876 dosed groups and the placebo group will be 
analyzed using a similar MMRM approach.
Sensitivity analyses may be performed for the efficacy assessment.
Details on efficacy analyses will be described in the statistical analysis plan.
8.6.
Safety Analysis
All safety analyses will be performed using the safety analysis set.
Safety will be evaluated by assessment of clinical laboratory tests, physical examinations, vital 
signs measurements at various time points during the study, and by the documentation of AEs.


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All safety data collected on or after the first dose of study drug administration up to 30 days after 
the last dose of study drug, unless specified otherwise, will be summarized by treatment group 
according to the study drug received.
8.6.1.
Extent of Exposure
A subject’s extent of exposure to study drug will be generated from the study drug
administration page of the eCRF. Exposure data will be summarized by treatment group.
Duration of exposure to study drug will be expressed as the number of weeks between the first 
and last dose of the study drug, inclusive, regardless of temporary interruptions in study drug 
administration and summarized by treatment group.
8.6.2.
Adverse Events
Clinical and laboratory adverse events will be coded using the Medical Dictionary for 
Regulatory Activities (MedDRA). System Organ Class (SOC), High-Level Group Term 
(HLGT), High-Level Term (HLT), Preferred Term (PT), and Lower-Level Term (LLT) will be 
attached to the clinical database.
Treatment-emergent adverse events (TEAEs) are defined as one or both of the following:

Any AEs with an onset date on or after the study drug start date and no later than 30 days 
after permanent discontinuation of study drug.

Any AEs leading to premature discontinuation of study drug.
Summaries (number and percentage of subjects) of TEAEs by SOC and PT will be provided. 
Treatment-emergent AEs will also be summarized by relationship to study drug and severity. In 
addition, TEAEs leading to premature discontinuation of study drug and study will be 
summarized and listed.
8.6.3.
Laboratory Evaluations
Selected laboratory data will be summarized (n, mean, SD, median, Q1, Q3, minimum, and 
maximum) by treatment group. Absolute values and change from baseline at all scheduled 
timepoints will be summarized.
Graded laboratory abnormalities will be defined using CTCAE 4.03 grading scale (Appendix 4).
Incidence of treatment-emergent laboratory abnormalities, defined as values that increase at least
one toxicity grade from baseline at any time post baseline up to the date of last dose of study 
drug plus 30 days, will be summarized by treatment.


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8.6.4. 
Other Safety Evaluations 
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Individual data for physical examination findings, prior and concomitant medications and 
medical hist01y will be provided. Twelve-lead ECGs and vital signs will be listed by subject or 
summarized by descriptive statistics as appropriate. 
8.7. 
Pharmacokinetic Analysis 
Plasma concentTations of GS-9876 and filgotinib and the active metabolite of filgotinib 
(GS-829845) will be listed and summarized using descriptive statistics ( eg, sample size, 
arithmetic mean, geometTic mean, % coefficient of variation, standard deviation, median, 
minimum, and maximum). 
PD 
Plasma concenfl·ations ofGS-9876 metabolite(s), other filgotinib metabolite(s) and/or MTX may 
also be detennined and analyzed. 
8.9. 
Sample Size 
Sample sizes for GS-9876 and placebo groups are detennined based on the superiority test of one 
dose ofGS-9876 compared to placebo based on the change from baseline in DAS28 (CRP) at 
Week 12. When assuming a difference of 1.2 between the two groups and a common standard 
deviation of 1.3 5, 20 subjects in each of the GS-987 6 groups and 20 in the placebo group are 
required to obtain 78% ower at a 2-sided 0.05-level. TwentyPPD 
~-----~--~~~~=~----
. Therefore, the total sample size will be 
80~20~p-e-r~t-
re-a~tm
--
en~t-~-.o-l-~~
. ------------~ 
CONFIDENTIAL 
Page 68 
11 July 2016 


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Amendment 2
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9.
RESPONSIBILITIES
9.1.
Investigator Responsibilities
9.1.1.
Good Clinical Practice
The investigator will ensure that this study is conducted in accordance with the principles of the 
Declaration of Helsinki (as amended in Edinburgh, Tokyo, Venice, Hong Kong, and 
South Africa), International Conference on Harmonisation (ICH) guidelines, or with the laws and 
regulations of the country in which the research is conducted, whichever affords the greater 
protection to the study subject. These standards are consistent with the EU Clinical Trials 
Directive 2001/20/EC and Good Clinical Practice Directive 2005/28/EC.
The investigator will ensure adherence to the basic principles of Good Clinical Practice, as 
outlined in 21 Code of Federal Regulations (CFR) 312, subpart D, “Responsibilities of Sponsors 
and Investigators,” 21 CFR, part 50, 1998, and 21 CFR, part 56, 1998.
The investigator and all applicable sub-investigators will comply with 21 CFR, Part 54, 1998, 
providing documentation of their financial interest or arrangements with Gilead, or proprietary 
interests in the investigational drug under study. This documentation must be provided prior to 
the investigator’s (and any sub-investigator’s) participation in the study. The investigator and 
sub-investigator agree to notify Gilead of any change in reportable interests during the study and 
for 1 year following completion of the study. Study completion is defined as the date when the 
last subject completes the protocol-defined activities.
9.1.2.
Institutional Review Board (IRB)/Independent Ethics Committee (IEC) 
Review and Approval
The investigator (or sponsor as appropriate according to local regulations) will submit this 
protocol, informed consent form, and any accompanying material to be provided to the subject 
(such as advertisements, subject information sheets, or descriptions of the study used to obtain 
informed consent) to an IRB/IEC. The investigator will not begin any study subject activities 
until approval from the IRB/IEC has been documented and provided as a letter to the 
investigator.
Before implementation, the investigator will submit to and receive documented approval from 
the IRB/IEC any modifications made to the protocol or any accompanying material to be 
provided to the subject after initial IRB/IEC approval, with the exception of those necessary to 
reduce immediate risk to study subjects.
9.1.3.
Informed Consent
The investigator is responsible for obtaining written informed consent from each individual 
participating in this study after adequate explanation of the aims, methods, objectives, and 
potential hazards of the study and before undertaking any study-related procedures. The 


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investigator must use the most current IRB/IEC approved consent form for documenting written 
informed consent. Each informed consent (or assent as applicable) will be appropriately signed 
and dated by the subject (legally authorized representatives are not allowed for this study) and 
the person conducting the consent discussion, and also by an impartial witness if required by 
IRB/IEC or local requirements. The consent form will inform subjects about optional genomic 
testing and sample retention.
9.1.4.
Confidentiality
The investigator must assure that subjects’ anonymity will be strictly maintained and that their 
identities are protected from unauthorized parties. Only subject initials, date of birth, another 
unique identifier (as allowed by local law), and an identification code will be recorded on any 
form or biological sample submitted to the Sponsor, IRB/IEC, or laboratory. Laboratory 
specimens must be labeled in such a way as to protect subject identity while allowing the results 
to be recorded to the proper subject. Refer to specific laboratory instructions. NOTE: The 
investigator must keep a screening log showing codes, names, and addresses for all subjects 
screened and for all subjects enrolled in the trial. Subject data will be processed in accordance 
with all applicable regulations. 
The investigator agrees that all information received from Gilead, including but not limited to the 
IB, this protocol, eCRF, the study drug, and any other study information, remain the sole and 
exclusive property of Gilead during the conduct of the study and thereafter. This information is 
not to be disclosed to any third party (except employees or agents directly involved in the 
conduct of the study or as required by law) without prior written consent from Gilead. The 
investigator further agrees to take all reasonable precautions to prevent the disclosure by any 
employee or agent of the study site to any third party or otherwise into the public domain.
9.1.5.
Study Files and Retention of Records
The investigator must maintain adequate and accurate records to enable the conduct of the study 
to be fully documented and the study data to be subsequently verified. These documents should 
be classified into at least the following two categories: (1) investigator’s study file, and 
(2) subject clinical source documents.
The investigator’s study file will contain the protocol/amendments, eCRF and query forms, IRB 
/IEC and governmental approval with correspondence, informed consent, drug records, staff 
curriculum vitae and authorization forms, and other appropriate documents and correspondence.
The required source data should include sequential notes containing at least the following 
information for each subject:

Subject identification (name, date of birth, gender);

Documentation that subject meets eligibility criteria, ie, history, physical examination, and 
confirmation of diagnosis (to support inclusion and exclusion criteria);


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
Documentation of the reason(s) a consented subject is not enrolled

Participation in study (including study number);

Study discussed and date of informed consent;

Dates of all visits;

Documentation that protocol specific procedures were performed;

Results of efficacy parameters, as required by the protocol;

Start and end date (including dose regimen) of study drug, including dates of dispensing and 
return;

Record of all adverse events and other safety parameters (start and end date, and including 
causality and severity);

Concomitant medication (including start and end date, dose if relevant; dose changes);

Date of study completion and reason for early discontinuation, if it occurs.
All clinical study documents must be retained by the investigator until at least 2 years or 
according to local laws, whichever is longer, after the last approval of a marketing application in 
an ICH region (ie, United States, Europe, or Japan) and until there are no pending or planned 
marketing applications in an ICH region; or, if no application is filed or if the application is not 
approved for such indication, until 2 years after the investigation is discontinued and regulatory 
authorities have been notified. Investigators may be required to retain documents longer if 
specified by regulatory requirements, by local regulations, or by an agreement with Gilead. The 
investigator must notify Gilead before destroying any clinical study records.
Should the investigator wish to assign the study records to another party or move them to another 
location, Gilead must be notified in advance.
If the investigator cannot provide for this archiving requirement at the study site for any or all of 
the documents, special arrangements must be made between the investigator and Gilead to store 
these records securely away from the site so that they can be returned sealed to the investigator 
in case of an inspection. When source documents are required for the continued care of the 
subject, appropriate copies should be made for storage away from the site.
9.1.6.
Case Report Forms
For each subject consented, an eCRF will be completed by an authorized study staff member 
whose training for this function is documented according to study procedures. Electronic CRFs
should be completed on the day of the subject visit to enable the sponsor to perform central 
monitoring of safety data.  The Eligibility Criteria eCRF should be completed only after all data 


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related to eligibility have been received.  Subsequent to data entry, a study monitor will perform 
source data verification within the electronic data capture (EDC) system. Original entries as well 
as any changes to data fields will be stored in the audit trail of the system.  Prior to database lock 
(or any interim timepoints as described in the clinical data management plan), the investigator 
will use his/her log in credentials to confirm that the forms have been reviewed, and that the 
entries accurately reflect the information in the source documents. The eCRF captures the data 
required per the protocol schedule of events and procedures. System-generated or manual 
queries will be issued to the investigative site staff as data discrepancies are identified by the 
monitor or internal Gilead staff, who routinely review the data for completeness, correctness, and 
consistency. The site coordinator is responsible for responding to the queries in a timely manner, 
within the system, either by confirming the data as correct or updating the original entry, and 
providing the reason for the update (eg, data entry error). At the conclusion of the trial, Gilead 
will provide the site with a read-only archive copy of the data entered by that site. This archive 
must be stored in accordance with the records retention requirements outlined in Section 9.1.5.
9.1.7.
Investigational Medicinal Product Accountability and Return
Where possible, study drug should be destroyed at the site. At the start of the study, the study 
monitor will evaluate each study center’s study drug disposal procedures and provide appropriate 
instruction for disposal or return of unused study drug supplies. If the site has an appropriate 
standard operating procedure (SOP) for drug destruction as determined by Gilead Sciences, the 
site may destroy used (empty or partially empty) and unused study drug supplies as long as 
performed in accordance with the site’s SOP. This can occur only after the study monitor has 
performed drug accountability during an on-site monitoring visit. 
A copy of the site’s study drug Disposal SOP or written procedure (signed and dated by the PI 
or designee) will be obtained for Gilead site files. If the site does not have acceptable 
procedures in place, arrangements will be made between the site and Gilead Sciences 
(or Gilead Sciences’ representative) for return of unused study drug supplies. 
If study drug is destroyed on site, the investigator must maintain accurate records for all study 
drugs destroyed. Upon study completion, copies of the study drug accountability records must be 
filed at the site. Another copy will be returned to Gilead.
The study monitor will review study drug supplies and associated records at periodic intervals.
9.1.8.
Inspections
The investigator will make available all source documents and other records for this trial to 
Gilead’s appointed study monitors, to IRBs or IECs, or to regulatory authority or health authority 
inspectors.
9.1.9.
Protocol Compliance
The investigator is responsible for ensuring the study is conducted in accordance with the 
procedures and evaluations described in this protocol.


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9.2.
Sponsor Responsibilities
9.2.1.
Protocol Modifications
Protocol modifications, except those intended to reduce immediate risk to study subjects, may be 
made only by Gilead. The investigator must submit all protocol modifications to the IRB/IEC in 
accordance with local requirements and receive documented IRB/IEC approval before 
modifications can be implemented.
9.2.2.
Study Report and Publications
A clinical study report (CSR) will be prepared and provided to applicable regulatory agencies.
Gilead will ensure that the report meets the standards set out in the ICH Guideline for Structure 
and Content of Clinical Study Reports (ICH E3). Note that an abbreviated report may be 
prepared in certain cases.
Investigators in this study may communicate, orally present, or publish in scientific journals or 
other scholarly media only after the following conditions have been met:
The results of the study in their entirety have been publicly disclosed by or with the consent of 
Gilead in an abstract, manuscript, or presentation form or the study has been completed at all 
study sites for at least 2 years.
The investigator will submit to Gilead any proposed publication or presentation along with the 
respective scientific journal or presentation forum at least 30 days before submission of the 
publication or presentation. 
No such communication, presentation, or publication will include Gilead’s confidential 
information (see Section 9.1.4).
The investigator will comply with Gilead’s request to delete references to its confidential 
information (other than the study results) in any paper or presentation and agrees to withhold 
publication or presentation for an additional 60 days in order to obtain patent protection if 
deemed necessary.
9.3.
Joint Investigator/Sponsor Responsibilities
9.3.1.
Payment Reporting
Investigators and their study staff may be asked to provide services performed under this 
protocol (eg, attendance at Investigator's Meetings).  If required under the applicable statutory 
and regulatory requirements, Gilead will capture and disclose to Federal and State agencies any 
expenses paid or reimbursed for such services, including any clinical trial payments, meal, travel 
expenses or reimbursements, consulting fees, and any other transfer of value.


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9.3.2.
Access to Information for Monitoring
In accordance with regulations and guidelines, the study monitor must have direct access to the 
investigator’s source documentation in order to verify the accuracy of the data recorded in the 
eCRF.
The monitor is responsible for routine review of the eCRF at regular intervals throughout the 
study to verify adherence to the protocol and the completeness, consistency, and accuracy of the 
data being entered on them. The monitor should have access to any subject records needed to 
verify the entries on the eCRF. The investigator agrees to cooperate with the monitor to ensure 
that any problems detected through any type of monitoring (central, on site) are resolved.
9.3.3.
Access to Information for Auditing or Inspections
Representatives of regulatory authorities or of Gilead may conduct inspections or audits of the 
clinical study. If the investigator is notified of an inspection by a regulatory authority the 
investigator agrees to notify the Gilead medical monitor immediately. The investigator agrees to 
provide to representatives of a regulatory agency or Gilead access to records, facilities, and 
personnel for the effective conduct of any inspection or audit.
9.3.4.
Study Discontinuation
Both the sponsor and the investigator reserve the right to terminate the study at any time. Should 
this be necessary, both parties will arrange discontinuation procedures and notify the appropriate 
regulatory authority(ies), IRBs, and IECs. In terminating the study, Gilead and the investigator 
will assure that adequate consideration is given to the protection of the subjects’ interests.


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10.
REFERENCES
Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO, 3rd, et al. 2010 
Rheumatoid arthritis classification criteria: an American College of 
Rheumatology/European League Against Rheumatism collaborative initiative. 
Arthritis Rheum 2010;62 (9):2569-81.
Arthritis Foundation. Rheumatoid Arthritis Fact Sheet.  2008.
Barr PM, Wei C, Roger J, Schaefer-Cutillo J, Kelly JL, Rosenberg AF, et al. Syk inhibition with 
fostamatinib leads to transitional B lymphocyte depletion. Clin Immunol 
2012;142 (3):237-42.
Braselmann S, Taylor V, Zhao H, Wang S, Sylvain C, Baluom M, et al. R406, an orally available
spleen tyrosine kinase inhibitor blocks fc receptor signaling and reduces immune 
complex-mediated inflammation. J Pharmacol Exp Ther 2006;319 (3):998-1008.
Cha HS, Boyle DL, Inoue T, Schoot R, Tak PP, Pine P, et al. A novel spleen tyrosine kinase 
inhibitor blocks c-Jun N-terminal kinase-mediated gene expression in 
synoviocytes. J Pharmacol Exp Ther 2006;317 (2):571-8.
Coffey G, DeGuzman F, Inagaki M, Pak Y, Delaney SM, Ives D, et al. Specific inhibition of 
spleen tyrosine kinase suppresses leukocyte immune function and inflammation in 
animal models of rheumatoid arthritis. J Pharmacol Exp Ther 2012;340 (2):350-9.
Felson DT, Anderson JJ, Boers M, Bombardier C, Furst D, Goldsmith C, et al. American College 
of Rheumatology. Preliminary definition of improvement in rheumatoid arthritis. 
Arthritis Rheum 1995;38 (6):727-35.
Helmick CG, Felson DT, Lawrence RC, Gabriel S, Hirsch R, Kwoh CK, et al. Estimates of the 
prevalence of arthritis and other rheumatic conditions in the United States. Part I. 
Arthritis Rheum 2008;58 (1):15-25.
Leandro MJ, Cambridge G, Ehrenstein MR, Edwards JC. Reconstitution of peripheral blood B 
cells after depletion with rituximab in patients with rheumatoid arthritis. Arthritis 
Rheum 2006;54 (2):613-20.
Liao C, Hsu J, Kim Y, Hu DQ, Xu D, Zhang J, et al. Selective inhibition of spleen tyrosine 
kinase (SYK) with a novel orally bioavailable small molecule inhibitor, RO9021, 
impinges on various innate and adaptive immune responses: implications for SYK 
inhibitors in autoimmune disease therapy. Arthritis research & therapy 2013;15 
(5):R146.
Martin F, Chan AC. B cell immunobiology in disease: evolving concepts from the clinic. Annu 
Rev Immunol 2006;24:467-96.


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Namour F, Diderichsen PM, Cox E, Vayssiere B, Van der Aa A, Tasset C, et al. 
Pharmacokinetics and Pharmacokinetic/Pharmacodynamic Modeling of Filgotinib 
(GLPG0634), a Selective JAK1 Inhibitor, in Support of Phase IIB Dose Selection. 
Clin Pharmacokinet 2015;54 (8):859-74.
Navarro-Millan I, Curtis JR. Newest clinical trial results with antitumor necrosis factor and 
nonantitumor necrosis factor biologics for rheumatoid arthritis. Current opinion in 
rheumatology 2013;25 (3):384-90.
Pine PR, Chang B, Schoettler N, Banquerigo ML, Wang S, Lau A, et al. Inflammation and bone 
erosion are suppressed in models of rheumatoid arthritis following treatment with 
a novel Syk inhibitor. Clin Immunol 2007;124 (3):244-57.
Prevoo ML, van 't Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL. 
Modified disease activity scores that include twenty-eight-joint counts. 
Development and validation in a prospective longitudinal study of patients with 
rheumatoid arthritis. Arthritis Rheum 1995;38 (1):44-8.
Shlomchik MJ. Sites and stages of autoreactive B cell activation and regulation. Immunity 
2008;28 (1):18-28.
Song YW, Kang EH. Autoantibodies in rheumatoid arthritis: rheumatoid factors and 
anticitrullinated protein antibodies. QJM 2010;103 (3):139-46.


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11.
APPENDICES
Appendix 1.
Investigator Signature Page
Appendix 2.
Study Procedures Tables
Appendix 3.
Laboratory Assessments Table
Appendix 4.
Common Terminology Criteria for Adverse Events (CTCAE) v4.03
Appendix 5.
Pregnancy Precautions, Definition for Female of Childbearing Potential, and 
Contraceptive Requirements
Appendix 6.
The 2010 American College of Rheumatology –European League Against 
Rheumatism Collaborative Initiative Classification Criteria for Rheumatoid 
Arthritis {Aletaha et al 2010}
Appendix 7.
American College of Rheumatology Response Evaluations/ Preliminary Definition 
of Improvement in Rheumatoid Arthritis {Felson et al 1995}
Appendix 8.
Disease Activity Score for 28 Joint Count (DAS28) {Prevoo et al 1995}
Appendix 9.
Procedures and Specifications


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Gilead Sciences, Inc. 
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Appendix 1. 
Investigator Signature Page 
GILEAD SCIENCES, INC. 
STUDY ACKNOWLEDGEMENT 
A Randomized, Double-Blind, Placebo-Controlled, Multicenter, Phase 2 Proof-of-Concept 
Study to Evaluate Safety, Tolerability, and Efficacy of GS-9876 in Subjects with Active 
Rheumatoid Arthritis on Background Therapy with Methotrexate 
GS-US-379-1582, Amendment 2 Protocol, 11 July 2016 
This protocol has been approved by Gjlead Sciences, Tnc. The following signature documents 
this approval. 
PPD~----
Franziska Matzk:ies, MD 
Medical Monitor Name (Printed) 
12 - ]t{f - 2..a lc: 
Date 
INVESTIGATOR STATEMENT 
I have read the protocol, including all appendices, and I agree that it contains all necessary 
details for me and my staff Lo conduct this study as described. I will conduct this study as 
outlined herein and will make a reasonable effort to complete the study within the time 
designated. 
I will provide all study personnel under my supervision copies of the protocol and access to all 
information provided by Gilead Sciences, Inc. I will discuss this material with them to ensure 
that they are fully infom1ed about the drugs and the study. 
Principal Investigator Name (Printed) 
Signature 
Date 
Site Number 
CONFIDENTIAL 
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Gilead Sciences, Inc. 
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Appendix 2. 
Study Procedures Tables 
Post-Treatment 
Visit 
Screeninga 
Dayl 
Week2 
Week4 
Week8 
Week12 
ETb 
Week 4c 
Window in Days 
-28 
±3 
±3 
±3 
±3 
±3 
±5 
Written Infonned Consent for Main Study 
X 
lPPD 
I 
X 
Medical History d 
X 
Physical Examination e 
X 
X 
X 
X 
X 
X 
X 
X 
Vital Signs, Height, and Weight f 
X 
X 
X 
X 
X 
X 
X 
X 
12-LeadECG 
X 
xg 
X 
X 
X 
X 
X 
X 
66 Swollen and 68 Tender Joint Count Assessment h 
X 
X 
X 
X 
X 
X 
X 
Hematology, Chemistry and Coagulation i,j,k 
X 
X 
X 
X 
X 
X 
X 
X 
Lipid Panel i,j, k, 1 
X 
X 
X 
X 
X 
X 
X 
X 
CRPi,j,k 
X 
X 
X 
X 
X 
X 
X 
X 
Serum or Urine Pregnancy Test i,j,k,m 
X 
X 
X 
X 
X 
X 
X 
X 
Serologyi 
X 
Urinalysis and Urine Drug Screen i 
X 
TSHi 
X 
HbA1ci 
X 
QuantiFERON® TB-Gold i 
X 
CD19 Countj,n 
X 
Randomization after Confinnation of Eligibility h 
X 
Disease-Specific Questionnaires and Activity Scales i, o 
X 
X 
X 
X 
X 
X 
RF /CCP i, i. k 
X 
X 
X 
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Visit 
Window in Days 
Inflammation and Pathway Biomarkers i,j, k, P 
RNA Sample i,j,k 
.. k 
Immunoglobulins'· J, 
Whole Blood Sample for MoA Studies i,j, k 
.. k I 
Bone Marker (Urine)''J' ' 
.. k 
BandT Cell Panels •,J, 
I 
J ~ 
PK Samples r -
i 
Study Drug Dispensation 
Study Drug Administration (In-Clinic) 
1 
Study Drug Bottle Return u 
Adverse Events v 
Concomitant Medications w 
Screeninga 
Dayl 
Week2 
Week4 
Week8 
-28 
±3 
±3 
±3 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
Continuous 
Continuous 
a 
Prospective subjects should be screened no more than 28 days prior to administration of the first dose of study drug. 
b 
Early Termination assessments should be performed within 72 hours of subject discontinuation. 
c 
Twenty-eight (±5) days after the last administration of study drug, all subjects will return for an in-clinic follow-up visit. 
Week12 
ETb 
±3 
±3 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
Final 
Amendment 2 
Post-Treatment 
Week 4c 
±5 
d 
Medical history, including but not limited to, RA, prior RA medication history, and any personal or family histories of bleeding disorders and cardiovascular disease 
e 
Screening visit includes complete PE as outlined in Appendix 9. All other PEs are symptom driven. A symptom driven PE should be performed after Screening when a 
subject reports a new symptom or a worsening symptom at a study visit. If a subject reports no change in symptoms, then no PE is necessary. 
f 
Vital signs include resting blood pressure, pulse, respiration rate, temperature, height and weight. Weight will be collected at all study visits. Height will be collected at 
Screening only. 
g 
Conduct Day 1 ECG predose (prior to study drug administration). 
h 
The 66 swollen and 68 tender joint count assessments must be performed prior to all other study procedures on Day 1 and prior to randomization to confirm subject eligibility. 
At Day 1, the subject questionnaires (ie, HAQ-DI including Patient's Assessment of Pain, and Patient's Global Assessment of Disease Activity) are recommended to be done 
prior to any invasive study procedures. At Week 12, the subject questionnaires are recommended to be done prior to the 66 swollen and 68 tender joint count assessments and 
before any invasive study procedures. At both Day 1 and Week 12, blood draws should be the last study assessment prior to study dosing. 
CONFIDENTIAL 
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Amendment 2 
J 
k 
I 
111 
n 
0 
p 
q 
I' 
s 
u 
v 
w 
Refer to Appendix 3 for complete laboratory assessments. 
Samples to be collected prior to dosing, except at Week 4 visit. 
Lipid panel and bone marker (urine) samples should be fasting at Day 1 and Week 12. 
At Screening, a senm1 pregnancy test will be collected. At all other visits, a urine pregnancy test will be collected. If a tume pregnancy test is positive, a senm1 pregnancy test 
will also be collected. 
As needed per exclusion criteria (refer to Section 4.3) 
Disease-specific questiollllaires and activity scales include the HAQ-DI including the Patient's Assessment of Pain, Patient's Global Assessment of Disease Activity, and 
Physician's Global Assessment of Disease Activity. 
Samples will be collected at Day 1, Week 4, and Week 12 or ET visits for PPD 
and/or pathway markers relevant to rhetu11atoid atilu1tis. Sampling timepoints 
and assessments may be modified during the study based on assay availabt!ity andlor emerg!.;;m;;~.;;.
da
;;.;t.;;.a;..
. -----------. 
~i~mples wifloecollected'Efior to stueych·ug adirunistration (P.re-<I?Sej at Weeks 2, 8, and 12 or ET. At WeekT,PK samples will be collected 2 hom·s ost dose. 
ppo-
On Day 1, study diug achninistrattOii"tin-cllliic) slioufa be'the last study procedm·e petfonned. On Week 4, study dmg administration (in-clinic) should be the fll'Ststudy 
proce.dm·e performed (with the exception of predose PK for[PPD 
I subjects only). At all other treatment visits, study dmg administration should occtu· after 
pre.dose assessments are completed. 
Subject should bring their study dmg to all study visits. At Week 4, Week 8, and Week 12 or ET, site should collect any previously dispensed study dmg bottles. 
After informed c.onsent, but prior to initiation of study medication, all SAEs and adverse events related to protocol-mandated procedm·es shall be collected. Following 
initiation of study medication, all SAEs and all AEs, regardless of cause or relationship, shall be collected. Refer to Section 7.3 for more detail. 
At Screening, allme.dication taken up to 30 days pt1or to the Screening visit will be recorded on the eCRF. 
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Appendix 3.
Laboratory Assessments Table
Hematology
Chemistry
Urinalysis
Other
Hematocrit
Hemoglobin
Platelet count
Red blood cell (RBC) 
count
White blood cell (WBC) 
count
Differentials (absolute 
and percentage), 
including:
Leukocytes
Monocytes
Neutrophils
Eosinophils
Basophils
Reticulocyte count
Mean corpuscular 
volume (MCV)
Alkaline phosphatase
Aspartate aminotransferase
(AST)
Alanine aminotransferase
(ALT)
Total bilirubin
Direct and indirect 
bilirubin
Total protein
Albumin
Bicarbonate
Blood urea nitrogen 
(BUN)
Calcium
Chloride
Serum creatinine
Glucose
Phosphorus
Magnesium
Potassium
Sodium
Amylase
Lipase 
Creatine phosphokinase 
(CPK)
Clarity
Blood
Color
Glucose
Leukocyte esterase
pH
Protein
Urobilinogen
Reflex to microscopic 
urinalysis if dipstick result 
is abnormal.
Urine drug screen for:
Amphetamines
Cocaine
Methadone
Opiates
Inflammation and pathway 
biomarkers
B and T cell panels
Immunoglobulins: IgA, IgE, 
IgG, IgM
Whole blood sample for 
MoA studies
Bone marker (urine)
C-reactive protein (CRP)
Rheumatoid factor and 
cyclic citrullinated peptide 
(RF/CCP)
QuantiFERON® TB-Gold 
CD19 (if required per 
exclusion criteria)
RNA
TSH
HbA1c
Lipid Panel
Total cholesterol
Low-density lipoprotein 
(LDL)
High-density lipoprotein 
(HDL)
Triglycerides
Coagulation
Serology
Pregnancy
Activated partial 
thromboplastin time 
(aPTT)
Prothrombin time (PT)
International normalized 
ratio (INR)
Hepatitis BsAg and core 
Ab 
Hepatitis C Ab
HIV
In females of childbearing 
potential:
Serum β-hCG (Screening and 
if positive urine β-hCG)
Urine β-hCG (all study visits
other than Screening)
Ab = antibody
β-hCG = beta-human chorionic gonadotropin
BsAg = B surface antigen
IgA, IgE, IgG, IgM = immunoglobulins A, E, G, M


GS-9876
Protocol GS-US-379-1582
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 83
11 July 2016
Appendix 4.
Common Terminology Criteria for Adverse Events (CTCAE) v4.03
CTCAE v4.03 can be accessed from the below link:
http://evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4.03_2010-06-14_QuickReference_8.5x11.pdf
The only modification to the CTCAE criteria is the addition of a Grade 1 upper respiratory 
infection as follows:
CTCAE 
v4.0 Term
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
CTCAE v4.03 
AE Term 
Definition
Upper 
respiratory 
infection
Mild 
symptoms; 
symptomatic 
relief (eg, 
cough 
suppressant, 
decongestant)
Moderate 
symptoms; 
oral 
intervention 
indicated 
(eg, antibiotic, 
antifungal, 
antiviral)
IV antibiotic, 
antifungal, or 
antiviral 
intervention 
indicated; 
radiologic, 
endoscopic, or 
operative 
intervention 
indicated
Life-
threatening 
consequences; 
urgent 
intervention 
indicated
Death
A disorder 
characterized by 
an infectious 
process involving 
the upper 
respiratory tract 
(nose, paranasal 
sinuses, pharynx, 
larynx, or 
trachea).


GS-9876
Protocol GS-US-379-1582
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 84
11 July 2016
Appendix 5.
Pregnancy Precautions, Definition for Female of Childbearing 
Potential, and Contraceptive Requirements
1) Definitions
a) Definition of Childbearing Potential
For the purposes of this study, a female born subject is considered of childbearing potential 
following the initiation of puberty (Tanner stage 2) until becoming post-menopausal, unless 
permanently sterile or with medically documented ovarian failure.  
Women are considered to be in a postmenopausal state when they are > 54 years of age with 
cessation of previously occurring menses for > 12 months without an alternative cause.  
Permanent sterilization includes hysterectomy, bilateral oophorectomy, or bilateral 
salpingectomy in a female subject of any age.
b) Definition of Male Fertility
For the purposes of this study, a male born subject is considered fertile after the initiation of 
puberty unless permanently sterile by bilateral orchidectomy or medical documentation.
2) Contraception Requirements for Female Subjects
a) Study Drug Effects on Pregnancy and Hormonal Contraception
GS-9876 is contraindicated in pregnancy as its teratogenicity/fetotoxicity profile is unknown. 
Filgotinib is contraindicated in pregnancy as there is a possibility of human
teratogenicity/fetotoxicity in early pregnancy based on non-clinical data. 
GS-9876 has insufficient data to exclude the possibility of a clinically relevant interaction with 
hormonal contraception that results in reduced contraception efficacy.  A dedicated study 
assessing the impact of filgotinib on the efficacy of hormonally-based contraceptives 
(with ovulation inhibition as mechanism of action) has not yet been performed to fully verify the 
absence of any clinically significant interaction between filgotinib and oral contraceptives. 
However, based on the totality of the available in vitro and clinical data, clinically relevant drug 
interactions between filgotinib or GS-829845 with hormonal contraceptives are not expected. In 
this study, contraceptive steroids are not recommended as a contraceptive method either solely or 
as a part of a contraceptive regimen. Subjects may remain on their hormonal contraception if 
they prefer to do so, but will still be required to choose from contraceptive methods delineated 
below as the efficacy of their hormonal contraception during study dosing is unknown. 
Please refer to the latest versions of the GS-9876 and filgotinib IBs for additional information.
b) Contraceptive Methods Permitted for Female Subjects of Childbearing Potential
The inclusion of female subjects of childbearing potential requires the use of highly effective
contraceptive measures.  Women must agree to also not rely on hormone-containing 
contraceptives as a form of birth control during the study, though they may continue hormonal 
contraception if they prefer to do so.  Women must have a negative serum pregnancy test at 
Screening and a negative pregnancy test on the Day 1 visit prior to first dose of study drug.  
Pregnancy tests will be performed as defined by the schedule of assessments (Appendix 2).


GS-9876
Protocol GS-US-379-1582
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 85
11 July 2016
Female subjects of childbearing potential must agree to one of the following from Screening 
until 35 days following the last dose of study drug.

Complete abstinence from intercourse of reproductive potential.  Abstinence is an acceptable 
method of contraception only when it is in line with the subject’s preferred and usual 
lifestyle.
Or
Consistent and correct use of 1 of the following methods of birth control listed below. 

Intrauterine device (IUD) with a failure rate of <1% per year

Tubal sterilization

Essure micro-insert system (provided confirmation of success 3 months after procedure)

Vasectomy in the male partner (provided that the partner is the sole sexual partner and had 
confirmation of surgical success at least 3 months after procedure)
Female subjects must also refrain from egg donation and in vitro fertilization during treatment 
and until at least 35 days after the last dose of study drug.
Contraception Requirements for Male Subjects
It is theoretically possible that a relevant systemic concentration may be achieved in a female 
partner from exposure of the male subject’s seminal fluid.  Therefore, male subjects with female 
partners of childbearing potential must agree to use condoms during treatment and until 90 days 
after the last dose of study drug.  Additional contraception recommendations should also be 
considered if the female partner is of childbearing potential.
Male subjects must also refrain from sperm donation during treatment and until at least 90 days 
after the last dose of study drug.
Unacceptable Birth Control Methods
Birth control methods that are unacceptable include periodic abstinence (eg, calendar, ovulation, 
symptothermal, post-ovulation methods), withdrawal (coitus interruptus), spermicides only, and 
lactational amenorrhea method (LAM).  Female condom and male condom should not be used 
together.
Procedures to be Followed in the Event of Pregnancy
Subjects will be instructed to notify the investigator if they become pregnant at any time during 
the study, or if they become pregnant within 35 days of last study drug dose. Subjects who 
become pregnant or who suspect that they are pregnant during the study must report the 
information to the investigator and discontinue study drug immediately.  Subjects whose partner 
has become pregnant or suspects she is pregnant during the study must report the information to 
the investigator.  Instructions for reporting pregnancy, partner pregnancy, and pregnancy 
outcome are outlined in Section 7.7.2.1.


GS-9876
Protocol GS-US-379-1582
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 86
11 July 2016
Appendix 6.
The 2010 American College of Rheumatology –European League 
Against Rheumatism Collaborative Initiative Classification Criteria 
for Rheumatoid Arthritis {Aletaha et al 2010}
Target population (Who should be tested?): Patients who have at least 1 joint with 
definite clinical synovitis (swelling)a with the synovitis not better explained by 
another diseaseb
Classification criteria for RA (score-based algorithm: add score of categories A - D;
a score of ≥6/10 is needed for classification of a patient as having definite RA)c
A. Joint involvementd
1 large jointe
0
2-10 large joints
1
1-3 small joints (with or without involvement of large joints)f
2
4-10 small joints (with or without involvement of large joints)
3
>10 joints (at least 1 small joint)g
5
B. Serology (at least 1 test result is needed for classification)h
Negative RF and negative ACPA
0
Low-positive RF or low-positive ACPA
2
High-positive RF or high-positive ACPA
3
C. Acute-phase reactants (at least 1 test result is needed for classification)i
Normal CRP and normal ESR
0
Abnormal CRP or abnormal ESR
1
D. Duration of symptomsj
<6 weeks
0
≥6 weeks
1
a
The criteria are aimed at classification of newly presenting patients. In addition, patients with erosive disease typical of 
rheumatoid arthritis (RA) with a history compatible with prior fulfillment of the 2010 criteria should be classified as having 
RA. Patients with longstanding disease, including those whose disease is inactive (with or without treatment) who, based on 
retrospectively available data, have previously fulfilled the 2010 criteria should be classified as having RA.
b
Differential diagnoses vary among patients with different presentations, but may include conditions such as systemic lupus 
erythematosus, psoriatic arthritis, and gout. If it is unclear about the relevant differential diagnoses to consider, an expert 
rheumatologist should be consulted.
c
Although patients with a score of <6/10 are not classifiable as having RA, their status can be reassessed and the criteria 
might be fulfilled cumulatively over time.
d
Joint involvement refers to any swollen or tender joint on examination, which may be confirmed by imaging evidence of 
synovitis. Distal interphalangeal joints, first carpometacarpal joints, and first metatarsophalangeal joints are excluded from 
assessment. Categories of joint distribution are classified according to the location and number of involved joints, with 
placement into the highest category possible based on the pattern of joint involvement.
e
"Large joints" refers to shoulders, elbows, hips, knees, and ankles.
f
"Small joints" refers to the metacarpophalangeal joints, proximal interphalangeal joints, second through 
fifth metatarsophalangeal joints, thumb interphalangeal joints, and wrists.
g
In this category, at least 1 of the involved joints must be a small joint; the other joints can include any combination of large 
and additional small joints, as well as other joints not specifically listed elsewhere (eg, temporomandibular, 
acromioclavicular, sternoclavicular).


GS-9876
Protocol GS-US-379-1582
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 87
11 July 2016
h
Negative refers to IU values that are less than or equal to the ULN for the laboratory and assay; low-positive refers to IU 
values that are higher than the ULN but ≤3 times the ULN for the laboratory and assay; high-positive refers to IU values that 
are >3 times the ULN for the laboratory and assay. Where rheumatoid factor (RF) information is only available as positive 
or negative, a positive result should be scored as low-positive for RF. ACPA = anti-citrullinated protein antibody.
i
Normal/abnormal is determined by local laboratory standards. CRP = C-reactive protein; ESR = erythrocyte sedimentation 
rate.
j
Duration of symptoms refers to patient self-report of the duration of signs or symptoms of synovitis (eg, pain, swelling, 
tenderness) of joints that are clinically involved at the time of assessment, regardless of treatment status.


GS-9876
Protocol GS-US-379-1582
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 88
11 July 2016
Appendix 7.
American College of Rheumatology Response Evaluations/ 
Preliminary Definition of Improvement in Rheumatoid Arthritis 
{Felson et al 1995}
ACR 20/50/70 Requires
≥20%/50%/70% improvement in tender joint count, AND
≥20%/50%/70% improvement in swollen joint count, AND
≥20%/50%/70% improvement in at least 3 of the following 5:

Patient’s Assessment of Pain

Patient’s Global Assessment of Disease Activity

Physician’s Global Assessment of Disease Activity

Patient’s assessment of physical  function (HAQ-DI)

Acute-phase reactant (CRP)
The following lists the disease activity measure followed by the method of assessment
1.
Tender joint count
ACR TJC is an assessment of 68. The joint count should be done by scoring several different 
aspects of tenderness, as assessed by pressure and joint manipulation on physical examination. 
The information on various types of tenderness should then be collapsed into a single 
tender-versus-nontender dichotomy.
2.
Swollen joint count
ACR SJC is an assessment of 66. Joints are classified as either swollen or not swollen.
3.
Patient’s Assessment of Pain
The Patient’s Assessment of Pain, part of the HAQ-DI assessment, is a horizontal (0 – 100) 
visual analog scale (VAS) that will be used to assess the subject’s current level of pain.2
How much pain have you had because of your illness in the past week? Place a vertical (|) 
mark on the line to indicate the severity of the pain: 
No Pain                                                              Severe Pain
0
      100
                                                
2 Visual analog scales provided in this protocol are not to scale and should not be utilized for assessments.


GS-9876
Protocol GS-US-379-1582
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
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4.
Patient’s Global Assessment of Disease Activity
A horizontal (0 – 100) VAS will be used to collect the subject’s overall assessment of how their
arthritis is doing.
Place a mark on the line below to indicate how you assess your current rheumatoid 
arthritis disease activity:
No Arthritis
Severe Arthritis
5.
Physician’s Global Assessment of Disease Activity
A horizontal (0 – 100) VAS will be used to measure the physician’s assessment of the patient’s 
current disease activity.
Place a mark on the line below to indicate RA disease activity (independent of the subject’s
self-assessment):
No Disease Activity
Maximum Disease Activity
6.
Patient’s Assessment of Physical Function
The HAQ-DI will be used to provide a subject’s self-assessment of physical function. The 
HAQ-DI includes the Patient’s Assessment of Pain VAS.
7.
Acute-phase reactant value
C-reactive protein level


GS-9876
Protocol GS-US-379-1582
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 90
11 July 2016
Appendix 8.
Disease Activity Score for 28 Joint Count (DAS28) {Prevoo et al 1995}
Assessments of RA in subjects by the Disease Activity Score (modified to include the 28 joint 
counts according to Smolen* 1995) will be conducted at the measured timepoints. The DAS28 
consists of a composite score of the following variables: tender joint count, swollen joint count, 
CRP, and Patient’s Global Assessment of Disease Activity score. The following equation will be 
used to calculate the DAS28 (CRP)

DAS28 (CRP) 0.56 √TJC28 0.28√SJC28 0.36ln(CRP 1) 0.014×(Patient’s Global 
Assessment of Disease Activity) 0.96
TJC28 = number of joints tender out of 28
SJC28 = number of joints swollen out of 28
CRP = C-reactive protein
Patient’s Global Assessment of Disease Activity on a 100 mm VAS recorded by the 
subject


GS-9876
Protocol GS-US-379-1582
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 91
11 July 2016
Appendix 9.
Procedures and Specifications 
Complete Physical Examination
A complete physical examination must include source documentation of general appearance, and 
the following body systems: Head, neck and thyroid; eyes, ears, nose, throat, mouth and tongue; 
chest (excluding breasts); respiratory; cardiovascular; lymph nodes, abdomen; skin, hair, nails; 
musculoskeletal; neurological (must be performed at Screening). 
Vital Signs
Assessment of vital signs will include measurement of resting blood pressure, pulse, respiratory 
rate, and temperature.
Blood pressure will be measured using the following standardized process:

Subject should sit for 5 minutes with feet flat on the floor and measurement arm supported 
so that the midpoint of the manometer cuff is at heart level;

Use a mercury sphygmomanometer or automatic blood pressure device with an appropriately
sized cuff with the bladder centered over the brachial artery;

Measure and record the blood pressure to the nearest 2 mmHg mark on the manometer or to 
the nearest whole number on an automatic device.
Height and Weight
The subject’s standing height will be collected at Screening only. The subject’s weight will be 
collected at all study visits.
12-Lead ECG
Subjects will be required to rest in a supine position for 5 minutes prior to making a recording.
The investigator (or qualified designee) should review the ECG traces recorded in real time for 
clinically significant abnormalities.  On treatment ECGs should be compared to the subject’s 
Baseline as part of routine safety monitoring.  
Fridericia Formula (QTcF)
QTcF = QT/(RR)^(1/3), where RR = 60/HR 
RR = RR interval in seconds
HR = heart rate in beats per minute
Creatinine Clearance (estimated GFR) Formula
Creatinine clearance (estimated GFR) (mL/min) = [(140 – age (yrs)) x weight (kg) x (0.85 if 
female)] / [serum creatinine (mg/dL) x 72], where weight is total body mass in kilograms


GS-9876
Protocol GS-US-379-1582
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 92
11 July 2016
Health Assessment Questionnaire – Disability Index including the Patient’s Assessment of 
Pain
The HAQ-DI is a subject reported questionnaire specific for RA.  It consists of 20 questions 
referring to 8 component sets:  dressing/grooming, arising, eating, walking, hygiene, reach, grip, 
and activities. It includes the Patient’s Assessment of Pain horizontal VAS that ranges from 
“No Pain” (0) to “Severe Pain” (100). 
Patient’s Global Assessment of Disease Activity 
The Patient’s Global Assessment of Disease Activity is a horizontal (0 – 100) VAS that ranges
from “No Arthritis” to “Severe Arthritis”.  
Physician’s Global Assessment of Disease Activity 
The Physician’s Global Assessment of Disease Activity is a horizontal (0 – 100) VAS that 
ranges from “No Disease Activity” to “Maximum Disease Activity”.  
Joint Assessment
An assessment of 66 joints for swelling and 68 joints for tenderness will be performed. Joints 
will be assessed and classified as swollen or not swollen and tender or not tender by pressure and 
joint manipulation upon physical examination.  Joint exams should be performed by a trained 
and experienced joint assessor.   Every effort should be made for the same joint assessor to 
perform the joint exams on the same subject particularly during the blinded phase of the study.

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INDNumber: 
EudraCT Number: 
Clinical Trials.gov 
Identifier: 
Indication: 
Protocol ID: 
~ GILEAU 
CLINICAL STUDY PROTOCOL 
A Randomized, Double-Blind, Placebo-Controlled, Multicenter, 
Phase 2 Proof-of-Concept Study to Evaluate Safety, Tolerability, and 
Efficacy of GS-9876 in Subjects with Active Rheumatoid Althritis on 
Background Therapy with Methotrexate 
Gilead Sciences, Inc. 
333 Lakeside Drive 
Foster City, CA 94404 
IND 123903 
2016-001496-75 
TBD 
Rheumatoid Arthritis 
GS-US-379-1582 
Gilead Clinical 
Name: 
TomDoan 
Program Manager: 
Telephone: 
Gilead Medical 
Name: 
Monitor: 
Telephone: 
Fax: 
Mobile: 
Protocol Version/Date: 
Original: 
Amendment 1: 
PPD 
Franziska Matzkies 
PPD 
PPD 
PPD 
08 April 2016 
27 Jlme 2016 
CONFIDENTIALITY STATEMENT 
The infonnation contained in this document, pruticularly unpublished data, is the prope1ty or 
under control of Gilead Sciences, Inc., and is provided to you in confidence as an investigator, 
potential investigator, or consultant, for review by you, your staff, and an applicable Institutional 
Review Board or Independent Ethics Committee. The infmmation is only to be used by you in 
connection with authorized clinical studies of the investigational dmg described in the protocol. 
You will not disclose any of the infmmation to others without written authorization from 
Gilead Sciences, Inc., except to the extent necessa1y to obtain inf01med consent from those 
persons to whom the dmg may be administered. 


GS-9876
Protocol GS-US-379-1582
Gilead Sciences, Inc.
Amendment 1
CONFIDENTIAL
Page 2
27 June 2016
TABLE OF CONTENTS
TABLE OF CONTENTS ..............................................................................................................................................2
LIST OF IN-TEXT TABLES........................................................................................................................................5
LIST OF IN-TEXT FIGURES ......................................................................................................................................5
PROTOCOL SYNOPSIS ..............................................................................................................................................6
GLOSSARY OF ABBREVIATIONS AND DEFINITION OF TERMS....................................................................12
1.
INTRODUCTION ..............................................................................................................................................16
1.1.
Background ............................................................................................................................................16
1.2.
GS-9876 .................................................................................................................................................17
1.2.1.
General Information .............................................................................................................17
1.2.2.
Nonclinical Pharmacology and Toxicology .........................................................................17
1.2.3.
Clinical Trials of GS-9876 ...................................................................................................19
1.3.
Filgotinib................................................................................................................................................20
1.3.1.
General Information .............................................................................................................20
1.3.2.
Nonclinical Pharmacology, Absorption, Distribution, Metabolism, and 
Excretion (ADME) and Toxicology.....................................................................................20
1.3.3.
Clinical Trials of Filgotinib..................................................................................................22
1.4.
Information about Methotrexate.............................................................................................................23
1.5.
Rationale for Current Study ...................................................................................................................23
1.6.
Rationale for Dose Selection..................................................................................................................24
1.7.
Risk/Benefit Assessment for the Study..................................................................................................24
1.8.
Compliance ............................................................................................................................................26
2.
OBJECTIVES.....................................................................................................................................................27
3.
STUDY DESIGN................................................................................................................................................28
3.1.
Endpoints ...............................................................................................................................................28
3.2.
Study Design..........................................................................................................................................28
3.3.
Study Treatments ...................................................................................................................................29
3.4.
Duration of Treatment............................................................................................................................29
3.5.
Criteria for Interruption and Discontinuation Criteria............................................................................30
3.5.1.
Study drug interruption considerations ................................................................................30
3.5.2.
Study drug discontinuation considerations...........................................................................30
3.6.
End of Study...........................................................................................................................................32
3.7.
Post Study Care......................................................................................................................................32
3.8.
Pharmacokinetic (PK) Assessments.......................................................................................................32
3.9.
Biomarker Testing..................................................................................................................................32
3.9.1.
Biomarker Samples for Optional Future Research...............................................................33
3.9.2.
Optional Genomic Research.................................................................................................33
4.
SUBJECT POPULATION..................................................................................................................................34
4.1.
Number of Subjects and Subject Selection ............................................................................................34
4.2.
Inclusion Criteria....................................................................................................................................34
4.3.
Exclusion Criteria...................................................................................................................................35
5.
INVESTIGATIONAL MEDICINAL PRODUCTS ...........................................................................................38
5.1.
Randomization, Blinding and Treatment Codes ....................................................................................38
5.1.1.
Procedures for Breaking Treatment Codes...........................................................................38
5.2.
Description of GS-9876 and PTM GS-9876 ..........................................................................................38


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Protocol GS-US-379-1582
Gilead Sciences, Inc.
Amendment 1
CONFIDENTIAL
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5.2.1.
Formulation of GS-9876 and PTM GS-9876 .......................................................................38
5.2.2.
Packaging and Labeling of GS-9876 and PTM GS-9876 ....................................................39
5.3.
Description of Filgotinib and PTM Filgotinib........................................................................................39
5.3.1.
Formulation of Filgotinib and PTM Filgotinib.....................................................................39
5.3.2.
Packaging and Labeling of Filgotinib and PTM Filgotinib..................................................39
5.4.
Storage and Handling of Study Drugs....................................................................................................40
5.5.
Dosage and Administration of Study Drugs...........................................................................................40
5.6.
Other Medication Administered.............................................................................................................41
5.7.
Prior and Concomitant Medications.......................................................................................................41
5.8.
Investigational Medicinal Product Accountability and Disposal or Return ...........................................44
6.
STUDY PROCEDURES ....................................................................................................................................45
6.1.
Subject Enrollment and Treatment Assignment.....................................................................................45
6.2.
Pretreatment Assessments......................................................................................................................45
6.2.1.
Screening Visit (within 28 days prior to randomization) .....................................................45
6.3.
Randomization (Day 1)..........................................................................................................................47
6.4.
Treatment Assessments..........................................................................................................................47
6.4.1.
Day 1 ....................................................................................................................................47
6.4.2.
Week 2 (+ 3 days) ................................................................................................................49
6.4.3.
Week 4 (+ 3 days) ................................................................................................................49
6.4.4.
Week 8 (+ 3 days) ................................................................................................................51
6.4.5.
Week 12 (+ 3 days) ..............................................................................................................52
6.5.
Early Termination (+ 3 days) .................................................................................................................53
6.6.
Post-Treatment Assessments (+ 5 days).................................................................................................54
6.7.
Sample Storage.......................................................................................................................................55
7.
ADVERSE EVENTS AND TOXICITY MANAGEMENT...............................................................................56
7.1.
Definitions of Adverse Events, Adverse Reactions, and Serious Adverse Events.................................56
7.1.1.
Adverse Events.....................................................................................................................56
7.1.2.
Serious Adverse Events........................................................................................................56
7.1.3.
Clinical Laboratory Abnormalities and Other Abnormal Assessments as 
Adverse Events or Serious Adverse Events .........................................................................57
7.2.
Assessment of Adverse Events and Serious Adverse Events.................................................................57
7.2.1.
Assessment of Causality for Study Drugs and Procedures...................................................57
7.2.2.
Assessment of Severity ........................................................................................................58
7.3.
Investigator Requirements and Instructions for Reporting Adverse Events and Serious 
Adverse Events to Gilead.......................................................................................................................58
7.3.1.
Requirements for collection prior to study drug initiation: ..................................................58
7.4.
Gilead Reporting Requirements.............................................................................................................60
7.5.
Clinical Laboratory Abnormalities and Other Abnormal Assessments as Adverse Events or 
Serious Adverse Events..........................................................................................................................60
7.5.1.
Grades 1 and 2 Laboratory Abnormality or Clinical Event..................................................60
7.5.2.
Grade 3 Laboratory Abnormality or Clinical Event.............................................................60
7.5.3.
Grade 4 Laboratory Abnormality or Clinical Event.............................................................61
7.6.
Toxicity Management ............................................................................................................................61
7.7.
Special Situations Reports......................................................................................................................61
7.7.1.
Definitions of Special Situations..........................................................................................61
7.7.2.
Instructions for Reporting Special Situations.......................................................................62
8.
STATISTICAL CONSIDERATIONS................................................................................................................64
8.1.
Analysis Objectives and Endpoints........................................................................................................64
8.1.1.
Analysis Objectives..............................................................................................................64
8.1.2.
Primary Endpoint .................................................................................................................64
8.1.3.
Secondary Endpoint .............................................................................................................64


GS-9876
Protocol GS-US-379-1582
Gilead Sciences, Inc.
Amendment 1
CONFIDENTIAL
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8.1.4.
Exploratory Endpoints..........................................................................................................64
8.2.
Analysis Conventions.............................................................................................................................65
8.2.1.
Analysis Sets ........................................................................................................................65
8.3.
Data Handling Conventions ...................................................................................................................66
8.4.
Demographic Data and Baseline Characteristics ...................................................................................66
8.5.
Efficacy Analysis ...................................................................................................................................66
8.6.
Safety Analysis.......................................................................................................................................67
8.6.1.
Extent of Exposure...............................................................................................................67
8.6.2.
Adverse Events.....................................................................................................................67
8.6.3.
Laboratory Evaluations ........................................................................................................67
8.6.4.
Other Safety Evaluations......................................................................................................68
8.7.
Pharmacokinetic Analysis......................................................................................................................68
8.8.
Biomarker Analysis................................................................................................................................68
8.9.
Sample Size............................................................................................................................................68
9.
RESPONSIBILITIES..........................................................................................................................................69
9.1.
Investigator Responsibilities ..................................................................................................................69
9.1.1.
Good Clinical Practice..........................................................................................................69
9.1.2.
Institutional Review Board (IRB)/Independent Ethics Committee (IEC) 
Review and Approval...........................................................................................................69
9.1.3.
Informed Consent.................................................................................................................69
9.1.4.
Confidentiality......................................................................................................................70
9.1.5.
Study Files and Retention of Records ..................................................................................70
9.1.6.
Case Report Forms...............................................................................................................71
9.1.7.
Investigational Medicinal Product Accountability and Return.............................................72
9.1.8.
Inspections............................................................................................................................72
9.1.9.
Protocol Compliance............................................................................................................72
9.2.
Sponsor Responsibilities ........................................................................................................................73
9.2.1.
Protocol Modifications.........................................................................................................73
9.2.2.
Study Report and Publications .............................................................................................73
9.3.
Joint Investigator/Sponsor Responsibilities ...........................................................................................73
9.3.1.
Payment Reporting...............................................................................................................73
9.3.2.
Access to Information for Monitoring..................................................................................74
9.3.3.
Access to Information for Auditing or Inspections ..............................................................74
9.3.4.
Study Discontinuation..........................................................................................................74
10.
REFERENCES ...................................................................................................................................................75
11.
APPENDICES ....................................................................................................................................................77
Appendix 1.
Investigator Signature Page....................................................................................................78
Appendix 2.
Study Procedures Tables ........................................................................................................79
Appendix 3.
Laboratory Assessments Table...............................................................................................82
Appendix 4.
Common Terminology Criteria for Adverse Events (CTCAE) v4.03....................................83
Appendix 5.
Pregnancy Precautions, Definition for Female of Childbearing Potential, and 
Contraceptive Requirements...................................................................................................84
Appendix 6.
The 2010 American College of Rheumatology –European League Against 
Rheumatism Collaborative Initiative Classification Criteria for Rheumatoid 
Arthritis {Aletaha et al 2010}.................................................................................................86
Appendix 7.
American College of Rheumatology Response Evaluations/ Preliminary Definition 
of Improvement in Rheumatoid Arthritis {Felson et al 1995} ...............................................88
Appendix 8.
Disease Activity Score for 28 Joint Count (DAS28) {Prevoo et al 1995} .............................90
Appendix 9.
Procedures and Specifications................................................................................................91


GS-9876
Protocol GS-US-379-1582
Gilead Sciences, Inc.
Amendment 1
CONFIDENTIAL
Page 5
27 June 2016
LIST OF IN-TEXT TABLES
Table 1-1.
Margins for GS-9876 Based on Systemic Exposure Relative to the Observed 
Human Exposure at 30 mg once daily (AUC)........................................................................19
Table 5-1.
Examples of Disallowed Medications ....................................................................................44
LIST OF IN-TEXT FIGURES
Figure 3-1.
Study Schema.........................................................................................................................29


GS-9876 
Protocol GS-US-379-1582 
Gilead Sciences, Inc. 
Study Title: 
INDNumber: 
EudraCT Number: 
Clinical Trials.gov 
Identifier: 
Study Centers 
Planned: 
Objectives: 
CONFIDENTIAL 
PROTOCOL SYNOPSIS 
Gilead Sciences, Inc. 
333 Lakeside Drive 
Foster City, CA 94404 
Amendment 1 
A Randomized, Double-Blind, Placebo-Controlled, Multicenter, 
Phase 2 Proof-of-Concept Study to Evaluate Safety, Tolerability, and 
Efficacy of GS-9876 in Subjects with Active Rheumatoid Arthritis 
on Backgrmmd Therapy with Methotrexate 
IND 123903 
2016-001496-75 
TBD 
Approximately 60 centers globally 
The primaty objective of this study is as follows: 
• 
To evaluate the effect ofGS-9876 versus placebo for the 
treatment of signs and symptoms of rheumatoid atihritis (RA) in 
subjects with active RA as measmed by change from baseline in 
Disease Activity Score for 28 joint count using C-reactive protein 
(CRP) (DAS28 [CRP]) at Week 12 
The secondaty objective of this study is as follows: 
• 
To evaluate the safety and tolerability of GS-9876 in subjects 
withRA 
• 
To explore the effect of GS-9876 on other disease-specific 
outcomes in RA 
The explorat01y objectives of this study are: 
I 
I 
Page 6 
27 June 2016 


GS-9876
Protocol GS-US-379-1582
Gilead Sciences, Inc.
Amendment 1
CONFIDENTIAL
Page 7
27 June 2016
Study Design:
This is a randomized, double-blind, placebo-controlled, multicenter, 
Phase 2 proof-of-concept (POC) study evaluating the safety, 
tolerability, and efficacy of GS-9876 in adult male and female 
subjects with active RA despite MTX therapy who had an inadequate 
response to MTX (either alone or in combination with biological 
disease modifying anti-rheumatic drug [bDMARDs]).
Approximately 80 subjects will be randomized in a 1:1:1:1 ratio to 
receive daily doses of 30 mg GS-9876, 10 mg GS-9876, 200 mg 
filgotinib, or placebo-to-match (PTM) in addition to background 
therapy with MTX for up to 12 weeks:

GS-9876 30 mg: GS-9876 (1 x 30 mg tablet QD) + PTM 
filgotinib (2 x placebo tablets QD) (N=20)

GS-9876 10 mg: GS-9876 (1 x 10 mg tablet QD) + PTM 
filgotinib (2 x placebo tablets QD) (N=20)

Filgotinib 200 mg: filgotinib (2 x 100 mg tablets QD) + PTM 
GS-9876 (1 x placebo tablet QD) (N=20)

Placebo only: PTM GS-9876 (1 x placebo tablet QD) + PTM 
filgotinib (2 x placebo tablets QD) (N=20)
Randomization will be stratified by prior inadequate response to 
biologic therapy and geographic region.
Subjects will be followed for 4 weeks after their last dose of study 
drug. 
Number of Subjects 
Planned:
Approximately 80 subjects
Target Population:
Subjects with active RA on background MTX therapy who had an 
inadequate response to MTX (either alone or in combination with
bDMARDs). 
Duration of 
Treatment:
Up to 12 weeks
Diagnosis and Main 
Eligibility Criteria:
For a complete list of inclusion and exclusion criteria, please refer to 
Section 4 of the protocol.
Male or non-pregnant female subjects with active RA, between 
18 and 75 years of age (inclusive)
Key Inclusion Criteria include:
1) Active RA disease as defined by: a tender joint count (TJC) 
of ≥6 (out of 68), a swollen joint count (SJC) of ≥6 (out of 
66) at Screening and Day 1
2) Inadequate response to treatment with oral or parenteral MTX 
7.5 to 25 mg/week continuously for at least 12 weeks, with at 
least 6 weeks at a stable dose (defined as no change in 
prescription) prior to the first dose of study drug


GS-9876
Protocol GS-US-379-1582
Gilead Sciences, Inc.
Amendment 1
CONFIDENTIAL
Page 8
27 June 2016
3) Subjects must be receiving a folic or folinic acid 
supplementation at a stable dose. Subjects who are not taking 
folic or folinic acid at Screening, should be initiated on an 
adequate dose of folic acid (≥5 mg/week total dose or as per 
local practice) or equivalent and maintained throughout the 
study.
4) Use of oral corticosteroids of no more than 10 mg prednisone 
or its equivalent per day is allowed if the dose is stable 
(defined as no change in prescription) for at least 28 days 
prior to the first dose of study drug 
5) Nonsteroidal Anti-inflammatory Drugs (NSAIDs) or other 
analgesics (including aspirin ≤ 100 mg daily) are allowed if 
doses are stable (defined as no change in prescription) for at 
least 14 days prior to the first dose of study drug; pro re nata 
(PRN) use for other indications is allowed.
6) No evidence of active or latent TB as demonstrated by a
negative QuantiFERON® TB-Gold In-Tube test at Screening. 
Tests with inconclusive results may be repeated one time. If 
an inconclusive test is repeated and is returned with 
inconclusive results a second time, the subject will be 
excluded from the study. Any prior history of active or latent
TB (regardless of treatment) is exclusionary.
Key Exclusion Criteria include:
1) Prior treatment with B-cell depleting agents (eg, rituximab), 
unless more than 6 months prior to the first dose of study drug 
and documented return of CD19+ cells at Screening 
2) Prior treatment with any commercially available or 
investigational SYK inhibitor 
3) Concurrent treatment at Screening with any other
conventional synthetic DMARD (csDMARD) other than 
MTX and/or hydroxychloroquine (HCQ) (prior csDMARD 
treatment allowed if appropriate wash out as defined in 
Section 5.7)
4) Concurrent treatment at Screening with any bDMARD (prior 
bDMARD treatment allowed if appropriate wash out as 
defined in Section 5.7). Prior failure to treatment with 
bDMARDs is not an exclusion criterion.
5) QT interval corrected for heart rate using the Fridericia 
formula (QTcF) > 450 msec determined by the average of 
values at the Screening visit


GS-9876
Protocol GS-US-379-1582
Gilead Sciences, Inc.
Amendment 1
CONFIDENTIAL
Page 9
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6) History of any major bleeding event defined as Grade 3 
severity and above (as defined by modified the Common 
Terminology Criteria for Adverse Events [CTCAE]
4.03[Appendix 4]) within the last year or personal or family 
history of bleeding disorder
OR
Current use of chronic anticoagulant, not including daily 
aspirin for cardiac prophylaxis
7) Treatment with moderate or strong CYP3A inducers or 
inhibitors within 2 weeks prior to the first dose of study drug 
(examples are provided in Section 5.7)
Study Procedures/
Frequency:
All subjects will complete the following study visits: Screening, 
Day 1 (first dose), and on-treatment visits at Weeks 2, 4, 8, and 12.  
All subjects will be followed for safety for an additional 4 weeks 
after their last dose of study drug. 
Screening assessments will be completed no more than 28 days prior 
to the Day 1 visit and will include a complete physical examination
(PE), joint count assessment, medical history, vital signs, height and 
weight, electrocardiogram (ECG), adverse events (AEs) related to 
screening procedures, concomitant medications, safety laboratory 
tests (including hematology, chemistry, coagulation, and lipid panel), 
CRP, serology (HIV, HCV, HBV), QuantiFERON® TB-Gold In-
Tube test, urinalysis, urine drug screen, thyroid-stimulating hormone 
(TSH), HbA1c, and CD19 count as applicable and as outlined in the 
protocol . Serum pregnancy testing will be performed for females of 
childbearing potential (as defined per protocol).
On-treatment assessments include a symptom driven PE, joint count 
assessment, disease-specific questionnaires and activity scales, vital 
signs, ECGs, AEs, concomitant medications, safety laboratory tests 
(including hematology, chemistry, coagulation, and lipid panel 
[fasting on Day 1 and Week 12]), B and T cell  panels (Day 1, 
Week 4, and Week 12 ), immunoglobulins (Day 1 and Week 12 or 
ET), RNA (Day 1, Week 4, and Week 12 or ET), RF/CCP (Day 1
and Week 12 or ET), CRP, urine pregnancy test, inflammation and 
pathway biomarkers (Day 1, Week 4, and Week 12 or ET), whole 
blood samples for mechanism of action (MoA) studies (Day 1, 
Week 4 and Week 12), and urine bone marker samples (Day 1
[fasting], Week 4, and Week 12 [fasting]). Additional testing will 
include PK sampling (Weeks 2, 4, 8 and 12 or ET).  


GS-9876 
Protocol GS-US-379-1582 
Gilead Sciences, Inc. 
Test Product, Dose, 
and Mode of 
Administration: 
Reference Therapy, 
Dose, and Mode of 
Administration 
Required Background 
Therapy 
Criteria for 
Evaluation: 
Safety: 
Efficacy: 
Pharmacokinetics: 
CONFIDENTIAL 
Amendment 1 
Post-treatment assessments include symptom driven PE, vital signs, 
ECGs, AEs, concomitant medications, safety laborato1y tests 
(including hematology, chemistry, and coagulation), CRP, and urine 
pregnancy test where applicable. 
For subjects who provide their additional and specific consent, 
PPD 
For subjects who rovide their additional and s ecific consent, PO 
GS-9876 30 mg (1 x 30 mg tablet), administered orally once daily 
GS-9876 10 mg (1 x 10 mg tablet), administered orally once daily 
Filgotinib 200 mg (2 x 100 mg tablets), administered orally once 
daily 
PTM GS-9876 (1 x placebo tablet), administered orally once daily 
PTM filgotinib (2 x placebo tablets), administered orally once daily 
MTX 7.5 to 25 mg, administered orally or parenterally once a week 
and folic acid supplementation 
Safety will be assessed through the reporting of AEs, clinical 
laboratmy tests, PEs, vital sign assessments, and ECGs at various 
time points during the study. Concomitant medication usage will 
also be docmnented throughout the study. 
The primary endpoint is change from baseline in DAS28 (CRP) at 
Week 12. 
The secondary endpoints include: 
• 
The propmtion of subjects who achieve ACR 20/50/70 at 
Week 12 
• 
Change from baseline in Heath Assessment 
Questionnaire- Disability Index (HAQ-DI) score at Week 12 
Plasma concenu·ations of GS-9876, filgotinib and the active 
metabolite offilgotinib (GS-829845) will be dete1mined. 
Page 10 
27 June 2016 


GS-9876 
Protocol GS-US-379-1582 
Gilead Sciences, Inc. 
Explorat01y: 
Statistical Methods: 
Amendment 1 
PPD 
The primmy endpoint is change from baseline in DAS28 (CRP) at 
Week 12. The primru.y analysis will consist of a superiority test of 
each of the GS-9876 doses compared to placebo based on the change 
from baseline in DAS28 (CRP) at Week 12. 
All continuous endpoints will be summm·ized using an 8-number 
summmy [n, mean, standard deviation (SD), median, 1st quartile 
(Ql ), 3rd qum1ile (Q3), minimum, maximum] by treatment group. 
All categorical endpoints will be summm·ized by the number and 
percentage of subjects who meet the endpoint definition. 
Safety endpoints will be analyzed by the number and percent of 
subjects with events or abnonnalities for categorical values or 
8-number surnmmy (n, mean, SD, median, Ql, Q3, minimum, 
maximum) for continuous data by treatment group. 
Sample sizes for GS-9876 and placebo groups are detennined based 
on the superiority test of one dose of GS-9876 compm·ed to placebo 
based on the change from baseline in DAS28 (CRP) at Week 12. 
When assuming a difference of 1.2 between the two groups and a 
common standm·d deviation of 1.35, 20 subjects in each of the 
GS-9876 groups and 20 in the placebo gi"OUp are re uired to obtain 
78% power at a 2-sided 0.05-level. PO 
Therefore, the total sample size will be 80 (20 per treatment group). 
This study will be conducted in accordance with the guidelines of Good Clinical Practice (GCP) 
including archiving of essential documents. 
CONFIDENTIAL 
Page 11 
27 June 2016 


GS-9876
Protocol GS-US-379-1582
Gilead Sciences, Inc.
Amendment 1
CONFIDENTIAL
Page 12
27 June 2016
GLOSSARY OF ABBREVIATIONS AND DEFINITION OF TERMS
°C
degrees Celsius
°F
degrees Fahrenheit 
β-hCG
beta-human chorionic gonadotropin
μM
micromolar
ACPA
anti-citrullinated protein antibody
ACR
American College of Rheumatology
ACR 20/50/70 
American College of Rheumatology 20/50/70%  improvement
ADP
adenosine di-phosphate
AE
adverse event
AhR
aryl hydrocarbon receptor
AKT
protein kinase B
ALT
alanine aminotransferase
APC
antigen-presenting cell
APTT
activated partial thromboplastin time
AST
aspartate aminotransferase
ATP
adenosine triphosphate
AUC
area under the curve
AUC0-last
area under the plasma/serum concentration versus time curve from time zero to 
the last quantifiable concentration
BCR
B-cell receptor
BCRP
breast cancer resistance protein
BDC
bile duct-cannulated
bDMARD
biological disease modifying anti-rheumatic drug
BLNK
B-cell linker protein
BLQ
below the limit of quantitation
BTK
Bruton’s tyrosine kinase
BUN
blood urea nitrogen
CBC
complete blood count
CCP
cyclic citrullinated peptide
CDAI
Clinical Disease Activity Index
CES
carboxylesterase
CFR
Code of Federal Regulations
CG
Cockcroft-Gault
CIA
collagen-induced arthritis 
Cmax
the maximum observed serum/plasma/peripheral blood mononuclear cell 
concentration of drug
CMH
Cochran–Mantel–Haenszel
CNS
central nervous system
CPK
creatine phosphokinase


GS-9876
Protocol GS-US-379-1582
Gilead Sciences, Inc.
Amendment 1
CONFIDENTIAL
Page 13
27 June 2016
CRO
contract research organization
CRP
C-reactive protein
csDMARD
conventional synthetic disease modifying anti-rheumatic drug
CTCAE
Common Toxicity Criteria for Adverse Events
CYP
cytochrome P450 
DAS28
Disease Activity Score for 28 joint count
DMARD
disease modifying anti-rheumatic drug
DSPH
Drug Safety and Public Health
DSS
dextran sulphate sodium
EC50
half maximal effective concentration 
ECG
electrocardiogram
eCRF
electronic case report form
EDC
electronic data capture
ERK
extracellular signal-regulated kinase
eSAE
electronic serious adverse event
ESR
erythrocyte sedimentation rate
ET
early termination
EU
European Union
FAS
Full Analysis Set
FDA
(United States) Food and Drug Administration
g
gram
GCP
Good Clinical Practice
Gilead
Gilead Sciences, Inc.
GLP
Good Laboratory Practice
GFR
glomerular filtration rate
HAQ-DI
Health Assessment Questionnaire – Disability Index
HBV
hepatitis B virus
HCQ
hydroxychloroquine
HCV
hepatitis C virus
HDL
high-density lipoprotein
HDPE
high density polyethylene
hERG
human ether-a-go-go-related gene
HIV
human immunodeficiency virus
HLGT
high-level group term
HLT
high-level term
IB
Investigator’s Brochure 
IC
immune complex
IC50
concentration that results in 50% inhibition
ICH
International Conference on Harmonization 
ICH E3
ICH Guideline for Structure and Content of Clinical Study Reports


GS-9876
Protocol GS-US-379-1582
Gilead Sciences, Inc.
Amendment 1
CONFIDENTIAL
Page 14
27 June 2016
ie
id est (that is)
IEC
Independent Ethics Committee
Ig
immunoglobulin
IL
interleukin
INR
International Normalized Ratio of prothrombin time
IR
inadequate response
IRB
Institutional Review Board
IU
international units
IUD
intrauterine device
IV
intravenous
IXRS
Interactive Web and Mobile Response System
JAK
Janus kinase
kg
kilogram
L
liter
LAM
lactational amenorrhea method
LDL
low-density lipoprotein
LLT
lower-level term
MAPK
mitogen-activated protein kinase
MCV
mean corpuscular volume 
MedDRA
Medical Dictionary for Regulatory Activities
MEK
MAPK/ERK kinase
mg
milligram
MMRM
mixed model repeated measures
MoA
mechanism of action
msec
millisecond
MTX
methotrexate
ng
nanogram
nM
nanomolar
NOAEL
no-observed-adverse-effect-level 
NSAID
nonsteroidal anti-inflammatory drug
OATP
organic anion transporting polypeptide
PAR-1
protease-activated receptor
PD
pharmacodynamics
PE
physical examination
P-gp
P-glycoprotein
PK
pharmacokinetics
PKC
protein kinase C
POC
proof-of-concept
PRN
pro re nata (as needed)
PT
preferred term or prothrombin time


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PTM
placebo-to-match
PTT
partial thromboplastin time
PXR
pregnane X receptor
Q1
first quartile
Q3
third quartile
QD
quaque die (each day)
QT
electrocardiographic interval between the beginning of the Q wave and 
termination of the T wave, representing the time for both ventricular 
depolarization and repolarization to occur
QTc
corrected QT interval
QTcF
QT interval corrected for heart rate using the Fridericia formula
RA
rheumatoid arthritis
RBC
red blood cell
RF
rheumatoid factor
RNA
ribonucleic acid
s
second
SADR
serious adverse drug reaction
SAE
serious adverse event
SD
standard deviation 
SDAI
Simplified Disease Activity Index
SJC
swollen joint count
SLE
systemic lupus erythematosus
SOC
system organ class
SOP
standard operating procedure
SS
Sjogren’s syndrome
STAT
signal transducer and activator of transcription
SUSAR
suspected unexpected serious adverse reaction
SYK
spleen tyrosine kinase
TB
tuberculosis
TEAE
treatment-emergent adverse event
TJC
tender joint count
TNF
tumor necrosis factor
TSH
thyroid-stimulating hormone
UGT
uridine disphosphate glucuronosyltransferase
ULN
upper limit of normal
US, USA
United States, United States of America
VAS
visual analog scale
WBC
white blood cell


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1.
INTRODUCTION
1.1.
Background
Rheumatoid Arthritis is a chronic, systemic inflammatory disease that affects approximately 
1.3 million adults in the United States (US) {Helmick et al 2008}. Rheumatoid Arthritis
manifests principally as an attack on peripheral joints and may lead to marked destruction and 
deformity of joints, with considerable disability and impact on quality of life. It is characterized 
by the production of autoantibodies, synovial inflammation with formation of pannus tissue, and 
erosion of underlying cartilage and bone. Although people of any age can be affected, the onset 
of RA is most frequent between the age of 40 and 50 years, and women are affected 3 times 
more often than men. While the cause of RA is still not completely understood, aberrant B-cell 
activation, T-cell co-stimulation, osteoclast differentiation, and cytokine release all have been 
implicated in its pathogenesis. Subjects with RA experience a high risk of disability and 
mortality {Arthritis Foundation 2008}.
Despite the currently available treatment options for RA, there is still a need for new treatments 
because not all subjects respond adequately (or maintain response) to current therapies and some 
subjects experience toxicities and/or intolerance that limit the use of such therapies. All currently 
available treatments have safety considerations that can develop during chronic use that may 
require a change to a different therapy. The unmet medical need for new therapeutic options with 
a favorable efficacy and safety profile that do not require injection/infusion have prompted 
efforts to develop oral small molecule inhibitors of protein kinases involved in cellular signaling 
associated with the underlying RA disease pathology. 
GS-9876 is a potent and selective inhibitor of SYK and is being developed by Gilead Sciences, 
Inc. (Gilead) as an oral agent for the treatment of inflammatory diseases. Spleen tyrosine kinase 
is a nonreceptor cytoplasmic tyrosine kinase primarily expressed in cells of hematopoietic 
lineage, where it functions as a key signaling molecule mediating immunoreceptor signaling in a 
range of cells involved in inflammatory disease. Given its central role in immune cell signaling, 
inhibition of SYK is expected to affect multiple steps in the pathogenesis of RA resulting in 
pleiotropic anti-inflammatory effects.
Filgotinib (GS-6034, formerly GLPG0634) is being developed by Gilead as an oral agent, and is 
a potent and selective inhibitor of JAK1. While the pan JAK inhibitor tofacitinib (Xeljanz®) has 
shown an early onset of action and long-term efficacy in RA as monotherapy and in combination 
with background csDMARD therapy, dose levels were limited by side effects potentially 
mediated by its effect on JAK 2 and JAK 3. This highlights the need for more selective and 
targeted therapies with improved immunomodulatory and hematologic effects.  JAK1 is thought 
to be an integral part of RA pathogenesis due its role in transmitting inflammatory cytokine 
signaling. Hence, targeted inhibition of JAK1 has great potential for the treatment of RA with an 
improved safety and side effect profile.


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1.2.
GS-9876
1.2.1.
General Information
For further information on GS-9876, refer to the current Investigator’s Brochure (IB).
1.2.2.
Nonclinical Pharmacology and Toxicology
1.2.2.1.
Nonclinical Pharmacology and Safety Pharmacology
GS-9876 is a selective and potent adenosine triphosphate (ATP)-competitive inhibitor of SYK
with an IC50 value of 9.5 nM. Overall, GS-9876 is at least 7-fold more selective biochemically 
for SYK relative to all other protein kinases assayed. Functionally, GS-9876 inhibited 
anti-IgM-induced BCR/SYK-mediated phosphorylation and activation of multiple downstream
signaling pathways in primary human B-cells, suppressed anti-IgM mediated CD69 and CD86 
activation marker expression on B-cells, and proliferation of peripheral B cells.  GS-9876 
showed a 12-fold selectivity for B-cell proliferation versus anti-CD3/anti-CD28 costimulation of 
T-cell proliferation.  Furthermore, GS-9876 inhibited immune-complex stimulated TNFand 
IL-1release from primary human monocytes. In human blood, GS-9876 inhibited SYK
autophosphorylation, anti-IgD/BCR-induced CD69 expression on B-cells, and
anti-FceRI-stimulated CD63 expression on basophils with geometric mean EC50 values ranging 
from 171 nM to 301 nM.
In two independent rat collagen-induced arthritis (CIA) models in animals with established 
disease, treatment with GS-9876 caused significant and dose-dependent amelioration of clinical 
and histopathology parameters when dosed either early (at initiation of ankle swelling) or late 
(at time of peak ankle swelling) after disease onset. Histological evaluation of joints in the 
animals from the study demonstrated that GS-9876 treatment reduced pannus formation, 
cartilage damage, bone resorption, and periosteal bone formation with an effective dose inducing 
a 50% inhibitory effect (ED50) of < 6.25 mg/kg, QD and 11.6 mg/kg, QD in the early and late 
CIA models, respectively.  Significant efficacy was seen with GS-9876 doses that produced 
Cave exposures that were calculated to inhibit SYK phosphorylation by 50% (EC50).  GS-9876 
was well tolerated at all doses and there were no treatment-related adverse effects on body 
weight, food and drink intake, in-life observations or clinical pathology parameters.  
Safety pharmacology studies were conducted to examine the potential effects of GS-9876 on the
cardiovascular system, respiratory system, and central nervous system (CNS). There were no 
clinically-relevant effects on the respiratory, and CNS systems after single oral doses up to 300 
mg/kg. Cardiovascular effects in telemetered cynomolgus monkeys at ≥ 20 mg/kg included 
prolonged QTc interval from 5 through 25 hours postdose, slightly higher systolic, diastolic, and 
mean arterial pressure with lower heart rate through 6 hours postdose, and higher heart rate from 
9 through 25 hours postdose. While differences in QTc interval were generally small, the 
changes were of sufficient magnitude to be considered biologically relevant. There were no 
inhibitory effects on the hERG potassium current when GS-9876 was tested up to a free drug 
concentration of 30 μM, approximately 207-fold above the observed steady state Cmax at a 30 mg 
QD clinical dose. Further, no cardiovascular effects were observed in telemetered cynomolgus 
monkeys administered GS-9876 for 13 weeks at doses up to 15 mg/kg/day. The potential for 


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GS-9876 to prolong the QTc interval was assessed with intensive time matched ECG monitoring 
in Gilead studies GS-US-379-1372 and GS-US-379-1900 (cohorts 1 and 2), and no clinical 
significant change in time matched QTc intervals was observed. No clinical significant changes 
in vital signs during serial vital sign measurements were observed.
1.2.2.2.
Nonclinical Toxicology
In the repeat-dose studies, the toxicity profile of GS-9876 was assessed in rats and monkeys 
administered GS-9876 orally for up to 26 weeks. Dose-dependent effects on lymphocytes in both 
rats and monkeys were consistent with the expected pharmacology of SYK inhibition. Effects on 
hemostasis were observed in rats and monkeys, with increased erythrocyte turnover in rats at 
≥10 mg/kg/day, and hemorrhage and thrombosis in monkeys at ≥20 mg/kg/day. At higher doses 
in rats (≥30 mg/kg/day), mortality associated with bacterial infections, likely resulting from the 
immunomodulatory activity of GS-9876, was seen. Additional findings included lymphoid 
depletion in the thymus, changes in the pancreas, with secondary effects related to the 
immunomodulatory activity of GS-9876, and likely opportunistic bacterial infection, observed in 
several tissues. The no-observed-adverse-effect level (NOAEL) in rats was 10 mg/kg/day after 
26 weeks dosing. For the highest proposed dose 30 mg dose, estimated exposure margins are 
2.4-/5.9- fold based on exposures at the NOAELs in the 26 week study in male/female rats.  
Subjects will be closely monitored for any infection and changes in the differential CBC.
In monkeys, the NOAEL in the 28-day study was identified at 10 mg/kg/day, which was 
associated with AUC0-24hr of 4290 ng•hr/mL. In the 13-week monkey study, there were no effects 
on hemostasis, and the NOAEL was the high dose of 15 mg/kg/day. However in the ongoing 
39-week study, one 15 mg/kg/day monkey was euthanized moribund during Week 22 with 
persistent fecal changes, weight loss, deteriorating clinical condition, and large bowel 
inflammation. All other animals survived to their scheduled necropsy after 39-weeks dosing. For 
the highest proposed dose 30 mg dose, the estimated exposure margin is 2.7-fold based on 
exposures at the 15 mg/kg/day NOAEL in the 13-week monkey study. Although the relationship 
of the moribund animal to GS-9876 treatment is uncertain, Gilead considers it prudent to limit 
exposures to mean exposures achieved in monkeys at the 10 mg/kg/day mid-dose at Week 13 of 
the 39-week study (6750 ng•h/mL), which were 1.8-fold above estimated exposures at the 
highest proposed dose 30 mg dose.
In GLP range-finding developmental toxicity studies in pregnant rats and rabbits, no 
Caesarean-sectioning, litter parameters, or gross external or visceral alterations were affected by 
GS-9876 at dose levels up to 100 mg/kg/day in rats, or up to 30 mg/kg/day in rabbits. In rabbits 
at 100 mg/kg/day, mortality, clinical observations, reduced body weights and food consumption
in does were associated with increased resorptions and reduced fetal body weights.  In rats, the 
maternal no-observed-effect level (NOEL) was 30 mg/kg/day, and the embryo-fetal development 
NOEL was 100 mg/kg/day. In rabbits, the maternal and embryo-fetal development NOEL was 
30 mg/kg/day.
GS-9876 was negative in the bacterial reverse mutation (Ames) assay, in vitro chromosomal
aberration assay, and in vivo rat micronucleus assay and is therefore considered to be
nongenotoxic. In the in vitro chromosome aberration assay in human lymphocytes, slight, but
statistically significant increases in the number of polyploid cells was observed at the highest


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GS-9876 dose level evaluated. GS-9876 did not induce structural chromosome breakage when
evaluated in the in vitro assay. 
Table 1-1.
Margins for GS-9876 Based on Systemic Exposure Relative to the 
Observed Human Exposure at 30 mg once daily (AUC)
Species
Duration
Route
NOAEL
(mg/kg/day)
AUC0-24
(ng•h/mL)a
Margin b
Rat
Once daily 
x 26 weeks
Oral
10 
8800/21,800
(male/female)
2.4/5.9
(male/female)
Cynomolgus Monkey
Once daily 
x 13 weeks
Oral
15c
10,100
2.7
a
NOAEL, no observed adverse effect level. Week 4 male and female rat AUC and week 13 Cynomolgus monkey AUC
(combined sex)
b
Margins of exposure were calculated using observed steady-state exposure (AUCtau) in humans of 3708 ng•h/mL at 30 mg 
once daily in study GS-US-379-1900.
c
One animal was euthanized moribund during Week 22 at the 15 mg/kg/day dose level.
1.2.2.3.
Nonclinical Drug Metabolism and Pharmacokinetics
GS-9876 exhibits high absorption in rats, dogs and monkeys. Plasma protein binding is moderate 
in all species with the mean free fraction in humans being of 20.4%.
After oral dosing to albino and pigmented rats, [14C]GS-9876-derived radioactivity was rapidly 
distributed to most tissues and concentrations of radioactivity were below the limit of 
quantitation by 168 hours postdose. The lowest levels of radioactivity were observed in the 
brain, bone, adipose, and testis. Melanin containing tissues exhibited higher concentrations than 
their non-pigmented counterparts but binding was reversible.  Recovery of radioactivity was high 
(≥ 97.8%) and the main route of elimination of GS-9876 was hepatobiliary with ≤ 5.1% orally 
dosed radioactivity found in urine and 69.4% in bile.
In vitro, GS-9876 exhibits high metabolic stability with human hepatocytes, liver fractions and 
individual metabolizing enzymes.  GS-9876 had little inhibitory effect on the activities of the 
major human drug metabolizing CYP enzymes and was a weak inhibitor of human UGT1A1.   
GS-9876 is a weak inhibitor of P-gp and BCRP and is a substrate for those efflux transports.  It is 
a weak inhibitor of the hepatic uptake transporters OATP1B1 and OATP1B3 but is a substrate 
for neither. Drug-drug interactions in vivo are unlikely through inhibition of human CYP 
enzymes, UGT1A1, or efflux or uptake transporters.  The potential of GS-9876 to cause 
drug-drug interactions through induction is low as there is little activation of PXR or AhR in 
vitro.
1.2.3.
Clinical Trials of GS-9876
As of 14 June 2016, 74 healthy volunteers have been dosed with GS-9876 in two clinical studies.


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Completed Clinical Trial
GS-US-379-1372: This was a first-in-human, Phase 1, single-dose ranging study of GS-9876 in 
healthy adult volunteers to evaluate the safety, tolerability, PK, PD, food effect, and drug-drug 
interaction potential using a representative acid reducing agent (omeprazole). No risks were 
identified and no grade 3 or 4 AEs were reported. There were no clinically significant changes in 
vital signs, physical findings, bleeding times, or ECGs. For further information, refer to the 
current IB.
Ongoing Clinical Trial
GS-US-379-1900: This is a single- and multiple-dose Phase 1 study of GS-9876 in healthy 
volunteers to evaluate the safety, tolerability, PK and PD of GS-9876.
1.3.
Filgotinib
1.3.1.
General Information
For further information on filgotinib, refer to the current IB.
1.3.2.
Nonclinical Pharmacology, Absorption, Distribution, Metabolism, and 
Excretion (ADME) and Toxicology
Filgotinib and its metabolite, GS-829845 have been extensively characterized in nonclinical 
studies. This program includes cellular assays demonstrating potency and selectivity of the 
compound against JAK1, efficacy studies in rats and mice, repeat dose toxicity studies (up to 
26 weeks in the rat and 39 weeks in the dog), in vitro and in vivo safety pharmacology and 
genetic toxicology studies, and reproductive toxicology studies in rats and rabbits. Additional 
toxicology studies conducted include phototoxicity studies and dose-range finding studies in 
support of a definitive rat juvenile toxicity study and a 6 month carcinogenicity study in 
transgenic (TgrasH2) mice. A 2 year rat oral carcinogenicity study is ongoing.
1.3.2.1.
Primary and Secondary Pharmacology
Filgotinib is an ATP-competitive inhibitor of JAK1. It is highly selective for inhibition of JAK1 
over 451 other kinases evaluated in vitro. In cellular assays, it inhibits JAK/STAT-driven 
processes with half maximal inhibitory concentration (IC50) values from 179 nM onwards.  In 
human whole blood, JAK1 is inhibited by filgotinib with an IC50 of 629 nM and exhibits 
approximately 30-fold selectivity over JAK2. Filgotinib demonstrated significant efficacy in the 
rat CIA model as well as in the mouse dextran sulphate sodium (DSS)-induced colitis model.
Metabolite GS-829845 exhibits a similar JAK1 selectivity profile but is approximately 10 to 
20-fold less potent than the parent filgotinib in in vitro assays. GS-829845 was as effective as 
filgotinib in the rat CIA model, but at doses that required a 10-fold higher exposure.


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1.3.2.2.
Safety Pharmacology
Filgotinib and GS-829845 had no effects on the respiratory system and CNS up to respectively 
40- and 5-fold the exposure in RA subjects given filgotinib 200 mg QD.
Filgotinib and GS-829845 had no relevant effects on cardiovascular parameters (hERG and dog 
telemetry studies), apart from a slight non-adverse increase in heart rate and arterial pressure 
with GS-829845 at exposures 7-fold that of the Cmax in subjects with RA dosed with 200 mg QD
filgotinib. There were no relevant effects on ECG and QT.
1.3.2.3.
Nonclinical ADME
Filgotinib demonstrates good oral bioavailability in mice, rats, dogs, and mini-pigs but less in 
monkeys.  Plasma protein binding is low (< 70%) in all species, including humans.
The PK of filgotinib is generally dose proportional without gender differences.  No accumulation 
occurs with repeated dosing. The mean terminal half-life after oral administration is 4 and 5 
hours in rats and dogs, respectively.
In the rat, filgotinib showed a rapid and even distribution throughout the body.  High 
concentrations were observed only in the gastrointestinal tract and urinary bladder. Filgotinib 
does not penetrate into CNS tissues.  The distribution of filgotinib indicates some affinity for 
melanin-containing tissues.
Excretion is nearly complete within 24 hours (rat) and 48 hours (dog) post-dosing.  In the rat, 
fecal and urinary excretion accounted for 40% and 53% of the administered dose, respectively, 
with a bile secretion of about 15%.  In the dog, fecal excretion was the primary route of 
excretion, accounting for 59% of the administered dose, with urinary excretion accounting for 
25%.
In vitro metabolism studies in all species revealed one major metabolite (GS-829845). The 
formation of GS-829845 is mediated by carboxylesterases (CES) and is not dependent on CYP.
In vitro experiments have shown that drug-drug interactions with filgotinib and GS-829845 are 
unlikely.  There is no inhibition or induction of CYPs or UGTs, and no relevant inhibition of key 
drug transporters, including the organic anion transporters involved in the renal elimination of 
MTX, by filgotinib or GS-829845.
1.3.2.4.
Nonclinical Toxicology
In repeat oral dose toxicity studies in both rats and dogs, the primary target tissues identified for 
filgotinib were the lymphoid tissues which are expected based on the pharmacology of JAK 
inhibition. Additional filgotinib-related findings were observed in the male reproductive organs 
of both species, and in the incisor teeth of rats only. Effects on the lymphoid system were fully 
reversible. Testicular toxicity demonstrated reversibility, however sperm counts remained low; 
this may have been a result of a recovery period of insufficient duration. A dose of 200 mg/day 
of filgotinib results in an estimated mean clinical AUC of 2.80 μg∙h/mL, which represents an 


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exposure margin of 2.7-fold when considering the mean AUC in male dogs at the NOELs across 
studies of ≥26 weeks in duration (mean AUC of 7.5 μg∙h/mL).
GS-829845-related findings in general repeat dose toxicity studies were similar to those of the 
parent filgotinib, however no testicular toxicity was noted following administration of 
GS-829845.
Filgotinib and GS-829845 were non-genotoxic when evaluated in the bacterial mutagenicity 
assay, the in vitro mouse lymphoma mutagenicity assay, and the rat bone marrow micronucleus 
assay.
In embryofetal development studies, filgotinib and GS-829845 caused embryolethality and 
teratogenicity in rats and rabbits at exposures similar to the human exposure at 200 mg/day of 
filgotinib in subjects with RA.  Administration of filgotinib did not affect female fertility but 
impaired fertility was observed in male rats at exposures approximately 15-fold the human 
exposure at 200 mg of filgotinib in subjects with RA. GS-829845 did not have any effects on 
fertility parameters in either male or female rats.
In an in vitro phototoxicity study in 3T3 cells, the metabolite GS-829845 was positive for 
phototoxic potential and results with filgotinib were equivocal. A follow-up in vivo rat 
phototoxicity assay revealed a lack of phototoxic potential for both compounds.
1.3.3.
Clinical Trials of Filgotinib
As of January 2016, filgotinib has been administered to 153 healthy subjects, 1004 RA subjects, 
and 130 subjects with Crohn’s disease. The main Phase 2b studies are listed below. A detailed 
description of all clinical studies can be found in the IB. 
GLPG0634-CL-203: In this study, subjects with active RA on stable dose of MTX were 
randomized to receive either placebo or one of three total daily doses of filgotinib (50 mg,
100 mg, or 200 mg) on a once or twice daily schedule for 24 weeks. The primary objective of the
study was to evaluate the efficacy of different doses and dose regimens of filgotinib compared to 
placebo at Week 12.
GLPG0634-CL-204: This study evaluated filgotinib administered as a monotherapy in RA 
subjects. The primary objective of study GLPG0634-CL-204 was to evaluate the efficacy of 
three doses of daily filgotinib compared to placebo at Week 12.
In both 24-week, Phase 2b, randomized, double-blind, placebo-controlled studies in 
594 (Study GLPG0634-CL-203) and 283 subjects (Study GLPG0634-CL-204) with moderately 
to severely active RA who had insufficient response to MTX, filgotinib added to a stable dose of 
background MTX or administered as monotherapy was efficacious in a dose-dependent manner 
in treating the signs and symptoms of active RA. In Study GLPG0634-CL-203, an ACR20 
response was achieved by a statistically significantly higher percentage of subjects in the 100-mg 
once-daily, 200-mg once-daily, and 100-mg filgotinib twice-daily groups (63.5%, 68.6%, and 
78.6%, respectively) compared with placebo (44.2%) (p = 0.0435, 0.0068, and < 0.0001, 


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respectively). In Study GLPG0634-CL-204, an ACR20 response at Week 12 was achieved by a 
statistically significantly higher percentage of subjects in all filgotinib dose groups compared 
with placebo (66.7%, 65.7%, and 72.5% in the 50-mg once-daily, 100-mg once-daily, and 
200-mg filgotinib once-daily groups, respectively, compared with 29.2% on placebo) 
(p < 0.0001 for all comparisons). In both studies, the ACR20 appeared to plateau at Week 8 and 
was maintained through Week 24. In addition, at Week 12, filgotinib showed a beneficial effect 
across the following secondary efficacy parameters: ACR50, ACR70, ACR-N, DAS28 (CRP), 
CDAI, and SDAI. A dose-dependent fast onset of efficacy was reported, and the responses were 
maintained or continued to improve through 24 weeks. No significant difference in efficacy was 
observed between 100-mg and 200-mg once-daily dosing regimens.
1.4.
Information about Methotrexate 
Subjects will continue to receive stable weekly doses of MTX. Further information regarding
side effects, dosage and administration is available in the current local prescribing information.
1.5.
Rationale for Current Study
Over the last decade, changes in RA treatment strategies accompanied by advances in drug 
development and the addition of targeted biological therapies have greatly improved the 
outcomes for subjects with RA. Despite these developments, therapeutic challenges remain. The 
current conventional and biological DMARDs may be ineffective, produce only partial responses 
or loose therapeutic response over time due to development of neutralizing antibodies in some 
subjects and are associated with significant safety and tolerability concerns. There is an unmet 
medical need for simple, orally administered therapies with novel and targeted mechanisms of 
action that can effectively improve the disease course while being safe and well tolerated.
Given its central role in immune cell signaling, inhibition of SYK is expected to have pleiotropic
anti-inflammatory effects and affect multiple steps in RA pathogenesis. B cells have been
implicated as playing a critical role in the pathogenesis of RA as demonstrated by the clinical
activity of the anti-CD20 monoclonal antibody, rituximab, in RA subjects {Leandro et al 2006, 
Navarro-Millan et al 2013}. B cells contribute to the pathogenesis of RA through their ability to 
act as antigen presenting cells (APCs) presenting self-antigens to auto-reactive T cells 
{Shlomchik 2008}, and through the production of autoantibodies and pro-inflammatory 
cytokines {Martin et al 2006, Song et al 2010}. As a critical mediator of BCR signaling, SYK
inhibition suppresses BCR-stimulated proliferation, co-stimulatory molecule expression, and 
autoantibody production in B cells {Braselmann et al 2006, Coffey et al 2012}. 
Additionally, SYK inhibition suppresses IC-stimulated cytokine release from 
monocytes/macrophages and prevents osteoclastogenesis {Liao et al 2013}. Spleen tyrosine 
kinase is expressed in the rheumatoid synovium {Cha et al 2006} and SYK inhibition reduces 
cellular infiltrates into synovial tissue {Coffey et al 2012}. Pharmacologic inhibition of SYK has 
been shown to inhibit disease progression and reduce inflammation in multiple animal models of 
RA, and has demonstrated disease modifying anti-rheumatic drug (DMARD) activity on 
endpoints such as cartilage destruction and bone erosion {Coffey et al 2012, Liao et al 2013, 
Pine et al 2007}.  A consistent finding in these nonclinical studies is that significant efficacy can 


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be achieved with minimum plasma concentrations (Cmin) that result in target coverage less 
than 50% {Liao et al2013}. 
Taken together, the in vitro and in vivo data suggest that inhibition of SYK may decrease several 
pathologically active mechanisms implicated in RA including B-cell activation, T -cell 
costimulation, and cytokine release. 
Filgotinib is an orally administered, small molecule inhibitor of JAK1, an intracellular tyrosine 
kinase dysregulated in subjects with inflannnatmy disorders including RA. Filgotinib has 
demonstrated clinical activity and a favorable safety and tolerability profile in Phase 2 studies in 
subjects with moderately to severely active RA. 
1.6. 
Rationale for Dose Selection 
In the rat CIA model, predicted GS-9876 exposure at the 30 mg and 10 mg QD doses are 
estimated to provide 75% and 37% of the maximal treatment response obsetved with GS-9876, 
respectively. The maximal treatment response obsetved with GS-9876 in this model was sitnilar 
to the positive control dexamethasone. In the multiple ascending dose study (GS-US-379-1900), 
doses up to 30 mg QD ofGS-9876 for 7 days were well tolerated in healthy vohmteers. 
Therefore both doses (10 mg QD and 30 mg QD) are expected to be safe and have the potential 
to be efficacious in RA. 
Results from Phase 2a studies (GLPG-CL-201 and GLPG-CL-202) and Phase 2b studies 
(GLPG-CL-203 and GLPG-CL-204) showed that 200 mg QD filgotinib was well tolerated and 
demonstrated promising clinical efficacy (ACR20/50/70 and DAS28[CRP]) in subjects with RA. 
Exposure-response analysis based on data from all Phase 2 studies indicated a dose-dependent 
increase in efficacy (ACR20/50/70, DAS28[CRP]), with a plateau at the 200 mg total daily dose 
on the dose-response cmve. These results are consistent with the relationship obsetved between 
filgotinib exposures and pSTAT1 activation (ex-vivo) following single and multiple filgotinib 
doses, where maximal inhibition ofpSTAT1 (~78%) was achieved at or above 200 mg total 
daily dose {N amour et al 2015} . Based on the overall risk -benefit observed in Phase 2b studies, 
200 mg QD filgotinib is expected to be safe and efficacious in subjects with RA, and is 
considered an appropriate dose to investigate the mechanism of action of a JAK inhibitor in 
comparison to a SYK inhibitor. 
1.7. 
Risk/Benefit Assessment for the Study 
Rheumatoid rutln-itis (RA) is a chronic, systetnic inflannnatmy disease that affects approximately 
1% of the population {Helmick et al 2008}. Despite the cmTently available medications for RA, 
there is still a need for new treatments because not all patients respond adequately (or maintain 
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response) to current therapies and some experience toxicities and/or intolerance that limit the use 
of such therapies. The need for new, non-injectable therapeutic options with a favorable efficacy 
and safety profile have prompted efforts to develop orally administered, small molecules. The 
development of these drugs is important because in addition to RA, other inflammatory diseases, 
such as systemic lupus erythematosus (SLE) and Sjogren’s syndrome (SS), also have a need for 
additional therapeutic options. 
GS-9876 is a highly selective spleen tyrosine kinase (SYK) inhibitor with once daily dosing; 
SYK is a key signaling molecule involved in innate and adaptive immune system responses. It is
important in various cell types, including platelets, phagocytes, fibroblasts, and osteoclasts, and 
in the generation of the inflammasome. Nonclinical studies show that SYK inhibition may have 
therapeutic value in the treatment of RA, SLE, SS, autoimmune cytopenias, and allergic and 
autoinflammatory diseases. Clinical trials with fostamatinib (an experimental SYK inhibitor) 
have demonstrated responses in RA and in idiopathic thrombocytopenic purpura.
In repeat dose toxicity studies of GS-9876 (in rats for up to 26 weeks and in cynomolgus 
monkeys for up to 39 weeks), the primary observed effects were reversible, dose-dependent 
decreases in circulating lymphocytes, and decreased lymphocytes in various tissues (spleen, 
lymph nodes, thymus, and/or bone marrow), consistent with the expected pharmacology of SYK 
inhibition {Barr et al 2012}. Additionally, effects on erythrocyte turnover were seen in rats, and 
effects on hemostasis (hemorrhage and thrombosis) were seen in monkeys. In clinical studies of 
GS-9876 in healthy volunteers (GS-US-379-1372, single ascending dose, completed, and 
GS-US-379-1900, multiple ascending dose, ongoing), no risks were identified and no 
grade 3 or 4 AEs were reported. There were no clinically significant changes in vital signs, 
physical findings, or ECGs. Given the role of SYK in platelet activation and aggregation, 
bleeding time was evaluated in the study subjects; no prolongation was noted. 
In addition to GS-9876, filgotinib, a once-daily, oral, potent JAK-1 inhibitor, has the potential to 
address the medical needs of RA. As of January 2016, filgotinib has been administered to 
1004 subjects with RA and 152 subjects with Crohn’s disease (CD) at daily doses ranging from 
50 to 200 mg. Dose-dependent decreases in mean neutrophil counts and platelet counts were 
observed in the RA Phase 2b studies (but mean levels of both remained within normal laboratory 
reference ranges), and there were no decreases in mean lymphocytes or lymphocyte subsets. 
However, a potential increased risk of infection may be considered consistent with the 
mechanism of JAK inhibition. In the filgotinib RA program, three deaths have been reported, all 
due to infectious etiologies. One subject in the Phase 2b study died of community acquired 
pneumonia and septic shock; two subjects had entered the open-label extension study, one died
of meningococcal meningitis, and the other of pneumonia.
Nonclinical studies in rats and dogs identified lymphoid tissues and testes as target organs for 
filgotinib; microscopic findings in the testes included germ cell depletion and degeneration in 
both species, with reduced sperm content and reduced fertility in male rats. The clinical 
relevance of the testicular findings is unknown. A male safety study is planned to specifically 
address the effect (if any) of filgotinib on the human testes.


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Both GS-9876 and filgotinib are contraindicated in pregnancy; highly effective contraception is 
to be used across all clinical studies to mitigate this risk. Measures to minimize other potential 
risks to subjects will include site/investigator training regarding monitoring for infection, and 
collection of AEs of special interest, including major adverse cardiac events, malignancies, 
infections, and specific laboratory abnormalities. 
Preclinical and clinical data support the further clinical development of GS-9876 and filgotinib 
due to their potential benefit as novel therapies in inflammatory diseases, with an acceptable 
level of risk consistent with immunomodulation in these patient populations. Controlled trials 
will be utilized to minimize risk to subjects, while gaining understanding of the lowest effective 
doses of these drugs. With respect to GS-9876 and filogotinib, given the early clinical data, as 
well as the beneficial findings in nonclinical models and overall safety, tolerability, and PK 
characteristics of these drugs, there is a favorable benefit:risk profile for continued development 
as treatments for autoimmune/inflammatory diseases. The development of GS-9876 and 
filgotinib are expected to provide a valuable addition and alternative to existing treatments for
RA, SLE, SS, and related diseases.
1.8.
Compliance
This study will be conducted in compliance with this protocol, GCP, and all applicable 
regulatory requirements.


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2. 
OBJECTIVES 
The primaty objective of this study is: 
Amendment 1 
• 
To evaluate the effect of GS-987 6 versus placebo for the treatment of signs and symptoms of 
RAin subjects with active RA as measured by change from baseline in DAS28 (CRP) at 
Week 12 
The secondruy objectives of this study ru·e: 
• 
To evaluate the safety and tolerability of GS-9876 in subjects with RA 
• 
To explore the effect of GS-9876 on other disease-specific outcomes in RA 
The explorat01y objectives of this study are: 
IT 
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3. 
STUDY DESIGN 
3.1. 
Endpoints 
The primaty endpoint of this study is: 
• 
Change from baseline in DAS28 (CRP) at Week 12 
The secondaty endpoints of the study are: 
• 
The proportion of subjects who achieve ACR 20/50170 at Week 12 
• 
Change from baseline in HAQ-DI score at Week 12 
The explorat01y endpoints include: 
IT 
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3.2. 
Study Design 
Amendment 1 
This is a randomized, double-blind, placebo-controlled, Phase 2 POC study evaluating the safety, 
tolerability, and efficacy of GS-9876 in adult male and female subjects with active RA despite 
MTX therapy who had an inadequate response to MTX (either alone or in combination with 
bDMARDs). In addition, the effect ofGS-9876 and filgotinib on disease and/or pathway markers 
relevant to RA and/or the SYK and JAK pathways will be assessed. 
A total of approximately 80 subjects will be randomized in this study. 
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Figure 3-1.
Study Schema
3.3.
Study Treatments
Following completion of Screening assessments, eligible subjects will be randomized in a 
blinded fashion in a 1:1:1:1 ratio as follows (all groups will continue to take MTX):

GS-9876 30 mg: GS-9876 (1 x 30 mg tablet QD) + PTM filgotinib (2 x placebo tablets QD) 
(N=20)

GS-9876 10 mg: GS-9876 (1 x 10 mg tablet QD) + PTM filgotinib (2 x placebo tablets QD) 
(N=20)

Filgotinib 200 mg: Filgotinib (2 x100 mg tablets QD) + PTM GS-9876 (1 x placebo tablets 
QD) (N=20)

Placebo only: PTM GS-9876 (1 x placebo tablet QD) + PTM filgotinib (2 x placebo tablets 
QD) (N=20)
Randomization will be stratified by prior inadequate response to biologic therapy and geographic 
region.  
3.4.
Duration of Treatment
Subjects will be dosed for up to 12 weeks and then followed for 4 weeks after their last dose of 
study drug.


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3.5.
Criteria for Interruption and Discontinuation Criteria
3.5.1.
Study drug interruption considerations
The Gilead Medical Monitor should be consulted prior to study drug interruption when 
medically feasible. 
Study drug interruption should be considered in the following circumstances; prior to resumption 
of study drug, the investigator should discuss the case with the Gilead medical monitor:

Intercurrent illness that would, in the judgment of the investigator, affect assessments of 
clinical status to a significant degree.   

Subject is scheduled for emergency surgery (excluding minor skin procedures under local or 
no anesthesia); timing of study drug pausing should be determined in consultation with the 
Gilead medical monitor.  Elective surgery should not be planned during the 12 week study 
period. 

If the subject has any signs or symptoms suggestive of infection (regardless of severity), 
study drug dosing should be immediately interrupted, and the medical monitor notified. Any 
subject who develops a new infection during the study should undergo prompt and complete 
diagnostic testing appropriate for an immuncompromised individual, and the subject should 
be closely monitored. Study drug should continue to be paused until the subject’s event has 
resolved, per judgment of the investigator. Prior to resuming study drug dosing, the 
investigator should discuss these cases with the sponsor or its designee

NOTE: During the time of study drug interruption for any of the above, the subject may 
continue to have study visits and to take part in procedures and assessments, if deemed 
medically appropriate by the investigator.
3.5.2.
Study drug discontinuation considerations
The Gilead Medical Monitor should be consulted prior to study drug discontinuation when 
medically feasible. 
Study medication should be permanently discontinued in the following instances:

Any opportunistic infection

Any serious infection that requires antimicrobial therapy or hospitalization, or any infection 
that meets SAE reporting criteria. 

Complicated herpes zoster infection (with multi-dermatomal, disseminated, ophthalmic, or 
CNS involvement)

Unacceptable toxicity, or toxicity that, in the judgment of the investigator, compromises the 
subject’s ability to continue study-specific procedures or is considered to not be in the 
subject’s best interest


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
Subject request to discontinue for any reason

Subject noncompliance

Discontinuation of the study at the request of Gilead, a regulatory agency or an institutional 
review board or independent ethics committee (IRB/IEC)

Subjects use of non-permitted concurrent therapy

Pregnancy during the study; refer to Appendix 5

Investigator discretion
After becoming aware of any of the below described abnormal laboratory changes at any one 
time, an unscheduled visit (ie, second sequential) to retest must occur within 3 to 5 days. If the 
laboratory abnormality is confirmed by the retest, study medication should be discontinued.

2 sequential total WBCs <2000 cells/mm3 (SI: <2.0x109 cells/L)

2 sequential neutrophil counts <1000 neutrophils/mm3 (SI: <1.0x109 cells/L)

2 sequential lymphocyte counts <750 lymphocytes/mm3 (SI: <0.75x109 cells/L)

2 sequential hemoglobin values <8.0 g/dL (SI: <80 g/L)

2 sequential platelet counts <75,000 platelets/mm3 (SI: <75.0x109 cells/L)

2 sequential AST or ALT elevations >3xULN with ≥1 total bilirubin value >2xULN1

2 sequential AST or ALT elevations >3xULN accompanied by elevated international 
normalized ratio (INR)1

2 sequential AST or ALT elevations >5xULN, regardless of total bilirubin or accompanying 
symptoms1

2 sequential values for estimated creatinine clearance <40 mL/min based on the Cockroft 
Gault formula
Subjects who stop study medication for any reason will not be replaced. Subjects withdrawing 
from the study should complete the ET and Post-Treatment Week 4 visits. Subjects may
withdraw from the study at any time without providing reason(s) for withdrawal and without 
                                                
1 In each case, there is a need for additional investigations, such as review of ethanol, recreational drug and dietary 
supplement consumption; testing for acute hepatitis A, B or C infection and biliary tract imaging should be promptly 
discussed with the study Medical Monitor.


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prejudice to fmther treatment. The reason(s) for withdrawal will be documented in the electronic 
caserepoli fmm (eCRF). 
Reasonable efforts will be made to contact subjects who are lost to follow-up. All contacts and 
contact attempts must be documented in the subject's file. 
The sponsor has the right to terminate the study at any time in case of safety concems or if 
special circumstances conceming the study medication or the company itself occur, making 
fmther treatment of subjects impossible. fu this event, the investigator(s) and relevant authorities 
will be infmmed of the reason for study tetmination. 
3.6. 
End of Study 
End of Study is defined as when the last subject has completed up to 12 weeks of treatment and 
4 weeks of follow-up. 
3.7. 
Post Study Care 
Subjects may be offered the oppmtunity to emoll into an open-label extension study at a future 
date. At this time there are no confhmed post study care options to subjects that have 
patticipated on this study and the long tetm care of subjects will remain the responsibility of their 
primaty treating physician. 
3.8. 
Pharmacokinetic (PK) Assessments 
Plasma concentTations of GS-9876, filgotinib and the metabolite of filgotinib (GS-829845) will 
be measured and PK parameters detetmined. Plasma concentrations of GS-9876 metabolites may 
be detemlined and PK parameters may be explored, as applicable. PK sampling will occur 
relative to study dmg dosing at Weeks 2, 8, and 12 or ET, conesponding to a trough 
concentration taken approximately 24 hours after the previous dose of GS-987 6 or filgotinib, but 
prior to the next dose of GS-9876 or filgotinib. At Week 4, PK sampling will occur at 
approximately 2 hours postdose. The samples will be used to evaluate PK of GS-9876 or 
filgotinib and may also be used to measure protein binding of GS-9876 or filgotinib. Plasma 
concentrations ofGS-9876 metabolites, other filgotinib metabolite(s), and/or MTX may be 
detetmined. 
PPD 
3.9. 
Biomarker Testing 
PPD 
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Amendment 1 
Sampling for markers relevant to inflammation (including but not limited to disease-associated 
markers ofRA and/or the SYK and JAK pathways) may be perfmmed at Day 1, Week 4, and 
Week 12 or ET. Blood and mine samples will also be collected for assessments of 
immunoglobulins (Day 1 and Week 12 or ET), BandT cell panels (Day 1, Week 4, and 
Week 12), whole blood samples for MoA studies (Day 1, Week 4 and Week 12), and bone 
markers (Day 1 [fasting], Week 4, and Week 12 [fasting]). Sampling time points may be 
modified by the Sponsor based upon emerging data and assay feasibility. Samples for CRP will 
be drawn at evety visit. 
The testing outlined in this protocol is based upon the current state of scientific knowledge. It 
may be modified dming or after the end of the study to remove tests no longer indicated and/or 
to add new tests based upon the growing state of knowledge. Samples may be stored at Gilead 
Sciences for a period of up to 15 years after the end of the study. 
3.9.1. 
Biomarker Samples for Optional Future Research 
PPD 
3.9.2. 
Optional Genomic Research 
PD 
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4.
SUBJECT POPULATION
4.1.
Number of Subjects and Subject Selection
Approximately 80 subjects will be enrolled in this study with active RA who have an inadequate 
response to MTX (either alone or in combination with bDMARDs). In order to manage the total 
study enrollment, Gilead, at its sole discretion, may suspend screening and/or enrollment at any 
site or study-wide at any time.
4.2.
Inclusion Criteria
Subjects must meet all of the following inclusion criteria to be eligible for participation in this 
study.
1) Male or female subjects who are between 18 and 75 years of age, inclusive, on the day of 
signing informed consent
2) Have a diagnosis of RA as defined by the 2010 American College of 
Rheumatology - European League Against Rheumatism Collaborative Initiative 
Classification Criteria for Rheumatoid Arthritis (Appendix 6)
3) Active RA disease as defined by: a TJC of ≥6 (out of 68), an SJC of ≥6 (out of 66) at 
Screening and Day 1
4) Inadequate response to treatment with oral or parenteral MTX 7.5 to 25 mg/week 
continuously for at least 12 weeks, with at least 6 weeks at a stable dose (defined as no 
change in prescription) prior to the first dose of study drug
5) Subjects must be receiving a folic or folinic acid supplementation at a stable dose. Subjects 
who are not taking folic or folinic acid at Screening should be initiated on an adequate dose 
of folic acid (>5 mg/week total dose or as per local practice) or equivalent and maintained 
throughout the study.
6) Use of oral corticosteroids of no more than 10 mg prednisone or its equivalent per day is 
allowed if the dose is stable (defined as no change in prescription) for at least 28 days prior to 
the first dose of study drug  
7) NSAIDs or other analgesics (including aspirin ≤ 100 mg daily) are allowed if doses are stable 
(defined as no change in prescription) for at least 14 days prior to the first dose of study drug; 
PRN use for other indications is allowed.
8) No evidence of active or latent TB as demonstrated by a negative QuantiFERON® TB-Gold 
In-Tube test at Screening. Tests with inconclusive results may be repeated one time. If an 
inconclusive test is repeated and is returned with inconclusive results a second time, the 
subject will be excluded from the study. Any prior history of active or latent TB (regardless 
of treatment) is exclusionary.


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9) Able and willing to sign the informed consent as approved by the IRB/IEC. Written consent 
must be provided before initiating any Screening evaluations. Subjects must have read and 
understood the informed consent form (ICF), must fully understand the requirements of the 
study, and must be willing to comply with all study visits and assessments.
10) A negative serum pregnancy test is required for female subjects of childbearing potential, as 
defined in Appendix 5
11) Lactating females must agree to discontinue nursing before the study drug is administered
and for the duration of the study.
12) Male subjects and female subjects of childbearing potential who engage in heterosexual 
intercourse must agree to use protocol specified method(s) of contraception as described in 
Appendix 5.
13) Male subject agrees to refrain from sperm donation throughout the study period and for at 
least 90 days following their last dose of study drug.
14) Female subject agrees to refrain from egg donation/harvest throughout the study period and 
for at least 35 days after their last dose of study drug.
4.3.
Exclusion Criteria
1) Prior treatment with B-cell depleting agents (eg, rituximab), unless more than 6 months prior 
to the first dose of study drug and documented return of CD19+ cells at Screening
2) Prior treatment with any commercially available or investigational SYK inhibitor 
3) Concurrent treatment at Screening with any other csDMARD other than MTX and/or HCQ
(prior csDMARD treatment allowed if appropriate wash out as defined in Section 5.7)
4) Concurrent treatment at Screening with any bDMARD (prior bDMARD treatment allowed if 
appropriate wash out as defined in Section 5.7). Prior failure to treatment with bDMARDs is 
not an exclusion criterion.
5) QT interval corrected for heart rate using the Fridericia formula (QTcF) > 450 msec 
determined by the average of values at the Screening visit
6) History of any major bleeding event defined as Grade 3 severity and above (as defined by the 
modified CTCAE 4.03[Appendix 4]) within the last year or personal or family history of 
bleeding disorder
OR
current use of chronic anticoagulant, not including daily aspirin for cardiac prophylaxis
7) Treatment with moderate or strong CYP3A inducers or inhibitors within 2 weeks prior to the 
first dose of study drug (examples are provided in Section 5.6)


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8) Joint injections within 4 weeks prior to the first dose of study drug
9) Known hypersensitivity or allergy to GS-9876, filgotinib or MTX, and their metabolites, or 
their formulation excipients
10) Administration of a live or attenuated vaccine within 30 days of Screening or planned for 
during the study.
11) Participation in any investigational drug/device clinical study within 4 weeks or 5 half-lives 
prior to Screening, whichever is longer. Exposure to investigational biologics should be 
discussed with the sponsor. 
12) Have a diagnosis of any generalized musculoskeletal disorder that would interfere with study 
procedures or assessments per the discretion of the investigator (eg, generalized 
osteoarthritis, or systemic inflammatory condition other than RA such as, but not limited to: 
juvenile idiopathic arthritis, Felty’s syndrome, ankylosing spondylitis, reactive arthritis, 
psoriatic arthritis, inflammatory bowel disease associated arthropathies, systemic lupus 
erythematosus, scleroderma, inflammatory myopathy, mixed connective tissue disease, an 
overlap syndrome, systemic vasculitis or gout [participants with secondary Sjogren's 
syndrome or secondary limited cutaneous vasculitis with RA are not excluded]).
13) History of or current moderate to severe congestive heart failure (New York Heart 
Association [NYHA] class III or IV), or within the last 6 months prior to Screening: a 
cerebrovascular accident, myocardial infarction, unstable angina, unstable arrhythmia or any 
other cardiovascular condition which, in the opinion of the investigator, would put the 
subject at risk by participating in the study.
14) History of malignancy within the past 5 years prior to Screening (except for adequately 
treated basal cell carcinoma or non-metastatic squamous cell carcinoma of the skin or 
cervical carcinoma in situ with no evidence of recurrence). 
15) History of lymphoproliferative disease or possible current lymphoproliferative disease
16) History of organ or bone marrow transplant.
17) Positive serology at Screening for human immunodeficiency virus (HIV) 1 or 2, hepatitis B 
virus (ie, surface antigen [Ag] or core antibody [Ab] positive) or hepatitis C virus (ie, HCV 
Ab positive) or any history of infectious hepatitis from any cause with the exception of 
hepatitis A.
18) History of opportunistic infection or immunodeficiency syndrome which would put the
subject at risk, as per investigator judgment.
19) Known active infection of any kind (excluding fungal infections of nail beds) or any major 
episode of infection requiring hospitalization or treatment with intravenous (IV) or oral 
anti-infectives within 4 weeks of Screening.


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20) History of symptomatic herpes zoster or herpes simplex infection within 12 weeks prior to 
Screening or history of disseminated/complicated herpes zoster infection (multi-dermatomal 
involvement, ophthalmic zoster, central nervous system involvement or postherpetic 
neuralgia).
21) History of an infected joint prosthesis or other implanted device with the prosthesis or device
still in situ.
22) History within the previous 2 years prior to Screening or current drug or alcohol abuse, or 
heavy tobacco use, per the investigator judgment.
23) Any condition or circumstances (such as fibromyalgia or others) which in the opinion of the 
investigator or sponsor may make a subject unlikely or unable to complete the study or 
comply with study procedures and requirements. 
24) Have any chronic, uncontrolled medical condition, which would put the subject at increased 
risk during study participation, such as uncontrolled: diabetes, hypertension, morbid obesity, 
thyroid, adrenal, pulmonary, hepatic, renal, neurologic or psychiatric disease, or other disease 
of concern, as per investigator judgment
25) Significant blood loss (>450 mL) or transfusion of any blood product within 12 weeks prior 
to the first dose of study drug
26) Subject has donated blood within 56 days of the first dose of study drug or plasma within 
7 days of the first dose of study drug or does not agree to refrain from blood donation 
throughout the study period and for at least 30 days following the last dose of study drug.
27) The results of the following laboratory tests performed at the central laboratory at Screening 
meet any of the criteria below (out of range lab values may be rechecked one time, per
investigator judgment, before subject is considered a screen-failure):
a) Hemoglobin <8.0 g/dL (International System of Units [SI]: <80 g/L);
b) White blood cells <3.0 x 103 cells/mm3 (SI: <3.0 x 109 cells/L); 
c) Neutrophils <1.5 x 103 cells/mm3 (SI: <1.5 x 109 cells/L);
d) Lymphocytes <0.5 x 103 cells/mm3 (SI: <0.5 x 109 cells/L);
e) Platelets <100 x 103 cells/mm3 (SI: <100 x 109 cells/L);
f)
Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) ≥1.5x ULN;
g) Total bilirubin level ≥2x ULN unless the subject has been diagnosed with Gilbert’s  
disease and this is clearly documented;
h) Creatinine clearance (estimated GFR) < 60 mL/min based on the Cockcroft-Gault (CG) 
formula


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5.
INVESTIGATIONAL MEDICINAL PRODUCTS
5.1.
Randomization, Blinding and Treatment Codes
An Interactive Web and Mobile Response System (IXRS) will be employed to manage subject 
randomization and treatment assignments. It is the responsibility of the investigator to ensure that 
the subject is eligible for the study prior to enrollment. Subjects will be assigned a Screening 
number at the time of consent.
5.1.1.
Procedures for Breaking Treatment Codes
In the event of a medical emergency where breaking the blind is required to provide medical care 
to the subject, the investigator or qualified designee may obtain treatment assignment directly 
from the IXRS system for that subject. Gilead recommends but does not require that the 
investigator contact the Gilead medical monitor before breaking the blind. Treatment assignment 
should remain blinded unless that knowledge is necessary to determine subject emergency 
medical care. The rationale for unblinding must be clearly explained in source documentation 
and on the eCRF, along with the date on which the treatment assignment was obtained. The
investigator is advised to contact the Gilead medical monitor promptly in case of any treatment 
unblinding.
Blinding of study treatment is critical to the integrity of this clinical trial and therefore, if a 
subject’s treatment assignment is disclosed to the investigator, the subject must discontinue study 
drug. All subjects will be followed until study completion unless consent to do so is specifically 
withdrawn by the subject.
Gilead Drug Safety and Public Health (DSPH) may independently unblind cases for expedited 
reporting of suspected unexpected serious adverse reactions (SUSARs).
5.2.
Description of GS-9876 and PTM GS-9876
5.2.1.
Formulation of GS-9876 and PTM GS-9876
GS-9876 will be supplied as 10 or 30 mg tablets that are round, biconvex, plain-faced and
film-coated blue. Each tablet contains either 10 mg or 30 mg of GS-9876 free base as the 
succinate form (GS-9876-02). The GS-9876 tablets contain commonly used excipients including 
microcrystalline cellulose, mannitol, croscarmellose sodium, magnesium stearate, polyvinyl 
alcohol, polyethylene glycol, titanium dioxide, talc, and FD&C blue #2/indigo carmine 
aluminum lake. 
Matching placebo tablets will be supplied that are identical in physical appearance to the 
10 and 30 mg GS-9876 tablets and contain the following inactive ingredients: 
microcrystalline cellulose, lactose monohydrate, croscarmellose sodium, magnesium stearate, 
polyvinyl alcohol, polyethylene glycol, titanium dioxide, talc, and FD&C blue #2/indigo carmine 
aluminum lake.


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5.2.2.
Packaging and Labeling of GS-9876 and PTM GS-9876
GS-9876 tablets, 10 mg or 30 mg, and PTM GS-9876 tablets are packaged in white, high-density
polyethylene (HDPE) bottles. Each bottle contains 30 tablets, silica gel desiccant and polyester 
packing material. Each bottle is enclosed with a white, continuous thread, child-resistant 
polypropylene screw cap with an induction-sealed and aluminum-faced liner.
Study drug(s) to be distributed to centers in the US and other participating countries will be 
labeled to meet applicable requirements of the United States Food and Drug Administration 
(FDA), European Union (EU) Guideline to Good Manufacturing Practice - Annex 13 
(Investigational Medicinal Products), and/or other local regulations.
5.3.
Description of Filgotinib and PTM Filgotinib
5.3.1.
Formulation of Filgotinib and PTM Filgotinib
Filgotinib will be provided as 100 mg tablets that are capsule-shaped, biconvex, and film-coated 
beige tablets debossed with “GSI” on one side and “100” on the other. Each tablet contains the 
equivalent of 100 mg filgotinib free base in the form of filgotinib maleate. In addition to the 
active ingredient, filgotinib tablets contain the following inactive ingredients: microcrystalline 
cellulose, lactose monohydrate, fumaric acid, pregelatinized starch, silicon dioxide, magnesium 
stearate, macrogol/PEG 3350, polyvinyl alcohol, talc, titanium dioxide, iron oxide yellow, and 
iron oxide red.
Placebo-to-match filgotinib tablets are identical in appearance to the active filgotinib tablets. 
Placebo-to-match filgotinib tablets contain the following inactive ingredients: microcrystalline 
cellulose, lactose monohydrate, croscarmellose sodium, magnesium stearate, 
macrogol/PEG 3350, polyvinyl alcohol, talc, titanium dioxide, iron oxide yellow, and iron oxide 
red.
5.3.2.
Packaging and Labeling of Filgotinib and PTM Filgotinib
Filgotinib 100 mg tablets and PTM filgotinib tablets are packaged in white, HDPE bottles. Each 
bottle contains 30 tablets, silica gel desiccant and polyester packing material. Each bottle is 
enclosed with a white, continuous thread, child-resistant polypropylene screw cap fitted with an 
induction-sealed, aluminum-faced liner.
Study drugs to be distributed to participating centers will be labeled to meet applicable 
requirements of the United States Food and Drug Administration (FDA), the EU Guideline to 
Good Manufacturing Practice - Annex 13 (Investigational Medicinal Products) and/or other local 
regulations, as applicable. 


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Protocol GS-US-379-1582
Gilead Sciences, Inc.
Amendment 1
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5.4.
Storage and Handling of Study Drugs
GS-9876 tablets, PTM GS-9876 tablets, filgotinib tables, and PTM filgotinib tablets should be 
stored at controlled room temperature of 25ºC (77ºF); excursions are permitted between 15ºC 
and 30ºC (59ºF and 86ºF). Storage conditions are specified on the label. 
Until dispensed to the subjects, all drug products should be stored in a securely locked area, 
accessible only to authorized site personnel. To ensure the stability of the study drugs and to 
ensure proper product identification, the drug products should not be stored in a container other 
than the containers in which they are supplied. Consideration should be given to handling, 
preparation, and disposal through measures that minimize drug contact with the body. 
Appropriate precautions should be followed to avoid direct eye contact or exposure when 
handling.
5.5.
Dosage and Administration of Study Drugs
Subjects will receive study drugs according to their randomization assignment to one of the 
following 4 arms:

GS-9876 30 mg: GS-9876 (1 x 30 mg tablet QD) + PTM filgotinib (2 x placebo tablets QD) 
(N=20)

GS-9876 10 mg: GS-9876 (1 x 10 mg tablet QD) + PTM filgotinib (2 x placebo tablets QD) 
(N=20)

Filgotinib 200 mg: Filgotinib (2 x100 mg tablets QD) + PTM GS-9876 (1 x placebo tablet 
QD) (N=20)

Placebo only: PTM GS-9876 (1 x placebo tablet QD) + PTM filgotinib (2 x placebo tablets
QD) (N=20)
The study drugs should be administered orally once daily with water, with or without food. The 
study drugs should be swallowed whole and administered together. Subjects will be instructed to 
take study drug at approximately the same time each morning. On Day 1, subjects will be 
instructed to take their dose in clinic as the last in-clinic study procedure (after all other 
procedures for that visit have been completed). At Weeks 2, 8 and 12, subjects will be instructed 
to take their dose after predose assessments have been completed (eg, PK sample collection). At 
Week 4, subjects will be instructed to take their dose in clinic as the first study procedure prior to 
any others scheduled for that visit.
For missed dose(s) of study medication, subjects should be instructed to take the missed dose(s) 
of study medication as soon as possible during the same day. If more than 12 hours has elapsed 
since the scheduled time of the missed dose, the subject should be instructed to wait and take the 
next dose at the regularly scheduled time. Subjects should be cautioned never to double the next 
dose with a missed dose of study drug under any circumstances. In those cases, the missed dose 
should be returned to the study drug bottle.


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Protocol GS-US-379-1582
Gilead Sciences, Inc.
Amendment 1
CONFIDENTIAL
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27 June 2016
5.6.
Other Medication Administered
Methotrexate should be administered weekly at a dose of 7.5 to 25 mg, orally or parenterally. 
Subjects must also receive folic acid supplementation.
5.7.
Prior and Concomitant Medications
At Screening, all medication taken up to 30 days prior to the Screening visit and all prior and 
current RA medication will be recorded on the eCRF. At each study visit, the site will capture 
any and all medications taken by the subject since the last visit or during the visit (as applicable). 
Concomitant medications include prescription, non-prescription medications, therapies, dietary 
supplements, and minerals.
Allowed Medications:

Subjects must have taken oral or parenteral MTX 7.5 to 25 mg/week continuously for at least 
12 weeks, with at least 6 weeks of stable dose (defined as no change in prescription) prior to 
first study dose and throughout the duration of the study. Subjects will continue to receive 
stable weekly doses of MTX. Further information regarding side effects, dosage and 
administration is available in the current local prescribing information.

Subjects are allowed to remain on HCQ, with at least 8 weeks of stable dose (defined as no 
change in prescription) prior to first study dose and maintained at a stable dose throughout 
the study.

Oral steroids ≤10 mg/day prednisone or equivalent, with at least 28 days of stable dose 
(defined as no change in prescription) prior to the first dose of study drug and maintained at a 
stable dose throughout the study.

NSAIDs or other analgesics (including aspirin ≤100 mg) are allowed if doses are stable
(defined as no change in prescription) for at least 14 days prior to first study dose and 
maintained at a stable dose throughout the study. Pro re nata use for other indications is 
allowed.

For pain while on study, the subject may take acetaminophen or other non-NSAID pain 
medications as directed by the treating physician.  Any scheduled or PRN pain medications, 
including chronic NSAIDs, should be held on study visit days until after the visit procedures 
have been completed.

Dose adjustments for management of toxicity of the above medications are allowed and 
should be documented, along with documentation of the AE which led to the change in the 
medication.
Prohibited Medications:

Any herbal/natural supplements, unless approved by the investigator


GS-9876
Protocol GS-US-379-1582
Gilead Sciences, Inc.
Amendment 1
CONFIDENTIAL
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
Any and all illegal or illicit drug use, including use of prescription drugs outside the care of 
the prescribing physician

Changes in the doses of background MTX, anti-malarial therapy, corticosteroids and/or 
NSAIDS (except for adverse events and toxicities per the discretion of the investigator)

Moderate or strong CYP3A4 inhibitors or inducers within 2 weeks prior to the first dose of 
study drug and while on study drug 

The following medications are prohibited within 4 weeks prior to the first dose of study drug 
and throughout the study: 
minocycline, penicillamine, sulfasalazine, anakinra, etanercept, azathioprine, 
cyclosporine, tacrolimus, sirolimus, everolimus, mycophenolate mofetil, tofacitinib or 
biosimilar versions of these drugs, where applicable

The following medications are prohibited within 10 weeks of the first dose of study drug and 
throughout the study: 
infliximab, golimumab, certolizumab pegol, abatacept, tocilizumab, adalimumab or 
biosimilar versions of these drugs, where applicable

Treatment with IV antibiotics for a clinical infection or other medical condition within 
30 days prior to first dose of study drug and throughout the study. If subject acquires an 
infection during the course of the study that requires antibiotic treatment, study drug should
be paused until discontinuation of the antibiotic treatment, clearance of the infection and 
discussion of the case with the medical monitor.

Treatment with B-cell depleting agents (ie, rituximab) within 6 months prior to the first dose 
of study drug and throughout the study 

Treatment with any other investigational study drug within 4 weeks or 5 half-lives prior to 
Screening (whichever is longer) and throughout the study

Prior treatment with any commercially available or investigational SYK inhibitor and 
throughout the study

Joint injections within 4 weeks prior to the first dose of study drug and throughout the study.
If a joint injection has been administered within 6 weeks of the first dose of study drug, the 
joint will be considered unevaluable throughout the study.

Concurrent therapy with any anti-coagulant (eg, coumadin [warfarin], any Vitamin K 
antagonist, any novel oral anticoagulant, any heparin or low molecular heparins, inhibitors of 
factor Xa) 

Concurrent therapy with any anti-platelet therapy (eg, adenosine diphosphate [ADP] receptor 
inhibitors, phosphodiesterase inhibitors, PAR-1 antagonists, Glycoprotein 2b/3a inhibitors) 
with the exception of ≤ 100 mg daily of aspirin and other NSAIDs


GS-9876
Protocol GS-US-379-1582
Gilead Sciences, Inc.
Amendment 1
CONFIDENTIAL
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Vaccine Guidelines:

Prior to study participation, it is recommended that the subject’s vaccinations be brought up 
to date according to local vaccination standards.

Live or attenuated vaccines (including, but not limited to varicella and inhaled flu vaccine) 
are prohibited within 30 days of Day 1, throughout the study, and for 6 weeks after the last 
dose of study drug.

Subjects should be advised to avoid routine household contact with persons vaccinated with 
live/attenuated vaccine components. General guidelines suggest that a study subject’s 
exposure to household contacts should be avoided for the below stated time periods:
Varicella or attenuated typhoid fever vaccination – avoid contact for 4 weeks following 
vaccination
Oral polio vaccination -- avoid contact for 6 weeks following vaccination
Attenuated rotavirus vaccine -- avoid contact for 10 days following vaccination
Inhaled flu vaccine -- avoid contact for 1 week following vaccination

Inactivated vaccines (such as inactivated flu vaccines) should be administered according to 
local vaccination standards whenever medically appropriate; however, there are no available 
data on the concurrent use of GS-9876 or filgotinib and their respective impact on immune 
responses following vaccination.
Examples of representative medications which are prohibited are listed below: 


GS-9876
Protocol GS-US-379-1582
Gilead Sciences, Inc.
Amendment 1
CONFIDENTIAL
Page 44
27 June 2016
Table 5-1.
Examples of Disallowed Medications
Drug Class
Agents Disallowed
Strong CYP3A4 Inhibitorsa
clarithromycin, conivaptan,  itraconazole, ketoconazole, nefazodone, 
posaconazole, telithromycin, voriconazole, ritonavir, cobicistat, telaprevir, 
boceprevir, grapefruit juice, idelalisib 
Strong CYP3A4 Inducersb
carbamazepine, phenytoin, rifampin, fosphenytoin, pentobarbital, primidone, 
rifabutin, rifapentine, phenobarbital, mitotane, avasimibe, St. John’s Wort
Moderate CYP3A4 Inhibitorsa
fluconazole, erythromycin, diltiazem, dronedarone, aprepitant, imatinib, 
verapamil, tofisopam, ciprofloxacin, cimetidine, cyclosporine, Schisandra 
sphenanthera
Moderate CYP3A4 Inducersb
efavirenz, tipranavir/ritonavir, bosentan, thioridazine, nafcillin, talviraline, 
lopinavir, modafinil, etravirine, lersivirine, semagacestat, genistein
Immunosuppressants
mycophenolate mofetil, azathioprine, quinacrin, gold, leflunomide
Calcineurin inhibitor
cyclosporine, tacrolimus
mTOR inhibitor
sirolimus, everolimus
Herbal/Natural Supplementsd
grapefruit juicea, St. John’s Wortb, fish oil, borage oil, Schisandra 
sphenanthera
Anti-plateletc
adenosine diphosphate (ADP) receptor inhibitors, phosphodiesterase 
inhibitors, PAR-1 antagonists, Glycoprotein 2b/3a inhibitors
Anti-coagulant
warfarin, any Vitamin K antagonist, any novel oral anticoagulant, any heparin 
or low molecular heparins, inhibitors of factor Xa
a
In vitro data indicate GS-9876 is a substrate of CYP3A4. Co-administration of CYP3A4 inhibitors may increase GS-9876
exposure. These agents are prohibited while subject is on study drug and 2 weeks prior to study drug administration.
b
In vitro data indicate GS-9876 is a substrate of CYP3A4. Co-administration of CYP3A4 inducers may decrease GS-9876
exposure. These agents are prohibited while subject is on study drug and 2 weeks prior to study drug administration.
c
≤ 100 mg aspirin and NSAIDs are permitted 
d
Herbal/Natural supplements not listed require investigator review and approval.
5.8.
Investigational Medicinal Product Accountability and Disposal or Return
The investigator is responsible for ensuring adequate accountability of all used and unused study 
drugs. This includes acknowledgement of receipt of each shipment of study drugs (quantity and 
condition). All used and unused study drugs dispensed to subjects must be returned to the site.
Accountability records will be maintained by each study site to:

Record the date received and quantity of study drugs; 

Record the date, subject number, subject initials, and the study drugs number dispensed; and

Record the date, quantity of used and unused study drugs returned, along with the initials of 
the person recording the information.
For additional information about study drug accountability and return, refer to Section 9.1.7.


GS-9876
Protocol GS-US-379-1582
Gilead Sciences, Inc.
Amendment 1
CONFIDENTIAL
Page 45
27 June 2016
6.
STUDY PROCEDURES
The study procedures to be conducted for each subject enrolled are presented in tabular form in 
Appendix 2 and described in the text that follows. The investigator must document any 
deviation from protocol procedures and notify the sponsor or contract research organization 
(CRO).
The study center will not initiate dosing until:

The IRB and IEC and other applicable regulatory agencies have reviewed and approved the 
study and the informed consent document;

All requested regulatory documents have been submitted to and approved by Gilead;

A Master Services Agreement and/or Study Agreement is executed;

The study initiation meeting has been conducted by the Gilead (or designee).
The initiation meeting will include but is not limited to a review of the protocol, the IB, study 
drugs, and investigator responsibilities.
Documentation of the personally signed and dated informed consent of each subject, using the 
study-specific, IRB-approved Informed Consent Forms (ICF), is required before initiating the 
screening process. 
6.1.
Subject Enrollment and Treatment Assignment
It is the responsibility of the investigator to ensure that subjects are eligible to participate in the 
study prior to enrollment and continue to remain eligible throughout the study.
Once informed consent has been obtained, all screening tests and procedures have been assessed, 
and study eligibility has been confirmed, eligible subjects will be randomized to study treatment
as described in Section 5.1.
6.2.
Pretreatment Assessments
6.2.1.
Screening Visit (within 28 days prior to randomization)
Written informed consent must be obtained from each subject before initiation of any visit 
procedures. After a subject has provided informed consent, the investigator will determine if the 
subject is eligible for participation in the study.  Subjects will be screened within 28 days before 
randomization (first dose of study drug) to determine eligibility for participation in the study.
The assessment will include a review of the Inclusion/Exclusion criteria and completion of all 
Screening Visit procedures as outlined in Appendix 2. A sufficient number of subjects will be 
screened to enroll approximately 80 subjects.


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Protocol GS-US-379-1582
Gilead Sciences, Inc.
Amendment 1
CONFIDENTIAL
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The following will be performed and documented at Screening:

Obtain written informed consent

Obtain medical history including but not limited to RA, prior RA medication history any 
personal or family histories of bleeding disorders and cardiovascular disease

Perform complete physical examination (refer to Appendix 9)

Obtain vital signs (refer to Appendix 9)

Obtain height and weight (refer to Appendix 9)

Complete 12-lead ECG (refer to Appendix 9)

Perform 66 swollen and 68 tender joint count assessment (refer to Appendix 7 and 
Appendix 9)

Obtain blood samples for (refer to Appendix 3):
Hematology, Chemistry and Coagulation
Lipid Panel
CRP
TSH
HbA1c
Serology (HIV, HCV, and HBV)
Serum pregnancy test for females of childbearing potential only
QuantiFERON® TB-Gold
CD19 count, as applicable (refer to exclusion criteria)

Obtain urine for urinalysis and urine drug screen (refer to Appendix 3)

Record any serious adverse events (SAEs) and all AEs related to protocol mandated 
procedures occurring after signing of the consent form (refer to Section 7).

Record any prior and concomitant medications
Subjects meeting all of the inclusion criteria and none of the exclusion criteria may return to the 
clinic after Screening for randomization into the study.


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Protocol GS-US-379-1582
Gilead Sciences, Inc.
Amendment 1
CONFIDENTIAL
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Subjects who do not meet the eligibility criteria will be considered screen failures and excluded 
from randomization. Screen failures may be considered for rescreening one time for the study in 
consultation with the Sponsor or its designee.
From the time of obtaining informed consent through the first administration of study drug, 
record all SAEs, as well as any AEs related to protocol-mandated procedures on the adverse 
events eCRF. All other untoward medical occurrences observed during the screening period, 
including exacerbation or changes in medical history are to be captured on the medical history 
eCRF. See Section 7 Adverse Events and Toxicity Management for additional details.
Screening labs may be repeated once within 28 days prior to administration of study drug to rule 
out laboratory error.
6.3.
Randomization (Day 1)
Subjects who meet all inclusion and exclusion criteria and complete screening will return for 
randomization into one of the 4 treatments as described in Section 3.3. The 66 swollen and 
68 tender joint count assessments must be performed prior to all other study procedures on Day 1 
and prior to randomization to confirm subject eligibility. Randomization will be completed as 
described in Section 5.1.
6.4.
Treatment Assessments
6.4.1.
Day 1
Study procedures and assessments are outlined in Appendix 2. The 66 swollen and 68 tender 
joint count assessments must be performed prior to all other study procedures on Day 1 and prior 
to randomization to confirm subject eligibility. The HAQ-DI including Patient’s Assessment of 
Pain, and Patient’s Global Assessment of Disease Activity are recommended to be done prior to 
any invasive study procedures. Blood draws should be the last study assessment prior to dosing 
and dosing should be the last study procedure on Day 1.
The following will be performed and documented on Day 1:

Confirm study eligibility

Perform symptom driven physical examination 

Obtain vital signs 

Obtain weight

Perform 12-lead ECG (predose)

Assess AEs and concomitant medications

Subject completes disease specific questionnaires and activity scales (refer to Appendix 9): 
HAQ-DI including Patient’s Assessment of Pain
Patient’s Global Assessment of Disease Activity   


GS-9876 
Protocol GS-US-379-1582 
Gilead Sciences, Inc. 
• 
Perf01m 66 swollen and 68 tender joint cmmt assessment (refer to Appendix 9) 
Amendment 1 
• 
Investigator completes Physician's Global Assessment of Disease Activity (refer to 
Appendix 9) 
• 
Obtain blood samples for: 
-
Hematology, Chemistty and Coagulation 
-
Lipid Panel (Fasting) 
-
CRP 
-
RF/CCP 
-
Inflammation and Pathway Biomarkers 
-RNA 
-
Imnumoglobulins 
-
Whole Blood Sample for MoA Studies 
-
B and T Cell Panels 
• 
Obtain urine sample for urine pregnancy test for females of childbearing potential only 
• 
Obtain urine sample for bone marker (fasting) 
• PPD 
• 
Dmg Administration 
-
Dispense study dtugs as directed by the IXRS. 
-
Instruct the subject on the packaging, storage and adtninistration of all study dtugs. 
-
Instmct the subject to document their daily dose adtninistr·ation. 
-
Observe the subject taking the first dose of study dt11g and record the time of the 
first dose. Study dtug should be administered as the last study procedure on Day 1. 
-
Instr11ct the subject to bring their study dtug to all study visits and not to take study dtug 
until after predose assessments at Week 2, Week 8, and Week 12 visits. Instruct the 
subject not to take study dt11g until in clinic and instmcted to do so at Week 4. 
CONFIDENTIAL 
Page48 
27 June 2016 


GS-9876 
Protocol GS-US-379-1582 
Gilead Sciences, Inc. 
6.4.2. 
Week 2 (± 3 days) 
Amendment 1 
Study procedures and assessments are outlined in Appendix 2. The following will be performed 
and documented at Week 2, within a± 3-day window: 
• 
Perform symptom driven physical examination 
• 
Obtain vital signs 
• 
Obtain weight 
• 
Perform 12-lead ECG 
• 
Assess AEs and concomitant medications 
• 
Subject completes disease specific questionnaires and activity scales: 
-
HAQ-DI including Patient's Assessment of Pain 
-
Patient's Global Assessment of Disease Activity 
• 
Perform 66 swollen and 68 tender joint count assessment 
• 
Investigator completes Physician's Global Assessment of Disease Activity 
• 
Obtain blood samples for: 
-
Hematology, Chemistry and Coagulation 
-
Lipid Panel 
-
CRP 
• 
Obtain urine sample for urine pregnancy test for females of childbearing potential only 
(obtain blood for serum pregnancy test if urine pregnancy test is positive) 
• 
Collect PK sample (predose) 
• 
Study drug administration after predose assessments completed (eg, PK sample collection). 
• 
Complete medication pill count 
• 
Review study drug compliance and drug administration instructions with subject. 
6.4.3. 
Week 4 (± 3 days) 
Study procedures and assessments are outlined in Appendix 2. The following will be performed 
and documented at Week 4, within a± 3-day window: 
• 
Study drug administration Qrior to other study procedures PPD 
~----------------------~ 
• 
Perform symptom driven physical examination 
CONFIDENTIAL 
Page 49 
27 June 2016 


GS-9876 
Protocol GS-US-379-1582 
Gilead Sciences, Inc. 
• 
Obtain vital signs 
• 
Obtain weight 
• 
Perfmm 12-lead ECG 
• 
Assess AEs and concomitant medications 
• 
Subject completes disease specific questimmaires and activity scales: 
-
HAQ-DI including Patient's Assessment of Pain 
-
Patient's Global Assessment of Disease Activity 
• 
Perfmm 66 swollen and 68 tender joint count assessment 
• 
Investigator completes Physician's Global Assessment of Disease Activity 
• 
Obtain blood samples for: 
-
Hematology, Chemistiy and Coagulation 
-
Lipid Panel 
-
CRP 
-
Inflammation and Pathway Biomarkers 
-RNA 
-
Whole Blood Sample for MoA Studies 
-
B and T Cell Panels 
Amendment 1 
• 
Obtain mine sample for mine pregnancy test for females of childbearing potential only 
(obtain blood for serum pregnancy test if mine pregnancy test is positive) 
• 
Obtain mine sample for bone marker 
• 
Collect PK sample (2 homs postdose) 
• 
PD 
• 
Study dmg will be dispensed as directed by IXRS. 
• 
Complete medication pill count 
• 
Review study dmg compliance and dmg administration instructions with subject. 
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27 June 2016 


GS-9876 
Protocol GS-US-379-1582 
Gilead Sciences, Inc. 
6.4.4. 
Week 8 (± 3 days) 
Amendment 1 
Study procedmes and assessments are outlined in Appendix 2. The following will be pe1f01med 
and documented at Week 8, within a± 3-day window: 
• 
Perfmm symptom driven physical examination 
• 
Obtain vital signs 
• 
Obtain weight 
• 
Perfmm 12-lead ECG 
• 
Assess AEs and concomitant medications 
• 
Subject completes disease specific questionnaires and activity scales: 
-
HAQ-DI including Patient's Assessment of Pain 
-
Patient's Global Assessment of Disease Activity 
• 
Perfmm 66 swollen and 68 tender joint count assessment 
• 
Investigator completes Physician's Global Assessment of Disease Activity 
• 
Obtain blood samples for: 
-
Hematology, Chemistiy and Coagulation 
-
Lipid Panel 
-CRP 
• 
Obtain mine sample for mine pregnancy test for females of childbearing potential only 
(obtain blood for semm pregnancy test if mine pregnancy test is positive) 
• 
Collect PK sample (predose) 
• PPD 
• 
Study drug administration after predose assessments completed (eg, PK sample collection). 
• 
Study dmg will be dispensed as directed by IXRS. 
• 
Complete medication pill cmmt 
• 
Review study drug compliance and dmg administration instluctions with subject. 
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Protocol GS-US-379-1582
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Amendment 1
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6.4.5.
Week 12 (+ 3 days)
Study procedures and assessments are outlined in Appendix 2. The HAQ-DI including Patient’s 
Assessment of Pain, and Patient’s Global Assessment of Disease Activity are recommended to 
be done prior to the 66 swollen and 68 tender joint count assessments and before any invasive 
study procedures. Blood draws should be done at the end of the study visit.
The following will be performed and documented on Day 1, within a + 3-day window:

Perform symptom driven physical examination 

Obtain vital signs 

Obtain weight

Perform 12-lead ECG

Assess AEs and concomitant medications

Subject completes disease specific questionnaires and activity scales: 
HAQ-DI including Patient’s Assessment of Pain 
Patient’s Global Assessment of Disease Activity

Perform 66 swollen and 68 tender joint count assessment (prior to Physician’s Global 
Assessment of Disease Activity)

Investigator completes Physician’s Global Assessment of Disease Activity

Obtain blood samples for:
Hematology, Chemistry and Coagulation
Lipid Panel (Fasting)
CRP
RF/CCP
Inflammation and Pathway Biomarkers
RNA
Immunoglobulins
Whole Blood Sample for MoA Studies
B and T Cell Panels

Obtain urine sample for urine pregnancy test for females of childbearing potential only
(obtain blood for serum pregnancy test if urine pregnancy test is positive)


GS-9876 
Protocol GS-US-379-1582 
Gilead Sciences, Inc. 
• 
Obtain urine sample for bone marker (fasting) 
• 
Collect PK sample (predose) 
• PPD 
Amendment 1 
• 
Study dmg administration after predose assessments completed (eg, PK sample collection). 
• 
All study dmg must be retumed by subject. Study chug not previously retumed by the subject 
should also be collected. 
• 
Complete medication pill count. 
6.5. 
Early Termination(± 3 days) 
If a subject discontinues study dosing (for example, as a result of an AE), evety attempt should 
be made to perfmm the required study-related follow-up and procedures (see Section 3.5, 
Discontinuation Criteria). 
Evaluations indicating a:bnmmal results believed to be possibly or probably related to study 
dosing at the ET visit should be repeated weekly or as often as deemed appropriate by the 
investigator tmtil the abnmmality resolves, retums to baseline visit levels, or is othetwise 
explained. 
If the subject discontinues prematurely from the study, the ET evaluations and/or procedures 
should be completed as outlined in Appendix 2 within 72 hours of subject's early te1mination 
from the study. The following will be perfmmed and documented at ET, within a± 3-day 
window: 
• 
Perfmm symptom ch·iven physical examination 
• 
Obtain vital signs 
• 
Perfmm 12-lead ECG 
• 
Assess AEs and concomitant medications 
• 
Subject completes disease specific questionnaires and activity scales: 
-
HAQ-DI, including Patient's Assessment of Pain 
-
Patient's Global Assessment of Disease Activity 
• 
Perfmm 66 swollen and 68 tender joint cmmt assessment 
• 
Investigator completes Physician's Global Assessment of Disease Activity 
CONFIDENTIAL 
Page 53 
27 June 2016 


GS-9876
Protocol GS-US-379-1582
Gilead Sciences, Inc.
Amendment 1
CONFIDENTIAL
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27 June 2016

Obtain blood samples for:
Hematology, Chemistry and Coagulation
Lipid Panel
CRP
RF/CCP
Inflammation and Pathway Biomarkers
RNA
Immunoglobulins

Obtain urine sample for urine pregnancy test for females of childbearing potential only
(obtain blood for serum pregnancy test if urine pregnancy test is positive)

Collect PK sample

All study drug must be returned by subject. Study drug not previously returned by the subject 
should also be collected.

Complete medication pill count.
6.6.
Post-Treatment Assessments (+ 5 days)
Study procedures and assessments are outlined in Appendix 2. The Post-Treatment Week 4 Visit 
will occur 28 days (+ 5 days) from the last administration of study drug. The following will be 
performed and documented:

Perform symptom driven physical examination 

Obtain vital signs 

Obtain weight

Perform 12-lead ECG

Assess AEs and concomitant medications

Obtain blood samples for:
Hematology, Chemistry, and Coagulation
Lipid Panel
CRP

Obtain urine sample for urine pregnancy test for females of childbearing potential only
(obtain blood for serum pregnancy test if urine pregnancy test is positive)


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Protocol GS-US-379-1582
Gilead Sciences, Inc.
Amendment 1
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6.7.
Sample Storage
From subjects who provide additional consent, residual samples from blood drawn at all visits 
will be frozen and stored. These stored samples may be used by Gilead or our research partners 
to help answer questions about the RA and related diseases, study drug, or clinical laboratory 
testing to provide additional safety data. No human genetic testing will be performed without 
express consent of the study subjects. At the conclusion of this study, PK samples may be 
retained in storage by Gilead at its research partner facility for a period of up to 2 years. Other
samples and samples collected for RNA may be retained in storage for Gilead for a period of up 
to 15 years.


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7.
ADVERSE EVENTS AND TOXICITY MANAGEMENT
7.1.
Definitions of Adverse Events, Adverse Reactions, and Serious Adverse 
Events
7.1.1.
Adverse Events
An AE is any untoward medical occurrence in a clinical study subject administered a medicinal 
product, which does not necessarily have a causal relationship with the treatment. An AE can 
therefore be any unfavorable and/or unintended sign, symptom, or disease temporally associated 
with the use of a medicinal product, whether or not considered related to the medicinal product.
AEs may also include pre- or post-treatment complications that occur as a result of protocol 
specified procedures, lack of efficacy, overdose, drug abuse/misuse reports, or occupational 
exposure. Preexisting events that increase in severity or change in nature during or as a 
consequence of participation in the clinical study will also be considered AEs.
An AE does not include the following:

Medical or surgical procedures such as surgery, endoscopy, tooth extraction, and transfusion.
The condition that led to the procedure may be an adverse event and must be reported.

Pre-existing diseases, conditions, or laboratory abnormalities present or detected before the 
Screening visit that do not worsen

Situations where an untoward medical occurrence has not occurred (eg, hospitalization for 
elective surgery, social and/or convenience admissions)

Overdose without clinical sequelae (see Section 7.7.2.2)

Any medical condition or clinically significant laboratory abnormality with an onset date 
before the consent form is signed and not related to a protocol-associated procedure is not an 
AE. It is considered to be pre-existing and should be documented on the medical history 
eCRF.
7.1.2.
Serious Adverse Events
An SAE is defined as an event that, at any dose, results in the following:

Death

Life-threatening (Note: The term “life-threatening” in the definition of “serious” refers to an 
event in which the subject was at risk of death at the time of the event; it does not refer to an 
event that hypothetically might have caused death if it were more severe.)

In-patient hospitalization or prolongation of existing hospitalization


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
Persistent or significant disability/incapacity

A congenital anomaly/birth defect

A medically important event or reaction: such events may not be immediately 
life-threatening or result in death or hospitalization but may jeopardize the subject or may 
require intervention to prevent one of the other outcomes constituting SAEs. Medical and 
scientific judgment must be exercised to determine whether such an event is a reportable 
under expedited reporting rules. Examples of medically important events include intensive 
treatment in an emergency room or at home for allergic bronchospasm; blood dyscrasias or 
convulsions that do not result in hospitalization; and development of drug dependency or 
drug abuse. For the avoidance of doubt, infections resulting from contaminated medicinal 
product will be considered a medically important event and subject to expedited reporting 
requirements.
7.1.3.
Clinical Laboratory Abnormalities and Other Abnormal Assessments as 
Adverse Events or Serious Adverse Events
Laboratory abnormalities without clinical significance are not recorded as AEs or SAEs. 
However, laboratory abnormalities (eg, clinical chemistry, hematology, and urinalysis) that 
require medical or surgical intervention or lead to study drug interruption, modification, or 
discontinuation must be recorded as an AE, as well as an SAE, if applicable. In addition, 
laboratory or other abnormal assessments (eg, electrocardiogram, x-rays, vital signs) that are 
associated with signs and/or symptoms must be recorded as an AE or SAE if they meet the 
definition of an AE or SAE as described in Sections 7.1.1 and 7.1.2. If the laboratory 
abnormality is part of a syndrome, record the syndrome or diagnosis (eg, anemia), not the 
laboratory result (ie, decreased hemoglobin).
For specific information on handling of clinical laboratory abnormalities in this study, please
refer to Section 7.5.
7.2.
Assessment of Adverse Events and Serious Adverse Events
The investigator or qualified sub-investigator is responsible for assessing AEs and SAEs for 
causality and severity, and for final review and confirmation of accuracy of event information 
and assessments.
7.2.1.
Assessment of Causality for Study Drugs and Procedures
The investigator or qualified sub-investigator is responsible for assessing the relationship to 
study drug therapy using clinical judgment and the following considerations:

No: Evidence exists that the adverse event has an etiology other than study drug. For SAEs, 
an alternative causality must be provided (eg, pre-existing condition, underlying disease, 
intercurrent illness, or concomitant medication).

Yes: There is reasonable possibility that the event may have been caused by the study drug.


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It should be emphasized that ineffective treatment should not be considered as causally related in 
the context of adverse event reporting. 
The relationship to study procedures (eg, invasive procedures such as venipuncture or biopsy) 
should be assessed using the following considerations:

No: Evidence exists that the adverse event has an etiology other than the study procedure.

Yes: The adverse event occurred as a result of a protocol procedure (eg, venipuncture).
7.2.2.
Assessment of Severity
The severity grading of AEs will be assessed as Grade 1, 2, 3 or 4 using the Common 
Terminology Criteria for Adverse Events (CTCAE) version 4.03. For AEs associated with 
laboratory abnormalities, the event should be graded on the basis of the clinical severity in the 
context of the underlying conditions; this may or may not be in agreement with the grading of 
the laboratory abnormality. 
The only modification to the CTCAE criteria is the addition of a Grade 1 upper respiratory, as 
described in Appendix 4.
7.3.
Investigator Requirements and Instructions for Reporting Adverse Events 
and Serious Adverse Events to Gilead
7.3.1.
Requirements for collection prior to study drug initiation:
After informed consent, but prior to initiation of study medication, the following types of events 
should be reported on the CRF/eCRF: all SAEs and adverse events related to protocol-mandated 
procedures.
7.3.1.1.
Adverse Events
Following initiation of study medication, collect all AEs, regardless of cause or relationship, 
until 30 days after last administration of study drug must be reported to the CRF/eCRF database 
as instructed.
All AEs should be followed up until resolution or until the adverse event is stable, if possible. 
Gilead Sciences may request that certain AEs be followed beyond the protocol defined follow-up 
period.
7.3.1.2.
Serious Adverse Events
All SAEs, regardless of cause or relationship, that occurs after the subject first consents to 
participate in the study (ie, signing the informed consent) and throughout the duration of the 
study, including the protocol-required post treatment follow-up period, must be reported to the 
CRF/eCRF database and Gilead DSPH as instructed. This also includes any SAEs resulting from 
protocol-associated procedures performed after informed consent is signed.


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Any SAEs and deaths that occur after the post treatment follow-up visit but within 4 weeks of 
the last dose of study drug, regardless of causality, should also be reported. 
Investigators are not obligated to actively seek SAEs after the protocol defined follow-up period; 
however, if the investigator learns of any SAEs that occur after study participation has concluded 
and the event is deemed relevant to the use of study drug, he/she should promptly document and 
report the event to Gilead DSPH.

All AEs and SAEs will be recorded in the CRF/eCRF database within the timelines outlined 
in the CRF/eCRF completion guideline.
7.3.1.3.
Electronic Serious Adverse Event (eSAE) Reporting Process 

Site personnel record all SAE data in the CRF/eCRF database and from there transmit the 
SAE information to Gilead DSPH within 24 hours of the investigator’s knowledge of the 
event. Detailed instructions can be found in the CRF/eCRF completion guidelines.

If for any reason it is not possible to record the SAE information electronically, ie, the 
CRF/eCRF database is not functioning, record the SAE on the paper serious adverse event 
reporting form and submit within 24 hours to:
Gilead DSPH
Email: Safety_FC@gilead.com
Fax: +1 650-522-5477

As soon as it is possible to do so, any SAE reported via paper must be transcribed into the 
CRF/eCRF Database according to instructions in the CRF/eCRF completion guidelines.

If an SAE has been reported via a paper form because the CRF/eCRF database has been 
locked, no further action is necessary.

All AEs and SAEs will be recorded in the CRF/eCRF database within the timelines outlined 
in the CRF/eCRF completion guideline. 

For fatal or life-threatening events, copies of hospital case reports, autopsy reports, and other 
documents are also to be submitted by e-mail or fax when requested and applicable. 
Transmission of such documents should occur without personal subject identification, 
maintaining the traceability of a document to the subject identifiers.

Additional information may be requested to ensure the timely completion of accurate safety 
reports.

Any medications necessary for treatment of the SAE must be recorded onto the concomitant 
medication section of the subject’s CRF/eCRF and the event description section of the SAE 
form.


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7.4.
Gilead Reporting Requirements
Depending on relevant local legislation or regulations, including the applicable US FDA Code of 
Federal Regulations, the EU Clinical Trials Directive (2001/20/EC) and relevant updates, and 
other country-specific legislation or regulations, Gilead may be required to expedite to 
worldwide regulatory agencies reports of SAEs, serious adverse drug reactions (SADRs), or 
SUSARs. In accordance with the EU Clinical Trials Directive (2001/20/EC), Gilead or a 
specified designee will notify worldwide regulatory agencies and the relevant IEC in concerned 
Member States of applicable SUSARs as outlined in current regulations.
Assessment of expectedness for SAEs will be determined by Gilead using reference safety 
information specified in the IB or relevant local label as applicable. 
All investigators will receive a safety letter notifying them of relevant SUSAR reports associated 
with any study drug. The investigator should notify the IRB/IEC of SUSAR reports as soon as is 
practical, where this is required by local regulatory agencies, and in accordance with the local 
institutional policy. 
7.5.
Clinical Laboratory Abnormalities and Other Abnormal Assessments as 
Adverse Events or Serious Adverse Events
Laboratory abnormalities are usually not recorded as AEs or SAEs. However, laboratory 
abnormalities (eg, clinical chemistry, hematology, and urinalysis) independent of the underlying 
medical condition that require medical or surgical intervention or lead to study drug interruption, 
modification, or discontinuation must be recorded as an AE, as well as an SAE, if applicable. In 
addition, laboratory or other abnormal assessments (eg, electrocardiogram, x-rays, vital signs) 
that are associated with signs and/or symptoms must be recorded as an AE or SAE if they meet 
the definition of an AE or SAE as described in Sections 7.1.1 and 7.1.2, respectively. If the 
laboratory abnormality is part of a syndrome, record the syndrome or diagnosis (i.e., anemia) not 
the laboratory result (i.e., decreased hemoglobin).
Severity should be recorded and graded according to the modified CTCAE Grading Scale as 
described in (Appendix 4). 
For adverse events associated with laboratory abnormalities, the event should be graded on the 
basis of the clinical severity in the context of the underlying conditions; this may or may not be 
in agreement with the grading of the laboratory abnormality.
7.5.1.
Grades 1 and 2 Laboratory Abnormality or Clinical Event
Continue study drug at the discretion of the investigator.
7.5.2.
Grade 3 Laboratory Abnormality or Clinical Event
For Grade 3 clinically significant laboratory abnormality or clinical event, study drug may be 
continued if the event is considered to be unrelated to study drug. 


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For a Grade 3 clinical event, or clinically significant laboratory abnormality confirmed by repeat 
testing, that is considered to be related to study drug, study drug should be withheld until the 
toxicity returns to ≤Grade 2. 
If a laboratory abnormality recurs to ≥Grade 3 following re-challenge with study drug and is 
considered related to study drug, then study drug should be permanently discontinued and the 
subject managed according to local clinical practice. Recurrence of laboratory abnormalities 
considered unrelated to study drug may not require permanent discontinuation.
7.5.3.
Grade 4 Laboratory Abnormality or Clinical Event
For a Grade 4 clinical event or clinically significant Grade 4 laboratory abnormality confirmed 
by repeat testing, study drug should be permanently discontinued and the subject managed 
according to local clinical practice. The subject should be followed as clinically indicated until 
the laboratory abnormality returns to baseline or is otherwise explained, whichever occurs first. 
A clinically significant Grade 4 laboratory abnormality that is not confirmed by repeat testing 
should be managed according to the algorithm for the new toxicity grade. 
Study drug may be continued without dose interruption for a clinically non-significant Grade 4 
laboratory abnormality (eg, Grade 4 CK after strenuous exercise or triglyceride elevation that is 
nonfasting or that can be medically managed) or a clinical event considered unrelated to study 
drug. 
7.6.
Toxicity Management 
Treatment-emergent toxicities will be noted by the investigator and brought to the attention of 
the Gilead Sciences Medical Monitor or designee. Whether or not considered treatment-related, 
all subjects experiencing AEs should be monitored periodically until symptoms subside, any 
abnormal laboratory values have resolved or returned to baseline levels or they are considered 
irreversible, or until there is a satisfactory explanation for the changes observed.
Grade 3 or 4 clinically significant laboratory abnormalities should be confirmed by repeat testing 
as soon as possible, and preferably within 3 calendar days after receipt of the original test results.
Grade 3 or 4 clinically significant laboratory abnormalities should be managed as outlined in 
Sections 7.5.2 and 7.5.3.
Any questions regarding toxicity management should be directed to the Gilead Sciences Medical 
Monitor or designee.
7.7.
Special Situations Reports
7.7.1.
Definitions of Special Situations
Special situation reports include all reports of medication error, abuse, misuse, overdose, reports 
of adverse events associated with product complaints, occupational exposure with an AE, 
pregnancy reports regardless of an associated AE, and an AE in an infant following exposure 
from breastfeeding.  


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Medication error is any unintentional error in the prescribing, dispensing, or administration of a 
medicinal product while in the control of the health care provider, subject, or consumer.
Abuse is defined as persistent or sporadic intentional excessive use of a medicinal product by a 
subject.
Misuse is defined as any intentional and inappropriate use of a medicinal product that is not in 
accordance with the protocol instructions or the local prescribing information.
An overdose is defined as an accidental or intentional administration of a quantity of a medicinal 
product given per administration or cumulatively which is above the maximum recommended 
dose as per protocol or in the product labelling (as it applies to the daily dose of the subject in 
question). In cases of a discrepancy in drug accountability, overdose will be established only 
when it is clear that the subject has taken the excess dose(s). Overdose cannot be established 
when the subject cannot account for the discrepancy except in cases in which the investigator has 
reason to suspect that the subject has taken the additional dose(s).
Product complaint is defined as complaints arising from potential deviations in the manufacture, 
packaging, or distribution of the medicinal product.
Occupational exposure is defined as exposure to a medicinal product as a result of one’s 
professional or non-professional occupation.
7.7.2.
Instructions for Reporting Special Situations
7.7.2.1.
Instructions for Reporting Pregnancies
The investigator should report pregnancies in female study subjects that are identified after 
initiation of study medication and throughout the study, including the post study drug follow-up 
period, to Gilead DSPH using the pregnancy report form within 24 hours of becoming aware of 
the pregnancy.
Refer to Section 7.3 and the CRF/eCRF completion guidelines for full instructions on the 
mechanism of pregnancy reporting.
The pregnancy itself is not considered an AE nor is an induced elective abortion to terminate a 
pregnancy without medical reasons.
Any premature termination of pregnancy (eg, a spontaneous abortion, an induced therapeutic 
abortion due to complications or other medical reasons) must be reported within 24 hours as an 
SAE. The underlying medical reason for this procedure should be recorded as the AE term.
A spontaneous abortion is always considered to be an SAE and will be reported as described in 
Section 7.3. Furthermore, any SAE occurring as an adverse pregnancy outcome post study must 
be reported to Gilead DSPH.


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The subject should receive appropriate monitoring and care until the conclusion of the 
pregnancy. The outcome should be reported Gilead DSPH using the pregnancy outcome report 
form. If the end of the pregnancy occurs after the study has been completed, the outcome should 
be reported directly to Gilead DSPH. Gilead DSPH contact information is as follows: 
Email: Safety_FC@gilead.com and Fax: +1 (650) 522-5477. 
Pregnancies of female partners of male study subjects exposed to Gilead or other study drugs 
must also be reported and relevant information should be submitted to Gilead DSPH using the 
pregnancy and pregnancy outcome forms within 24 hours. Monitoring of the subject should 
continue until the conclusion of the pregnancy. If the end of the pregnancy occurs after the study 
has been completed, the outcome should be reported directly to Gilead DSPH, fax number 
+1 (650) 522-5477 or email Safety_FC@gilead.com.
Refer to Appendix 5 for Pregnancy Precautions, Definition for Female of Childbearing Potential, 
and Contraceptive Requirements.
7.7.2.2.
Reporting Other Special Situations
All other special situation reports must be reported on the special situations report form and 
forwarded to Gilead DSPH within 24 hours of the investigator becoming aware of the situation. 
These reports must consist of situations that involve study drug and/or Gilead concomitant 
medications, but do not apply to non-Gilead concomitant medications. 
Special situations involving non-Gilead concomitant medications does not need to be reported on 
the special situations report form; however, for special situations that result in AEs due to a 
non--Gilead concomitant medication, the AE should be reported on the AE form. 
Any inappropriate use of concomitant medications prohibited by this protocol should not be 
reported as “misuse,” but may be more appropriately documented as a protocol deviation.
Refer to Section 7.3 and the CRF/eCRF completion guidelines for full instructions on the 
mechanism of special situations reporting.
All clinical sequelae in relation to these special situation reports will be reported as AEs or SAEs 
at the same time using the AE CRF/eCRF and/or the SAE report form. Details of the symptoms 
and signs, clinical management, and outcome will be reported, when available.


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8. 
STATISTICAL CONSIDERATIONS 
8.1. 
Analysis Objectives and Endpoints 
8.1.1. 
Analysis Objectives 
The primaty objective is: 
Amendment 1 
• 
To evaluate the effect of GS-987 6 versus placebo for the treatment of signs and symptoms of 
RA in subjects with active RA as measured by change from baseline in DAS28 (CRP) at 
Week 12 
The secondaty objectives are: 
• 
To evaluate the safety and tolerability of GS-9876 in subjects with RA 
• 
To explore the effect of GS-9876 on other disease-specific outcomes in RA 
The exploratmy objectives are: 
IT 
I 
I 
8.1.2. 
Primary Endpoint 
The primaty endpoint is change from baseline in DAS28 (CRP) at Week 12. 
8.1.3. 
Secondary Endpoint 
The secondruy endpoints include: 
• 
The proportion of subjects who achieve ACR 20/50/70 at Week 12 
• 
Change from baseline in HAQ-DI score at Week 12 
8.1.4. 
Exploratory Endpoints 
PPD 
I 
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8.2. 
8.2.1. 
8.2.1.1. 
Analysis Conventions 
Analysis Sets 
All Randomized 
Amendment 1 
The all randomized analysis set includes all subjects who are randomized in the study. This is the 
primaty analysis set for by-subject listings. 
8.2.1.2. 
Efficacy 
The primaty analysis set for efficacy analyses will be the Full Analysis Set (F AS), which 
includes all randomized subjects who received at least 1 dose of study drug. 
8.2.1.3. 
Safety 
The primaty analysis set for safety analyses will be the Safety Analysis Set, which includes all 
subjects who received at least 1 dose of study dmg. 
8.2.1.4. 
Phatmacokinetics 
8.2.1.4.1. 
PK Substudy Analysis Set 
The primaty analysis set for intensive PK analyses will be the PK substudy analysis set, which 
includes all subjects in the Safety Analysis Set who have enrolled into the PK substudy, and have 
intensive PK concentmtion data to provide interpretable results for the specific parameters of 
interest for the analyte 1mder evaluation. 
8.2.1.4.2. 
PK Analysis Set 
The primaty analysis set for general PK analyses will be the PK analysis set, which includes all 
subjects in the Safety Analysis Set who have at least 1 non-missing PK concentration data for 
GS-9876, filgotinib and/or their metabolite(s). 
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8.3.
Data Handling Conventions
Pharmacokinetic concentration values and PK parameter values below the limit of quantitation 
(BLQ) will be presented as “BLQ” in the data listings. The BLQ values that occur prior to the 
first dose will be treated as 0, BLQ values at all other time points will be treated as 1/2 of the 
lower limit of quantitation (LLOQ).
Laboratory data that are continuous in nature but are less than the lower limit of quantitation or 
above the upper limit of quantitation will be imputed to the value of the lower or upper limit 
minus or plus one significant digit, respectively (eg, if the result of a continuous laboratory test is 
< 20, a value of 19 will be assigned; if the result of a continuous laboratory test is < 20.0, a value 
of 19.9 will be assigned).
8.4.
Demographic Data and Baseline Characteristics
Demographic and baseline characteristics will be summarized using standard descriptive 
methods including sample size, mean, SD, median, Q1, Q3, minimum, and maximum for 
continuous variables and frequency and percentages for categorical variables.
Demographic data will include sex, race, ethnicity, and age.
Baseline characteristics will include DAS28 (CRP), HAQ-DI, SDAI, and CDAI.
8.5.
Efficacy Analysis
The primary endpoint for the study is change from baseline in DAS28 (CRP) at Week 12. The 
primary analysis will consist of a superiority test of each of the GS-9876 doses compared to 
placebo based on the change from baseline in DAS28 (CRP) at Week 12, which will be analyzed 
using a mixed model repeated measures (MMRM) approach. The model may include the fixed 
effects of treatment, visit, treatment by visit interaction, and baseline value.  Subjects will be 
included as a random effect. 
Secondary endpoints include proportion of subjects who achieve ACR 20/50/70 at Week 12 and 
change from baseline in HAQ-DI score at Week 12. The ACR 20/50/70 response rates between 
each of the 2 GS-9876 dosed groups and the placebo group will be compared using a stratified 
Cochran-Mantel-Haenszel (CMH) Chi-square test adjusting for stratification factor in 
randomization.  The difference in response rates between treatment groups and the 
corresponding 95% confidence intervals will be presented. The difference in change from 
baseline in HAQ-DI between each of the 2 GS-9876 dosed groups and the placebo group will be 
analyzed using a similar MMRM approach.
Sensitivity analyses may be performed for the efficacy assessment.
Details on efficacy analyses will be described in the statistical analysis plan.


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8.6.
Safety Analysis
All safety analyses will be performed using the safety analysis set.
Safety will be evaluated by assessment of clinical laboratory tests, physical examinations, vital 
signs measurements at various time points during the study, and by the documentation of AEs.
All safety data collected on or after the first dose of study drug administration up to 30 days after 
the last dose of study drug, unless specified otherwise, will be summarized by treatment group 
according to the study drug received.
8.6.1.
Extent of Exposure
A subject’s extent of exposure to study drug will be generated from the study drug
administration page of the eCRF. Exposure data will be summarized by treatment group.
Duration of exposure to study drug will be expressed as the number of weeks between the first 
and last dose of the study drug, inclusive, regardless of temporary interruptions in study drug 
administration and summarized by treatment group.
8.6.2.
Adverse Events
Clinical and laboratory adverse events will be coded using the Medical Dictionary for 
Regulatory Activities (MedDRA). System Organ Class (SOC), High-Level Group Term 
(HLGT), High-Level Term (HLT), Preferred Term (PT), and Lower-Level Term (LLT) will be 
attached to the clinical database.
Treatment-emergent adverse events (TEAEs) are defined as one or both of the following:

Any AEs with an onset date on or after the study drug start date and no later than 30 days 
after permanent discontinuation of study drug.

Any AEs leading to premature discontinuation of study drug.
Summaries (number and percentage of subjects) of TEAEs by SOC and PT will be provided. 
Treatment-emergent AEs will also be summarized by relationship to study drug and severity. In 
addition, TEAEs leading to premature discontinuation of study drug and study will be 
summarized and listed.
8.6.3.
Laboratory Evaluations
Selected laboratory data will be summarized (n, mean, SD, median, Q1, Q3, minimum, and 
maximum) by treatment group. Absolute values and change from baseline at all scheduled 
timepoints will be summarized.
Graded laboratory abnormalities will be defined using CTCAE 4.03 grading scale (Appendix 4).


GS-9876 
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Amendment 1 
Incidence of treatment-emergent laboratmy abnotmalities, defined as values that increase at least 
one toxicity grade from baseline at any time post baseline up to the date of last dose of study 
drug plus 30 days, will be summarized by treatment. 
8.6.4. 
Other Safety Evaluations 
Individual data for physical examination findings, prior and concomitant medications and 
medical histmy will be provided. Twelve-lead ECGs and vital signs will be listed by subject or 
summarized by descriptive statistics as appropriate. 
8.7. 
Pharmacokinetic Analysis 
Plasma concentrations ofGS-9876 and filgotinib and the active metabolite offilgotinib 
(GS-829845) will be listed and summarized using descriptive statistics ( eg, sample size, 
arithmetic mean, geometric mean, % coefficient of variation, standard deviation, median, 
minimum, and maximum). 
PPD 
Plasma concentrations of GS-9876 metabolite(s), other filgotinib metabolite(s) and/or MTX may 
also be determined and analyzed. 
8.8. 
Biomarker Analysis 
PD 
8.9. 
Sample Size 
Sample sizes for GS-9876 and placebo groups are detetmined based on the superiority test of one 
dose of GS-9876 compared to placebo based on the change from baseline in DAS28 (CRP) at 
Week 12. When assuming a difference of 1.2 between the two groups and a common standard 
deviation of 1.35, 20 subjects in each of the GS-9876 groups and 20 in the placebo group are 
required to obtain 78% ower at a 2-sided 0.05-level. [PP£0 
. There ore, the total sample size w11l e 
~~~--~~--------~--------------~ 
80 (20 per treatment group). 
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9.
RESPONSIBILITIES
9.1.
Investigator Responsibilities
9.1.1.
Good Clinical Practice
The investigator will ensure that this study is conducted in accordance with the principles of the 
Declaration of Helsinki (as amended in Edinburgh, Tokyo, Venice, Hong Kong, and 
South Africa), International Conference on Harmonisation (ICH) guidelines, or with the laws and 
regulations of the country in which the research is conducted, whichever affords the greater 
protection to the study subject. These standards are consistent with the EU Clinical Trials 
Directive 2001/20/EC and Good Clinical Practice Directive 2005/28/EC.
The investigator will ensure adherence to the basic principles of Good Clinical Practice, as 
outlined in 21 Code of Federal Regulations (CFR) 312, subpart D, “Responsibilities of Sponsors 
and Investigators,” 21 CFR, part 50, 1998, and 21 CFR, part 56, 1998.
The investigator and all applicable sub-investigators will comply with 21 CFR, Part 54, 1998, 
providing documentation of their financial interest or arrangements with Gilead, or proprietary 
interests in the investigational drug under study. This documentation must be provided prior to 
the investigator’s (and any sub-investigator’s) participation in the study. The investigator and 
sub-investigator agree to notify Gilead of any change in reportable interests during the study and 
for 1 year following completion of the study. Study completion is defined as the date when the 
last subject completes the protocol-defined activities.
9.1.2.
Institutional Review Board (IRB)/Independent Ethics Committee (IEC) 
Review and Approval
The investigator (or sponsor as appropriate according to local regulations) will submit this 
protocol, informed consent form, and any accompanying material to be provided to the subject 
(such as advertisements, subject information sheets, or descriptions of the study used to obtain 
informed consent) to an IRB/IEC. The investigator will not begin any study subject activities 
until approval from the IRB/IEC has been documented and provided as a letter to the 
investigator.
Before implementation, the investigator will submit to and receive documented approval from 
the IRB/IEC any modifications made to the protocol or any accompanying material to be 
provided to the subject after initial IRB/IEC approval, with the exception of those necessary to 
reduce immediate risk to study subjects.
9.1.3.
Informed Consent
The investigator is responsible for obtaining written informed consent from each individual 
participating in this study after adequate explanation of the aims, methods, objectives, and 
potential hazards of the study and before undertaking any study-related procedures. The 


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investigator must use the most current IRB/IEC approved consent form for documenting written 
informed consent. Each informed consent (or assent as applicable) will be appropriately signed 
and dated by the subject (legally authorized representatives are not allowed for this study) and 
the person conducting the consent discussion, and also by an impartial witness if required by 
IRB/IEC or local requirements. The consent form will inform subjects about optional genomic 
testing and sample retention.
9.1.4.
Confidentiality
The investigator must assure that subjects’ anonymity will be strictly maintained and that their 
identities are protected from unauthorized parties. Only subject initials, date of birth, another 
unique identifier (as allowed by local law), and an identification code will be recorded on any 
form or biological sample submitted to the Sponsor, IRB/IEC, or laboratory. Laboratory 
specimens must be labeled in such a way as to protect subject identity while allowing the results 
to be recorded to the proper subject. Refer to specific laboratory instructions. NOTE: The 
investigator must keep a screening log showing codes, names, and addresses for all subjects 
screened and for all subjects enrolled in the trial. Subject data will be processed in accordance 
with all applicable regulations. 
The investigator agrees that all information received from Gilead, including but not limited to the 
IB, this protocol, eCRF, the study drug, and any other study information, remain the sole and 
exclusive property of Gilead during the conduct of the study and thereafter. This information is 
not to be disclosed to any third party (except employees or agents directly involved in the 
conduct of the study or as required by law) without prior written consent from Gilead. The 
investigator further agrees to take all reasonable precautions to prevent the disclosure by any 
employee or agent of the study site to any third party or otherwise into the public domain.
9.1.5.
Study Files and Retention of Records
The investigator must maintain adequate and accurate records to enable the conduct of the study 
to be fully documented and the study data to be subsequently verified. These documents should 
be classified into at least the following two categories: (1) investigator’s study file, and 
(2) subject clinical source documents.
The investigator’s study file will contain the protocol/amendments, eCRF and query forms, IRB 
/IEC and governmental approval with correspondence, informed consent, drug records, staff 
curriculum vitae and authorization forms, and other appropriate documents and correspondence.
The required source data should include sequential notes containing at least the following 
information for each subject:

Subject identification (name, date of birth, gender);

Documentation that subject meets eligibility criteria, ie, history, physical examination, and 
confirmation of diagnosis (to support inclusion and exclusion criteria);


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
Documentation of the reason(s) a consented subject is not enrolled

Participation in study (including study number);

Study discussed and date of informed consent;

Dates of all visits;

Documentation that protocol specific procedures were performed;

Results of efficacy parameters, as required by the protocol;

Start and end date (including dose regimen) of study drug, including dates of dispensing and 
return;

Record of all adverse events and other safety parameters (start and end date, and including 
causality and severity);

Concomitant medication (including start and end date, dose if relevant; dose changes);

Date of study completion and reason for early discontinuation, if it occurs.
All clinical study documents must be retained by the investigator until at least 2 years or 
according to local laws, whichever is longer, after the last approval of a marketing application in 
an ICH region (ie, United States, Europe, or Japan) and until there are no pending or planned 
marketing applications in an ICH region; or, if no application is filed or if the application is not 
approved for such indication, until 2 years after the investigation is discontinued and regulatory 
authorities have been notified. Investigators may be required to retain documents longer if 
specified by regulatory requirements, by local regulations, or by an agreement with Gilead. The 
investigator must notify Gilead before destroying any clinical study records.
Should the investigator wish to assign the study records to another party or move them to another 
location, Gilead must be notified in advance.
If the investigator cannot provide for this archiving requirement at the study site for any or all of 
the documents, special arrangements must be made between the investigator and Gilead to store 
these records securely away from the site so that they can be returned sealed to the investigator 
in case of an inspection. When source documents are required for the continued care of the 
subject, appropriate copies should be made for storage away from the site.
9.1.6.
Case Report Forms
For each subject consented, an eCRF will be completed by an authorized study staff member 
whose training for this function is documented according to study procedures. Electronic CRFs
should be completed on the day of the subject visit to enable the sponsor to perform central 
monitoring of safety data.  The Eligibility Criteria eCRF should be completed only after all data 


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Protocol GS-US-379-1582
Gilead Sciences, Inc.
Amendment 1
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related to eligibility have been received.  Subsequent to data entry, a study monitor will perform 
source data verification within the electronic data capture (EDC) system. Original entries as well 
as any changes to data fields will be stored in the audit trail of the system.  Prior to database lock 
(or any interim timepoints as described in the clinical data management plan), the investigator 
will use his/her log in credentials to confirm that the forms have been reviewed, and that the 
entries accurately reflect the information in the source documents. The eCRF captures the data 
required per the protocol schedule of events and procedures. System-generated or manual 
queries will be issued to the investigative site staff as data discrepancies are identified by the 
monitor or internal Gilead staff, who routinely review the data for completeness, correctness, and 
consistency. The site coordinator is responsible for responding to the queries in a timely manner, 
within the system, either by confirming the data as correct or updating the original entry, and 
providing the reason for the update (eg, data entry error). At the conclusion of the trial, Gilead 
will provide the site with a read-only archive copy of the data entered by that site. This archive 
must be stored in accordance with the records retention requirements outlined in Section 9.1.5.
9.1.7.
Investigational Medicinal Product Accountability and Return
Where possible, study drug should be destroyed at the site. At the start of the study, the study 
monitor will evaluate each study center’s study drug disposal procedures and provide appropriate 
instruction for disposal or return of unused study drug supplies. If the site has an appropriate 
standard operating procedure (SOP) for drug destruction as determined by Gilead Sciences, the 
site may destroy used (empty or partially empty) and unused study drug supplies as long as 
performed in accordance with the site’s SOP. This can occur only after the study monitor has 
performed drug accountability during an on-site monitoring visit. 
A copy of the site’s study drug Disposal SOP or written procedure (signed and dated by the PI 
or designee) will be obtained for Gilead site files. If the site does not have acceptable 
procedures in place, arrangements will be made between the site and Gilead Sciences 
(or Gilead Sciences’ representative) for return of unused study drug supplies. 
If study drug is destroyed on site, the investigator must maintain accurate records for all study 
drugs destroyed. Upon study completion, copies of the study drug accountability records must be 
filed at the site. Another copy will be returned to Gilead.
The study monitor will review study drug supplies and associated records at periodic intervals.
9.1.8.
Inspections
The investigator will make available all source documents and other records for this trial to 
Gilead’s appointed study monitors, to IRBs or IECs, or to regulatory authority or health authority 
inspectors.
9.1.9.
Protocol Compliance
The investigator is responsible for ensuring the study is conducted in accordance with the 
procedures and evaluations described in this protocol.


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9.2.
Sponsor Responsibilities
9.2.1.
Protocol Modifications
Protocol modifications, except those intended to reduce immediate risk to study subjects, may be 
made only by Gilead. The investigator must submit all protocol modifications to the IRB/IEC in 
accordance with local requirements and receive documented IRB/IEC approval before 
modifications can be implemented.
9.2.2.
Study Report and Publications
A clinical study report (CSR) will be prepared and provided to applicable regulatory agencies.
Gilead will ensure that the report meets the standards set out in the ICH Guideline for Structure 
and Content of Clinical Study Reports (ICH E3). Note that an abbreviated report may be 
prepared in certain cases.
Investigators in this study may communicate, orally present, or publish in scientific journals or 
other scholarly media only after the following conditions have been met:
The results of the study in their entirety have been publicly disclosed by or with the consent of 
Gilead in an abstract, manuscript, or presentation form or the study has been completed at all 
study sites for at least 2 years.
The investigator will submit to Gilead any proposed publication or presentation along with the 
respective scientific journal or presentation forum at least 30 days before submission of the 
publication or presentation. 
No such communication, presentation, or publication will include Gilead’s confidential 
information (see Section 9.1.4).
The investigator will comply with Gilead’s request to delete references to its confidential 
information (other than the study results) in any paper or presentation and agrees to withhold 
publication or presentation for an additional 60 days in order to obtain patent protection if 
deemed necessary.
9.3.
Joint Investigator/Sponsor Responsibilities
9.3.1.
Payment Reporting
Investigators and their study staff may be asked to provide services performed under this 
protocol (eg, attendance at Investigator's Meetings).  If required under the applicable statutory 
and regulatory requirements, Gilead will capture and disclose to Federal and State agencies any 
expenses paid or reimbursed for such services, including any clinical trial payments, meal, travel 
expenses or reimbursements, consulting fees, and any other transfer of value.


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Amendment 1
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9.3.2.
Access to Information for Monitoring
In accordance with regulations and guidelines, the study monitor must have direct access to the 
investigator’s source documentation in order to verify the accuracy of the data recorded in the 
eCRF.
The monitor is responsible for routine review of the eCRF at regular intervals throughout the 
study to verify adherence to the protocol and the completeness, consistency, and accuracy of the 
data being entered on them. The monitor should have access to any subject records needed to 
verify the entries on the eCRF. The investigator agrees to cooperate with the monitor to ensure 
that any problems detected through any type of monitoring (central, on site) are resolved.
9.3.3.
Access to Information for Auditing or Inspections
Representatives of regulatory authorities or of Gilead may conduct inspections or audits of the 
clinical study. If the investigator is notified of an inspection by a regulatory authority the 
investigator agrees to notify the Gilead medical monitor immediately. The investigator agrees to 
provide to representatives of a regulatory agency or Gilead access to records, facilities, and 
personnel for the effective conduct of any inspection or audit.
9.3.4.
Study Discontinuation
Both the sponsor and the investigator reserve the right to terminate the study at any time. Should 
this be necessary, both parties will arrange discontinuation procedures and notify the appropriate 
regulatory authority(ies), IRBs, and IECs. In terminating the study, Gilead and the investigator 
will assure that adequate consideration is given to the protection of the subjects’ interests.


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Gilead Sciences, Inc.
Amendment 1
CONFIDENTIAL
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10.
REFERENCES
Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO, 3rd, et al. 2010 
Rheumatoid arthritis classification criteria: an American College of 
Rheumatology/European League Against Rheumatism collaborative initiative. 
Arthritis Rheum 2010;62 (9):2569-81.
Arthritis Foundation. Rheumatoid Arthritis Fact Sheet.  2008.
Barr PM, Wei C, Roger J, Schaefer-Cutillo J, Kelly JL, Rosenberg AF, et al. Syk inhibition with 
fostamatinib leads to transitional B lymphocyte depletion. Clin Immunol 
2012;142 (3):237-42.
Braselmann S, Taylor V, Zhao H, Wang S, Sylvain C, Baluom M, et al. R406, an orally available
spleen tyrosine kinase inhibitor blocks fc receptor signaling and reduces immune 
complex-mediated inflammation. J Pharmacol Exp Ther 2006;319 (3):998-1008.
Cha HS, Boyle DL, Inoue T, Schoot R, Tak PP, Pine P, et al. A novel spleen tyrosine kinase 
inhibitor blocks c-Jun N-terminal kinase-mediated gene expression in 
synoviocytes. J Pharmacol Exp Ther 2006;317 (2):571-8.
Coffey G, DeGuzman F, Inagaki M, Pak Y, Delaney SM, Ives D, et al. Specific inhibition of 
spleen tyrosine kinase suppresses leukocyte immune function and inflammation in 
animal models of rheumatoid arthritis. J Pharmacol Exp Ther 2012;340 (2):350-9.
Felson DT, Anderson JJ, Boers M, Bombardier C, Furst D, Goldsmith C, et al. American College 
of Rheumatology. Preliminary definition of improvement in rheumatoid arthritis. 
Arthritis Rheum 1995;38 (6):727-35.
Helmick CG, Felson DT, Lawrence RC, Gabriel S, Hirsch R, Kwoh CK, et al. Estimates of the 
prevalence of arthritis and other rheumatic conditions in the United States. Part I. 
Arthritis Rheum 2008;58 (1):15-25.
Leandro MJ, Cambridge G, Ehrenstein MR, Edwards JC. Reconstitution of peripheral blood B 
cells after depletion with rituximab in patients with rheumatoid arthritis. Arthritis 
Rheum 2006;54 (2):613-20.
Liao C, Hsu J, Kim Y, Hu DQ, Xu D, Zhang J, et al. Selective inhibition of spleen tyrosine 
kinase (SYK) with a novel orally bioavailable small molecule inhibitor, RO9021, 
impinges on various innate and adaptive immune responses: implications for SYK 
inhibitors in autoimmune disease therapy. Arthritis research & therapy 2013;15 
(5):R146.
Martin F, Chan AC. B cell immunobiology in disease: evolving concepts from the clinic. Annu 
Rev Immunol 2006;24:467-96.


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Namour F, Diderichsen PM, Cox E, Vayssiere B, Van der Aa A, Tasset C, et al. 
Pharmacokinetics and Pharmacokinetic/Pharmacodynamic Modeling of Filgotinib 
(GLPG0634), a Selective JAK1 Inhibitor, in Support of Phase IIB Dose Selection. 
Clin Pharmacokinet 2015;54 (8):859-74.
Navarro-Millan I, Curtis JR. Newest clinical trial results with antitumor necrosis factor and 
nonantitumor necrosis factor biologics for rheumatoid arthritis. Current opinion in 
rheumatology 2013;25 (3):384-90.
Pine PR, Chang B, Schoettler N, Banquerigo ML, Wang S, Lau A, et al. Inflammation and bone 
erosion are suppressed in models of rheumatoid arthritis following treatment with 
a novel Syk inhibitor. Clin Immunol 2007;124 (3):244-57.
Prevoo ML, van 't Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL. 
Modified disease activity scores that include twenty-eight-joint counts. 
Development and validation in a prospective longitudinal study of patients with 
rheumatoid arthritis. Arthritis Rheum 1995;38 (1):44-8.
Shlomchik MJ. Sites and stages of autoreactive B cell activation and regulation. Immunity 
2008;28 (1):18-28.
Song YW, Kang EH. Autoantibodies in rheumatoid arthritis: rheumatoid factors and 
anticitrullinated protein antibodies. QJM 2010;103 (3):139-46.


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Amendment 1
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11.
APPENDICES
Appendix 1.
Investigator Signature Page
Appendix 2.
Study Procedures Tables
Appendix 3.
Laboratory Assessments Table
Appendix 4.
Common Terminology Criteria for Adverse Events (CTCAE) v4.03
Appendix 5.
Pregnancy Precautions, Definition for Female of Childbearing Potential, and 
Contraceptive Requirements
Appendix 6.
The 2010 American College of Rheumatology –European League Against 
Rheumatism Collaborative Initiative Classification Criteria for Rheumatoid 
Arthritis {Aletaha et al 2010}
Appendix 7.
American College of Rheumatology Response Evaluations/ Preliminary Definition 
of Improvement in Rheumatoid Arthritis {Felson et al 1995}
Appendix 8.
Disease Activity Score for 28 Joint Count (DAS28) {Prevoo et al 1995}
Appendix 9.
Procedures and Specifications


GS-9876 
Protocol GS-US-379-1582 
Gilead Sciences, Inc. 
Appendix 1. 
Amendment I 
Investigator Signature Page 
GILEAD SCIENCES, INC. 
STUDY ACKNOWLEDGEMENT 
A Randomized, Double-Blind, Placebo-Controlled, Multicenter, Phase 2 Proof-of-Concept 
Study to Evaluate Safety, Tolerability, and Efficacy of GS-9876 in Subjects with Active 
Rheumatoid Arthritis on Background Therapy with Methotrexate 
GS-US-379-1582, Amendment 1 Protocol, 27 June 2016 
This protocol has been approved by Gilead Sciences, Inc. The following signature documents 
this approval. 
PPD 
Franziska Matzkies, MD 
Medical Monitor Name (Printed) 
Zf- J~Ahe - 2DI6 
Date 
INVESTIGATOR STATEMENT 
T have read the protocol, including all appendices, and I agree that it contains all necessary 
details for me and my staff to conduct this study as described. I wiJI conduct this study as 
outlined herein and will make a reasonable effort to complete the study within the time 
designated. 
1 will provide all study personnel under my supervision copies of the protocol and access to all 
information provided by Gilead Sciences, Inc. I will discuss this material with them to ensure 
that they are fully informed about the drugs and the study. 
Principal Investigator Name (Printed) 
Signature 
Date 
Site Number 
CONFIDENTIAL 
Page 78 
27 June 2016 


GS-9876 
Protocol GS-US-379-1582 
Gilead Sciences, Inc. 
Appendix 2. 
Study Procedures Tables 
Visit 
Window in Days 
Written Infonned Consent for Main Study 
lPPD 
I 
Medical History d 
Physical Examination e 
Vital Signs, Height, and Weight f 
12-LeadECG 
66 Swollen and 68 Tender Joint Count Assessment h 
Hematology, Chemistry and Coagulation i,j,k 
Lipid Panel i,j, k, 1 
CRPi,j,k 
Serum or Urine Pregnancy Test i,j,k,m 
Serologyi 
Urinalysis and Urine Drug Screen i 
TSHi 
HbA1ci 
QuantiFERON® TB-Gold i 
CD19 Count j,n 
Randomization after Confinnation of Eligibility h 
Disease-Specific Questionnaires and Activity Scales i, o 
RF /CCP i, i. k 
CONFIDENTIAL 
Screeninga 
Dayl 
-28 
X 
X 
X 
X 
X 
X 
X 
X 
xg 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
Page 79 
Amendment 1 
Post-
Treatment 
Week2 
Week4 
WeekS 
Week12 
ETb 
Week4c 
±3 
±3 
±3 
±3 
±3 
±5 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
27 June 2016 


GS-9876 
Protocol GS-US-379-1582 
Gilead Sciences, Inc. 
Visit 
Window in Days 
Inflammation and Pathway Biomarkers i,j, k, P 
RNA Sample i,j,k 
Immunoglobulins i, i. k 
Whole Blood Sample for MoA Studies i,j, k 
.. k I 
Bone Marker (Urine )'.J, ' 
.. k 
BandT Cell Panels '·l· 
I 
J ~ 
PK Samples r -
i 
Study Drug Dispensation 
Study Drug Administration (In-Clinic) 
1 
Study Drug Bottle Return u 
Adverse Events v 
Concomitant Medications w 
Screeninga 
-28 
Dayl 
Week2 
Week4 
Week8 
±3 
±3 
±3 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
Continuous 
Continuous 
a 
Prospective subjects should be screened no more than 28 days prior to administration of the first dose of study drug. 
b 
Early Termination assessments should be performed within 72 hours of subject discontinuation. 
c 
Twenty-eight (±5) days after the last administration of study drug, all subjects will return for an in-clinic follow-up visit. 
Amendment 1 
Post-
Treatment 
Week12 
ETb 
Week4c 
±3 
±3 
±5 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
d 
Medical history, including but not limited to, RA, prior RA medication history, and any personal or family histories of bleeding disorders and cardiovascular disease 
e 
Screening visit includes complete PE as outlined in Appendix 9. All other PEs are symptom driven. A symptom driven PE should be performed after Screening when a 
subject reports a new symptom or a worsening symptom at a study visit. If a subject reports no change in symptoms, then no PE is necessary. 
f 
Vital signs include resting blood pressure, pulse, respiration rate, temperature, height and weight. Weight will be collected at all study visits. Height will be collected at 
Screening only. 
g 
Conduct Day 1 ECG predose (prior to study drug administration). 
h 
The 66 swollen and 68 tender joint count assessments must be performed prior to all other study procedures on Day 1 and prior to randomization to confirm subject eligibility. 
CONFIDENTIAL 
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GS-9876 
Protocol GS-US-379-1582 
Gilead Sciences, Inc. 
Amendment 1 
J 
k 
1 
111 
n 
0 
p 
q 
r 
u 
v 
w 
At Day 1, the subject questionnaires (i.e, HAQ-DI including Patient's Assessment of Pain, and Patient's Global Assessment of Disease Activity) are reconunended to be done 
prior to any invasive study procedUl'es. At Week 12, the subject questionnaires are recollllllended to be done prior to the 66 swollen and 68 tender joint cotmt assessments and 
before any invasive study procedm·es. At both Day 1 and We.ek 12, blood draws should be the last study assessment prior to study dosing. 
Refer to Appendix 3 for complete laboratory assessments. 
Samples to be collected prior to dosing, except at Week 4 visit. 
Lipid panel and bone marker (urine) samples should be fasting at Day I and Week I2. 
At Screening, a senun pregnancy test will be collected. At all other visits, a lll'ine pregnancy test will be c.ol!ected. If a m-ine pregnancy test is positive, a senun pregnancy test 
will also be collected. 
As needed per exclusion ct-i.teria (refer to Section 4.3) 
Disease-specific questionnaires and activity scales include the HAQ-DI including the Patient's Assessment of Pain, Patient's Global Assessment of Disease Activity, and 
Physician's Global Assessment of Disease Activity. 
Samples will be collected at Day I, Week 4, and Week I2 or ET visits for[PPD 
j and/or pathway markers relevant to rhemnatoi.d artlu-i.tis. Sampling timepoints 
a11d assessments may be modified dm-i.ng the study based on assay availability anal or emerg!,;,;m;;.,go...;;.da;,;,;t..;;.a;... ----------... 
~i~n les wilf be coHecte'a pnor to stuC!y CliUgadministratlon (i)re·-Ciose at Wed(s 2, 87iiii"dT2 or ET. At Week 4, PK sam 1l will be collected 2 hom-s ost dose. 
PPD 
On Day 1, stuay diug adli'illiistratlon (m-clinic) s!iouldoethe last study procedm·e petfonned. On Week 4, study drug administl·ation (in-clinic) should be the first study 
procedm·e performed (with the exception of predose PK for PO 
subjects only). At all other ti·eatment visits, study dmg administration should occur after 
predose assessments are. completed. 
Subject should bring their study dmg to all study visits. At Week 4, Week 8, and Week 12 or ET, site should collect any pre·viously dispensed study drug bottles. 
After infonned c.onsent, but pt-i.or to initiation of study medication, all SAEs and advet-se events related to protocol-mandated procedtu·es shall be collected. Following 
initiation of sntdy medication, all SAEs and all AEs, regardless of cause or relationship, shall be collected. Refer to Section 7.3 for more detail. 
At Screening, all medication taken up to 30 days pt-i.or to d1e Screening visit will be recorded on the eCRF. 
CONFIDENTIAL 
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27 Jtme 2016 


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Gilead Sciences, Inc. 
Amendment 1
CONFIDENTIAL
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Appendix 3.
Laboratory Assessments Table
Hematology
Chemistry
Urinalysis
Other
Hematocrit
Hemoglobin
Platelet count
Red blood cell (RBC) 
count
White blood cell (WBC) 
count
Differentials (absolute 
and percentage), 
including:
Leukocytes
Monocytes
Neutrophils
Eosinophils
Basophils
Reticulocyte count
Mean corpuscular 
volume (MCV)
Alkaline phosphatase
Aspartate aminotransferase
(AST)
Alanine aminotransferase
(ALT)
Total bilirubin
Direct and indirect 
bilirubin
Total protein
Albumin
Bicarbonate
Blood urea nitrogen 
(BUN)
Calcium
Chloride
Serum creatinine
Glucose
Phosphorus
Magnesium
Potassium
Sodium
Amylase
Lipase 
Creatine phosphokinase 
(CPK)
Clarity
Blood
Color
Glucose
Leukocyte esterase
pH
Protein
Urobilinogen
Reflex to microscopic 
urinalysis if dipstick result 
is abnormal.
Urine drug screen for:
Amphetamines
Cocaine
Methadone
Opiates
Inflammation and pathway 
biomarkers
B and T cell panels
Immunoglobulins: IgA, IgE, 
IgG, IgM
Whole blood sample for MoA 
studies
Bone marker (urine)
C-reactive protein (CRP)
Rheumatoid factor and cyclic 
citrullinated peptide (RF/CCP)
QuantiFERON® TB-Gold 
CD19 (if required per 
exclusion criteria)
RNA
TSH
HbA1c
Lipid Panel
Total cholesterol
Low-density lipoprotein 
(LDL)
High-density lipoprotein 
(HDL)
Triglycerides
Coagulation
Serology
Pregnancy
Activated partial 
thromboplastin time 
(aPTT)
Prothrombin time (PT)
International normalized 
ratio (INR)
Hepatitis BsAg and core 
Ab 
Hepatitis C Ab
HIV
In females of childbearing 
potential:
Serum β-hCG (Screening and 
if positive urine β-hCG)
Urine β-hCG (all study visits
other than Screening)
Ab = antibody
β-hCG = beta-human chorionic gonadotropin
BsAg = B surface antigen
IgA, IgE, IgG, IgM = immunoglobulins A, E, G, M


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Gilead Sciences, Inc. 
Amendment 1
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Appendix 4.
Common Terminology Criteria for Adverse Events (CTCAE) v4.03
CTCAE v4.03 can be accessed from the below link:
http://evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4.03_2010-06-14_QuickReference_8.5x11.pdf
The only modification to the CTCAE criteria is the addition of a Grade 1 upper respiratory 
infection as follows:
CTCAE 
v4.0 Term
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
CTCAE v4.03 
AE Term 
Definition
Upper 
respiratory 
infection
Mild 
symptoms; 
symptomatic 
relief (eg, 
cough 
suppressant, 
decongestant)
Moderate 
symptoms; 
oral 
intervention 
indicated 
(eg, antibiotic, 
antifungal, 
antiviral)
IV antibiotic, 
antifungal, or 
antiviral 
intervention 
indicated; 
radiologic, 
endoscopic, or 
operative 
intervention 
indicated
Life-
threatening 
consequences; 
urgent 
intervention 
indicated
Death
A disorder 
characterized by 
an infectious 
process involving 
the upper 
respiratory tract 
(nose, paranasal 
sinuses, pharynx, 
larynx, or 
trachea).


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Appendix 5.
Pregnancy Precautions, Definition for Female of Childbearing 
Potential, and Contraceptive Requirements
1) Definitions
a) Definition of Childbearing Potential
For the purposes of this study, a female born subject is considered of childbearing potential 
following the initiation of puberty (Tanner stage 2) until becoming post-menopausal, unless 
permanently sterile or with medically documented ovarian failure.  
Women are considered to be in a postmenopausal state when they are > 54 years of age with 
cessation of previously occurring menses for > 12 months without an alternative cause.  
Permanent sterilization includes hysterectomy, bilateral oophorectomy, or bilateral 
salpingectomy in a female subject of any age.
b) Definition of Male Fertility
For the purposes of this study, a male born subject is considered fertile after the initiation of 
puberty unless permanently sterile by bilateral orchidectomy or medical documentation.
2) Contraception Requirements for Female Subjects
a) Study Drug Effects on Pregnancy and Hormonal Contraception
GS-9876 is contraindicated in pregnancy as its teratogenicity/fetotoxicity profile is unknown. 
Filgotinib is contraindicated in pregnancy as there is a possibility of human
teratogenicity/fetotoxicity in early pregnancy based on non-clinical data. 
GS-9876 has insufficient data to exclude the possibility of a clinically relevant interaction with 
hormonal contraception that results in reduced contraception efficacy.  A dedicated study 
assessing the impact of filgotinib on the efficacy of hormonally-based contraceptives (with 
ovulation inhibition as mechanism of action) has not yet been performed to fully verify the 
absence of any clinically significant interaction between filgotinib and oral contraceptives. 
However, based on the totality of the available in vitro and clinical data, clinically relevant drug 
interactions between filgotinib or GS-829845 with hormonal contraceptives are not expected. In 
this study, contraceptive steroids are not recommended as a contraceptive method either solely or 
as a part of a contraceptive regimen. Subjects may remain on their hormonal contraception if 
they prefer to do so, but will still be required to choose from contraceptive methods delineated 
below as the efficacy of their hormonal contraception during study dosing is unknown. 
Please refer to the latest versions of the GS-9876 and filgotinib IBs for additional information.
b) Contraceptive Methods Permitted for Female Subjects of Childbearing Potential
The inclusion of female subjects of childbearing potential requires the use of highly effective
contraceptive measures.  Women must agree to also not rely on hormone-containing 
contraceptives as a form of birth control during the study, though they may continue hormonal 
contraception if they prefer to do so.  Women must have a negative serum pregnancy test at 


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Screening and a negative pregnancy test on the Day 1 visit prior to first dose of study drug.  
Pregnancy tests will be performed as defined by the schedule of assessments (Appendix 2).
Female subjects of childbearing potential must agree to one of the following from Screening 
until 35 days following the last dose of study drug.

Complete abstinence from intercourse of reproductive potential.  Abstinence is an acceptable 
method of contraception only when it is in line with the subject’s preferred and usual 
lifestyle.
Or
Consistent and correct use of 1 of the following methods of birth control listed below. 

Intrauterine device (IUD) with a failure rate of <1% per year

Tubal sterilization

Essure micro-insert system (provided confirmation of success 3 months after procedure)

Vasectomy in the male partner (provided that the partner is the sole sexual partner and had 
confirmation of surgical success at least 3 months after procedure)
Female subjects must also refrain from egg donation and in vitro fertilization during treatment 
and until at least 35 days after the last dose of study drug.
Contraception Requirements for Male Subjects
It is theoretically possible that a relevant systemic concentration may be achieved in a female 
partner from exposure of the male subject’s seminal fluid.  Therefore, male subjects with female 
partners of childbearing potential must agree to use condoms during treatment and until 90 days 
after the last dose of study drug.  Additional contraception recommendations should also be 
considered if the female partner is of childbearing potential.
Male subjects must also refrain from sperm donation during treatment and until at least 90 days 
after the last dose of study drug.
Unacceptable Birth Control Methods
Birth control methods that are unacceptable include periodic abstinence (eg, calendar, ovulation, 
symptothermal, post-ovulation methods), withdrawal (coitus interruptus), spermicides only, and 
lactational amenorrhea method (LAM).  Female condom and male condom should not be used 
together.
Procedures to be Followed in the Event of Pregnancy
Subjects will be instructed to notify the investigator if they become pregnant at any time during 
the study, or if they become pregnant within 35 days of last study drug dose. Subjects who 
become pregnant or who suspect that they are pregnant during the study must report the 
information to the investigator and discontinue study drug immediately.  Subjects whose partner 
has become pregnant or suspects she is pregnant during the study must report the information to 
the investigator.  Instructions for reporting pregnancy, partner pregnancy, and pregnancy 
outcome are outlined in Section 7.7.2.1.


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Appendix 6.
The 2010 American College of Rheumatology –European League 
Against Rheumatism Collaborative Initiative Classification Criteria 
for Rheumatoid Arthritis {Aletaha et al 2010}
Target population (Who should be tested?): Patients who have at least 1 joint with 
definite clinical synovitis (swelling)a with the synovitis not better explained by 
another diseaseb
Classification criteria for RA (score-based algorithm: add score of categories A - D;
a score of ≥6/10 is needed for classification of a patient as having definite RA)c
A. Joint involvementd
1 large jointe
0
2-10 large joints
1
1-3 small joints (with or without involvement of large joints)f
2
4-10 small joints (with or without involvement of large joints)
3
>10 joints (at least 1 small joint)g
5
B. Serology (at least 1 test result is needed for classification)h
Negative RF and negative ACPA
0
Low-positive RF or low-positive ACPA
2
High-positive RF or high-positive ACPA
3
C. Acute-phase reactants (at least 1 test result is needed for classification)i
Normal CRP and normal ESR
0
Abnormal CRP or abnormal ESR
1
D. Duration of symptomsj
<6 weeks
0
≥6 weeks
1
a
The criteria are aimed at classification of newly presenting patients. In addition, patients with erosive disease typical of 
rheumatoid arthritis (RA) with a history compatible with prior fulfillment of the 2010 criteria should be classified as having 
RA. Patients with longstanding disease, including those whose disease is inactive (with or without treatment) who, based on 
retrospectively available data, have previously fulfilled the 2010 criteria should be classified as having RA.
b
Differential diagnoses vary among patients with different presentations, but may include conditions such as systemic lupus 
erythematosus, psoriatic arthritis, and gout. If it is unclear about the relevant differential diagnoses to consider, an expert 
rheumatologist should be consulted.
c
Although patients with a score of <6/10 are not classifiable as having RA, their status can be reassessed and the criteria 
might be fulfilled cumulatively over time.
d
Joint involvement refers to any swollen or tender joint on examination, which may be confirmed by imaging evidence of 
synovitis. Distal interphalangeal joints, first carpometacarpal joints, and first metatarsophalangeal joints are excluded from 
assessment. Categories of joint distribution are classified according to the location and number of involved joints, with 
placement into the highest category possible based on the pattern of joint involvement.
e
"Large joints" refers to shoulders, elbows, hips, knees, and ankles.
f
"Small joints" refers to the metacarpophalangeal joints, proximal interphalangeal joints, second through 
fifth metatarsophalangeal joints, thumb interphalangeal joints, and wrists.
g
In this category, at least 1 of the involved joints must be a small joint; the other joints can include any combination of large 
and additional small joints, as well as other joints not specifically listed elsewhere (eg, temporomandibular, 
acromioclavicular, sternoclavicular).


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h
Negative refers to IU values that are less than or equal to the ULN for the laboratory and assay; low-positive refers to IU 
values that are higher than the ULN but ≤3 times the ULN for the laboratory and assay; high-positive refers to IU values that 
are >3 times the ULN for the laboratory and assay. Where rheumatoid factor (RF) information is only available as positive
or negative, a positive result should be scored as low-positive for RF. ACPA = anti-citrullinated protein antibody.
i
Normal/abnormal is determined by local laboratory standards. CRP = C-reactive protein; ESR = erythrocyte sedimentation 
rate.
j
Duration of symptoms refers to patient self-report of the duration of signs or symptoms of synovitis (eg, pain, swelling, 
tenderness) of joints that are clinically involved at the time of assessment, regardless of treatment status.


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Protocol GS-US-379-1582
Gilead Sciences, Inc. 
Amendment 1
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Appendix 7.
American College of Rheumatology Response Evaluations/ 
Preliminary Definition of Improvement in Rheumatoid Arthritis 
{Felson et al 1995}
ACR 20/50/70 Requires
≥20%/50%/70% improvement in tender joint count, AND
≥20%/50%/70% improvement in swollen joint count, AND
≥20%/50%/70% improvement in at least 3 of the following 5:

Patient’s Assessment of Pain

Patient’s Global Assessment of Disease Activity

Physician’s Global Assessment of Disease Activity

Patient’s assessment of physical  function (HAQ-DI)

Acute-phase reactant (CRP)
The following lists the disease activity measure followed by the method of assessment
1.
Tender joint count
ACR TJC is an assessment of 68. The joint count should be done by scoring several different 
aspects of tenderness, as assessed by pressure and joint manipulation on physical examination. 
The information on various types of tenderness should then be collapsed into a single tender-
versus-nontender dichotomy.
2.
Swollen joint count
ACR SJC is an assessment of 66. Joints are classified as either swollen or not swollen.
3.
Patient’s Assessment of Pain
The Patient’s Assessment of Pain, part of the HAQ-DI assessment, is a horizontal (0 – 100) 
visual analog scale (VAS) that will be used to assess the subject’s current level of pain.2
How much pain have you had because of your illness in the past week? Place a vertical (|) 
mark on the line to indicate the severity of the pain: 
No Pain                                                              Severe Pain
0
      100
                                                
2 Visual analog scales provided in this protocol are not to scale and should not be utilized for assessments.


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4.
Patient’s Global Assessment of Disease Activity
A horizontal (0 – 100) VAS will be used to collect the subject’s overall assessment of how their
arthritis is doing.
Place a mark on the line below to indicate how you assess your current rheumatoid 
arthritis disease activity:
No Arthritis
Severe Arthritis
5.
Physician’s Global Assessment of Disease Activity
A horizontal (0 – 100) VAS will be used to measure the physician’s assessment of the patient’s 
current disease activity.
Place a mark on the line below to indicate RA disease activity (independent of the subject’s
self-assessment):
No Disease Activity
Maximum Disease Activity
6.
Patient’s Assessment of Physical Function
The HAQ-DI will be used to provide a subject’s self-assessment of physical function. The HAQ-
DI includes the Patient’s Assessment of Pain VAS.
7.
Acute-phase reactant value
C-reactive protein level


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Amendment 1
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Appendix 8.
Disease Activity Score for 28 Joint Count (DAS28) {Prevoo et al 1995}
Assessments of RA in subjects by the Disease Activity Score (modified to include the 28 joint 
counts according to Smolen* 1995) will be conducted at the measured timepoints. The DAS28 
consists of a composite score of the following variables: tender joint count, swollen joint count, 
CRP, and Patient’s Global Assessment of Disease Activity score. The following equation will be 
used to calculate the DAS28 (CRP)

DAS28 (CRP) 0.56 √TJC28 0.28√SJC28 0.36ln(CRP 1) 0.014×(Patient’s Global 
Assessment of Disease Activity) 0.96
TJC28 = number of joints tender out of 28
SJC28 = number of joints swollen out of 28
CRP = C-reactive protein
Patient’s Global Assessment of Disease Activity on a 100 mm VAS recorded by the 
subject


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Appendix 9.
Procedures and Specifications 
Complete Physical Examination
A complete physical examination must include source documentation of general appearance, and 
the following body systems: Head, neck and thyroid; eyes, ears, nose, throat, mouth and tongue; 
chest (excluding breasts); respiratory; cardiovascular; lymph nodes, abdomen; skin, hair, nails; 
musculoskeletal; neurological (must be performed at Screening). 
Vital Signs
Assessment of vital signs will include measurement of resting blood pressure, pulse, respiratory 
rate, and temperature.
Blood pressure will be measured using the following standardized process:

Subject should sit for 5 minutes with feet flat on the floor and measurement arm supported 
so that the midpoint of the manometer cuff is at heart level;

Use a mercury sphygmomanometer or automatic blood pressure device with an appropriately 
sized cuff with the bladder centered over the brachial artery;

Measure and record the blood pressure to the nearest 2 mmHg mark on the manometer or to 
the nearest whole number on an automatic device.
Height and Weight
The subject’s standing height will be collected at Screening only. The subject’s weight will be 
collected at all study visits.
12-Lead ECG
Subjects will be required to rest in a supine position for 5 minutes prior to making a recording.
The investigator (or qualified designee) should review the ECG traces recorded in real time for 
clinically significant abnormalities.  On treatment ECGs should be compared to the subject’s 
Baseline as part of routine safety monitoring.  
Fridericia Formula (QTcF)
QTcF = QT/(RR)^(1/3), where RR = 60/HR 
RR = RR interval in seconds
HR = heart rate in beats per minute
Creatinine Clearance (estimated GFR) Formula
Creatinine clearance (estimated GFR) (mL/min) = [(140 – age (yrs)) x weight (kg) x (0.85 if 
female)] / [serum creatinine (mg/dL) x 72], where weight is total body mass in kilograms


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Health Assessment Questionnaire – Disability Index including the Patient’s Assessment of 
Pain
The HAQ-DI is a subject reported questionnaire specific for RA.  It consists of 20 questions 
referring to 8 component sets:  dressing/grooming, arising, eating, walking, hygiene, reach, grip, 
and activities. It includes the Patient’s Assessment of Pain horizontal VAS that ranges from 
“No Pain” (0) to “Severe Pain” (100). 
Patient’s Global Assessment of Disease Activity 
The Patient’s Global Assessment of Disease Activity is a horizontal (0 – 100) VAS that ranges
from “No Arthritis” to “Severe Arthritis”.  
Physician’s Global Assessment of Disease Activity 
The Physician’s Global Assessment of Disease Activity is a horizontal (0 – 100) VAS that 
ranges from “No Disease Activity” to “Maximum Disease Activity”.  
Joint Assessment
An assessment of 66 joints for swelling and 68 joints for tenderness will be performed. Joints 
will be assessed and classified as swollen or not swollen and tender or not tender by pressure and 
joint manipulation upon physical examination.  Joint exams should be performed by a trained 
and experienced joint assessor.   Every effort should be made for the same joint assessor to 
perform the joint exams on the same subject particularly during the blinded phase of the study.

Prot_000.pdf: 
Study Title: 
Sponsor: 
INDNumber: 
EudraCT Number: 
Clinical Trials.gov 
Identifier: 
Indication: 
Protocol ID: 
~ GILEAU 
CLINICAL STUDY PROTOCOL 
A Randomized, Double-Blind, Placebo-Controlled, Multicenter, 
Proof-of-Concept Study to Evaluate Safety, Tolerability, and Efficacy 
of GS-987 6 in Subjects with Active Rheumatoid Arthritis on 
Background Therapy with Methotrexate 
Gilead Sciences, Inc. 
333 Lakeside Drive 
Foster City, CA 94404 
IND 123903 
2016-001496-75 
TBD 
Rheumatoid Arthritis 
GS-US-379-1582 
Gilead Clinical 
Name: 
Minnie Kuo 
PPD 
PPD 
Program Manager: 
Telephone: 
Fax: 
Gilead Medical 
Name: 
Monitor: 
Telephone: 
Fax: 
Mobile: 
Protocol Version/Date: 
Original: 
Franziska Matzkies 
PPD 
PPD 
PPD 
08 Apr 2016 
CONFIDENTIALITY STATEMENT 
The infmmation contained in this document, pruiicularly unpublished data, is the propeliy or 
under control of Gilead Sciences, Inc., and is provided to you in confidence as an investigator, 
potential investigator, or consultant, for review by you, your staff, and an applicable Institutional 
Review Board or Independent Ethics Committee. The infonnation is only to be used by you in 
com1ection with authorized clinical studies of the investigational dmg described in the protocol. 
You will not disclose any of the infmmation to others without written authorization from 
Gilead Sciences, Inc., except to the extent necessaty to obtain infmm ed consent from those 
persons to whom the dmg may be administered. 


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TABLE OF CONTENTS
TABLE OF CONTENTS ..............................................................................................................................................2
LIST OF IN-TEXT TABLES........................................................................................................................................5
LIST OF IN-TEXT FIGURES ......................................................................................................................................5
PROTOCOL SYNOPSIS ..............................................................................................................................................6
GLOSSARY OF ABBREVIATIONS AND DEFINITION OF TERMS....................................................................11
1.
INTRODUCTION ..............................................................................................................................................15
1.1.
Background ............................................................................................................................................15
1.2.
GS-9876 .................................................................................................................................................15
1.2.1.
General Information .............................................................................................................15
1.2.2.
Preclinical Pharmacology and Toxicology...........................................................................15
1.2.3.
Clinical Trials of GS-9876 ...................................................................................................19
1.3.
Information about Methotrexate.............................................................................................................20
1.4.
Rationale for Current Study ...................................................................................................................20
1.5.
Rationale for Dose Selection..................................................................................................................21
1.6.
Risk/Benefit Assessment for the Study..................................................................................................21
1.7.
Compliance ............................................................................................................................................22
2.
OBJECTIVES.....................................................................................................................................................23
3.
STUDY DESIGN................................................................................................................................................24
3.1.
Endpoints ...............................................................................................................................................24
3.2.
Study Design..........................................................................................................................................24
3.3.
Study Treatments ...................................................................................................................................25
3.4.
Duration of Treatment............................................................................................................................25
3.5.
Discontinuation Criteria.........................................................................................................................25
3.6.
End of Study...........................................................................................................................................27
3.7.
Post Study Care......................................................................................................................................27
3.8.
Pharmacokinetic (PK) Assessments.......................................................................................................27
3.9.
Biomarker Testing..................................................................................................................................28
3.9.1.
Optional Genomic Research.................................................................................................28
4.
SUBJECT POPULATION..................................................................................................................................29
4.1.
Number of Subjects and Subject Selection ............................................................................................29
4.2.
Inclusion Criteria....................................................................................................................................29
4.3.
Exclusion Criteria...................................................................................................................................30
5.
INVESTIGATIONAL MEDICINAL PRODUCTS ...........................................................................................33
5.1.
Randomization, Blinding and Treatment Codes ....................................................................................33
5.1.1.
Procedures for Breaking Treatment Codes...........................................................................33
5.2.
Description and Handling of GS-9876 and Placebo-To-Match (PTM) GS-9876 ..................................33
5.2.1.
Formulation..........................................................................................................................33
5.2.2.
Packaging and Labeling .......................................................................................................34
5.2.3.
Storage and Handling...........................................................................................................34
5.3.
Dosage and Administration of GS-9876 ................................................................................................34
5.4.
Other Medication Administered.............................................................................................................35
5.5.
Prior and Concomitant Medications.......................................................................................................35
5.6.
Investigational Medicinal Product Accountability and Disposal or Return ...........................................38
6.
STUDY PROCEDURES ....................................................................................................................................39


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6.1.
Subject Enrollment and Treatment Assignment.....................................................................................39
6.2.
Pretreatment Assessments......................................................................................................................39
6.2.1.
Screening Visit (within 28 days prior to randomization) .....................................................39
6.3.
Randomization (Day 1)..........................................................................................................................41
6.4.
Treatment Assessments..........................................................................................................................41
6.4.1.
Day 1 ....................................................................................................................................41
6.4.2.
Week 2 (+ 3 days) ................................................................................................................42
6.4.3.
Week 4 (+ 3 days) ................................................................................................................43
6.4.4.
Week 8 (+ 3 days) ................................................................................................................44
6.4.5.
Week 12 (+ 3 days) ..............................................................................................................45
6.5.
Early Termination (+ 3 days) .................................................................................................................46
6.6.
Post-Treatment Assessments (+ 5 days).................................................................................................47
6.7.
Sample Storage.......................................................................................................................................48
7.
ADVERSE EVENTS AND TOXICITY MANAGEMENT...............................................................................49
7.1.
Definitions of Adverse Events, Adverse Reactions, and Serious Adverse Events.................................49
7.1.1.
Adverse Events.....................................................................................................................49
7.1.2.
Serious Adverse Events........................................................................................................49
7.1.3.
Clinical Laboratory Abnormalities and Other Abnormal Assessments as 
Adverse Events or Serious Adverse Events .........................................................................50
7.2.
Assessment of Adverse Events and Serious Adverse Events.................................................................50
7.2.1.
Assessment of Causality for Study Drugs and Procedures...................................................50
7.2.2.
Assessment of Severity ........................................................................................................51
7.3.
Investigator Requirements and Instructions for Reporting Adverse Events and Serious 
Adverse Events to Gilead.......................................................................................................................51
7.3.1.
Requirements for collection prior to study drug initiation: ..................................................51
7.4.
Gilead Reporting Requirements.............................................................................................................53
7.5.
Clinical Laboratory Abnormalities and Other Abnormal Assessments as Adverse Events or 
Serious Adverse Events..........................................................................................................................53
7.5.1.
Grades 1 and 2 Laboratory Abnormality or Clinical Event..................................................53
7.5.2.
Grades 3 and 4 Laboratory Abnormality or Clinical Event..................................................53
7.6.
Toxicity Management ............................................................................................................................54
7.7.
Special Situations Reports......................................................................................................................54
7.7.1.
Definitions of Special Situations..........................................................................................54
7.7.2.
Instructions for Reporting Special Situations.......................................................................55
8.
STATISTICAL CONSIDERATIONS................................................................................................................57
8.1.
Analysis Objectives and Endpoints........................................................................................................57
8.1.1.
Analysis Objectives..............................................................................................................57
8.1.2.
Primary Endpoint .................................................................................................................57
8.1.3.
Secondary Endpoint .............................................................................................................57
8.1.4.
Exploratory Endpoints..........................................................................................................57
8.2.
Analysis Conventions.............................................................................................................................58
8.2.1.
Analysis Sets ........................................................................................................................58
8.3.
Data Handling Conventions ...................................................................................................................58
8.4.
Demographic Data and Baseline Characteristics ...................................................................................59
8.5.
Efficacy Analysis ...................................................................................................................................59
8.6.
Safety Analysis.......................................................................................................................................59
8.6.1.
Extent of Exposure...............................................................................................................60
8.6.2.
Adverse Events.....................................................................................................................60
8.6.3.
Laboratory Evaluations ........................................................................................................60
8.6.4.
Other Safety Evaluations......................................................................................................60
8.7.
Pharmacokinetic Analysis......................................................................................................................61
8.8.
Biomarker Analysis................................................................................................................................61


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8.9.
Data Monitoring Committee ..................................................................................................................61
8.10.
Sample Size............................................................................................................................................62
9.
RESPONSIBILITIES..........................................................................................................................................63
9.1.
Investigator Responsibilities ..................................................................................................................63
9.1.1.
Good Clinical Practice..........................................................................................................63
9.1.2.
Institutional Review Board (IRB)/Independent Ethics Committee (IEC) 
Review and Approval...........................................................................................................63
9.1.3.
Informed Consent.................................................................................................................63
9.1.4.
Confidentiality......................................................................................................................64
9.1.5.
Study Files and Retention of Records ..................................................................................64
9.1.6.
Case Report Forms...............................................................................................................65
9.1.7.
Investigational Medicinal Product Accountability and Return.............................................66
9.1.8.
Inspections............................................................................................................................66
9.1.9.
Protocol Compliance............................................................................................................67
9.2.
Sponsor Responsibilities ........................................................................................................................67
9.2.1.
Protocol Modifications.........................................................................................................67
9.2.2.
Study Report and Publications .............................................................................................67
9.3.
Joint Investigator/Sponsor Responsibilities ...........................................................................................67
9.3.1.
Payment Reporting...............................................................................................................67
9.3.2.
Access to Information for Monitoring..................................................................................68
9.3.3.
Access to Information for Auditing or Inspections ..............................................................68
9.3.4.
Study Discontinuation..........................................................................................................68
10.
REFERENCES ...................................................................................................................................................69
11.
APPENDICES ....................................................................................................................................................71
Appendix 1.
Investigator Signature Page....................................................................................................72
Appendix 2.
Study Procedures Tables ........................................................................................................73
Appendix 3.
Laboratory Assessments Table...............................................................................................76
Appendix 4.
Common Terminology Criteria for Adverse Events (CTCAE) v4.03....................................77
Appendix 5.
Pregnancy Precautions, Definition for Female of Childbearing Potential, and 
Contraceptive Requirements...................................................................................................78
Appendix 6.
The 2010 American College of Rheumatology –European League Against 
Rheumatism Collaborative Initiative Classification Criteria for Rheumatoid 
Arthritis {Aletaha et al 2010}.................................................................................................80
Appendix 7.
American College of Rheumatology Response Evaluations/ Preliminary Definition 
of Improvement in Rheumatoid Arthritis {Felson et al 1995} ...............................................82
Appendix 8.
Disease Activity Score for 28 Joint Count (DAS28) {Prevoo et al 1995} .............................84
Appendix 9.
Procedures and Specifications................................................................................................85


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LIST OF IN-TEXT TABLES
Table 1-1.
Margins for GS-9876 Based on Systemic Exposure Relative to the Observed 
Human Exposure at 30 mg once daily (AUC)........................................................................18
Table 5-1.
Examples of Disallowed Medications ....................................................................................37
LIST OF IN-TEXT FIGURES
Figure 3-1.
Study Schema.........................................................................................................................25


GS-9876 
Protocol GS-US-379-1582 
Gilead Sciences, Inc. 
Study Title: 
INDNumber: 
EudraCT Number: 
Clinical Trials.gov 
Identifier: 
Study Centers 
Planned: 
Objectives: 
CONFIDENTIAL 
PROTOCOL SYNOPSIS 
Gilead Sciences, Inc. 
333 Lakeside Drive 
Foster City, CA 94404 
Original 
A Randomized, Double-Blind, Placebo-Controlled, Multicenter, 
Proof-of-Concept Study to Evaluate Safety, Tolerability, and 
Efficacy of GS-9876 in Subjects with Active Rheumatoid Arthritis 
on Backgrmmd Therapy with Methotrexate 
IND 123903 
Not Available 
Not Available 
Approximately 30-40 centers globally 
The primaty objective of this study is as follows: 
• 
To evaluate the effect ofGS-9876 versus placebo for the 
treatment of signs and symptoms of rheumatoid atihritis (RA) in 
subjects with active RA as measmed by change from baseline in 
Disease Activity Score for 28 joint count using C-reactive protein 
(CRP) (DAS28 [CRP]) at Week 12 
The secondaty objective of this study is as follows: 
• 
To evaluate the safety and tolerability of GS-9876 in subjects 
withRA 
• 
To explore the effect of GS-9876 on other disease-specific 
outcomes in RA 
The explorat01y objectives of this study are: 
I 
I 
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GS-9876
Protocol GS-US-379-1582
Gilead Sciences, Inc. 
Original
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08 April 2016
Study Design:
This is a randomized, double-blind, placebo-controlled, 
proof-of-concept (POC) study evaluating the safety, tolerability, and 
efficacy of GS-9876 in adult male and female subjects with active 
RA despite MTX therapy who had an inadequate response to MTX 
(either alone or in combination with biological disease modifying 
anti-rheumatic drug [bDMARDs]).
Approximately 60 subjects will be randomized in a 1:1:1 ratio to 
receive 30 mg GS-9876, 10 mg GS-9876 or placebo-to-match (PTM) 
in addition to background therapy with MTX for up to 12 weeks:

GS-9876 (30 mg QD) (N=20)

GS-9876 (10 mg QD) (N=20)

GS-9876 PTM (QD) (N=20)
Randomization will be stratified by prior inadequate response to 
biologic therapy and geographic region.  
Subjects will be followed for 4 weeks after their last dose of study 
drug. 
Number of Subjects 
Planned:
Approximately 60 subjects
Target Population:
Subjects with active RA on background MTX therapy who had an 
inadequate response to MTX (either alone or in combination with
bDMARDs). 
Duration of 
Treatment:
Up to 12 weeks
Diagnosis and Main 
Eligibility Criteria:
Male or non-pregnant female subjects with active RA, between 
18 and 75 years of age (inclusive)
Key Inclusion Criteria include:
1) Active RA disease as defined by: a tender joint count (TJC) of
≥6 (out of 68), a swollen joint count (SJC) of ≥6 (out of 66),
and a CRP ≥ 5 mg/l
2) Inadequate response  to treatment with oral or parenteral MTX 
7.5 to 25 mg/week continuously for at least 12 weeks, with at 
least 6 weeks at a stable dose prior to the first dose of study drug
3) Subjects must be receiving a folic or folinic acid supplementation 
at a stable dose. Subjects who are not taking folic or folinic acid 
at Screening, should be initiated on an adequate dose of folic acid 
(≥5 mg/week total dose or as per local practice) or equivalent and 
maintained throughout the study.


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4) Use of oral corticosteroids of no more than 10 mg prednisone or 
its equivalent per day is allowed if the dose is stable for at least 
28 days prior to the first dose of study drug 
5) Nonsteroidal Anti-inflammatory Drugs (NSAIDs) or other 
analgesics (including aspirin ≤ 100 mg daily) are allowed if doses 
are stable for at least 14 days prior to the first dose of study drug  
Key Exclusion Criteria include:
1) Prior treatment with B-cell depleting agents (eg, rituximab), 
unless more than 6 months prior and documented return of 
CD19+ cells
2) Prior treatment with any commercially available or 
investigational SYK inhibitor 
3) Current treatment with any other conventional DMARD 
(cDMARD) other than MTX and/or hydroxychloroquine (HCQ) 
(unless appropriate wash out as defined in Section 5.5)
4) Current treatment with any bDMARD (unless appropriate wash 
out as defined in Section 5.5)
5) QT interval corrected for heart rate using the Fredericia formula 
(QTcF) > 450 msec determined by the average of values at the 
Screening visit
6) History of any major bleeding event defined as Grade 3 severity 
and above [as defined by modified the Common Terminology 
Criteria for Adverse Events (CTCAE) 4.03] within the last year
or personal or family history of bleeding disorder
7) If no history of a documented negative tuberculosis (TB) test 
within the last 12 months or documented course of adequate 
therapy for either latent or active TB, a Quantiferon must be 
performed according to local standards. Subjects with a positive 
Quantiferon at Screening are not eligible
8) Ongoing treatment with moderate or strong CYP3A inducers or 
inhibitors or within 2 weeks prior to study drug administration
Additional inclusion and exclusion criteria are outlined in Section 4
Subject Population.
Study Procedures/
Frequency:
All subjects will complete the following study visits: Screening, 
Day 1 (first dose), and on-treatment visits at Weeks 2, 4, 8, and 12.  
All subjects will be followed for safety for an additional 4 weeks 
after their last dose of study drug. 
Screening assessments will be completed no more than 28 days prior 
to the Day 1 visit and will include a complete physical examination
(PE), joint count assessment, medical history, vital signs, height and 
weight, electrocardiogram (ECG), adverse events (AEs) related to 


GS-9876 
Protocol GS-US-379-1582 
Gilead Sciences, Inc. 
Test Product, Dose, 
and Mode of 
Administration: 
Reference Therapy, 
Dose, and Mode of 
Administration 
Required Background 
therapy 
Criteria for 
Evaluation: 
Safety: 
CONFIDENTIAL 
Original 
screening procedures, concomitant medications, safety laboratmy 
tests (including hematology, chemistiy, and coagulation), CRP, 
serology (HIV, HCV, HBV), leukocyte subsets, biomarkers, RNA, 
TB test as applicable and as outlined in the protocol, urinalysis, urine 
dmg screen, and CD19 count as applicable and as outlined in the 
protocol. Pregnancy testing will be perfmmed for females of 
childbearing potential. 
On-ti·eatment assessments include a symptom driven PE, joint count 
assessment, disease-specific questionnaires and activity scales, vital 
signs, ECGs, AEs, concomitant medications, safety laboratmy tests 
(including hematology, chemistiy, and coagulation), leukocyte 
subsets (Day 1 and Week 12 ), quantitative imnllmoglobulins (Day 1 
and Week 12 or ET), RNA (Day 1, Week 4, and Week 12 or ET), 
RF/CCP [Day 1 and Week 12 or ET], CRP, urine pregnancy test, and 
biomarkers (Day 1, Week 4, and Week 12 or ET). Additional testing 
will include PK sampling (Day 1, Weeks 2, 4, 8 and 12 or ET). 
Post-treatment assessments include symptom driven PE, vital signs, 
ECGs, AEs, concomitant medications, safety laborato1y tests 
(including hematology, chemistly, and coagulation), CRP, and urine 
pregnancy test where indicated. 
For sub'ects who provide their additional and s ecific consent, 
PPD 
For subjects who provide their additional and specific consent, PO 
GS-9876 30 mg (1 x 30 mg tablet), administered orally once daily 
GS-9876 10 mg (1 x 10 mg tablet), administered orally once daily 
GS-9876 PTM (1 tablet), administered orally once daily 
MTX 7.5 to 25 mg, administered orally or parenterally once a week 
Safety will be assessed through the repmting of AEs, clinical 
laboratmy tests, PEs, vital sign assessments, and ECGs at various 
time points during the study. Concomitant medication usage will 
also be documented throughout the study. 
Page 9 
08 April2016 


GS-9876 
Protocol GS-US-379-1582 
Gilead Sciences, Inc. 
Efficacy: 
Phru.macokinetics: 
Exploratoty: 
Statistical Methods: 
Original 
The primru.y endpoint is change from baseline in DAS28 (CRP) at 
Week 12. 
The secondru.y endpoints include: 
• 
The propottion of subjects who achieve ACR 20/50/70 at 
Week 12 
• 
Change from baseline in Heath Assessment 
Questionnaire- Disability Index (HAQ-DI) score at Week 12 
Plasma concentrations ofGS-9876 will be detetmined. 
PPD 
The primmy endpoint is change from baseline in DAS28 (CRP) at 
Week 12. The primmy analysis will consist of a superiority test of 
each of the GS-9876 doses compared to placebo based on the change 
from baseline in DAS28 (CRP) at Week 12. 
All continuous endpoints will be summm·ized using an 8-number 
summaty [n, mean, standard deviation (SD), median, 1st quartile 
(Ql), 3rd quattile (Q3), minimum, maximum] by treatment group. 
All categorical endpoints will be summm·ized by the number and 
percentage of subjects who meet the endpoint definition. 
Safety endpoints will be analyzed by the mnnber and percent of 
subjects with events or abnonnalities for categorical values or 
8-number Slllllllla.J.Y (n, mean, SD, medim1, Ql, Q3, minimum, 
maximum) for continuous data by tl'eatment group. 
Sample size is detetmined based on the superiority test of one dose of 
GS-9876 compared to placebo based on the change from baseline in 
DAS28 (CRP) at Week 12. When assuming a difference of 
1.2 between the two groups and a common standard deviation of 
1.35, 20 subjects in each of the GS-9876 groups and 20 in the 
placebo group are required to obtain 78% power at a 2-sided 
0.05-level. Therefore, the total sample size will be 60 (20 per 
treatment group). 
This study will be conducted in accordance with the guidelines of Good Clinical Practice (GCP) 
including archiving of essential documents. 
CONFIDENTIAL 
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GLOSSARY OF ABBREVIATIONS AND DEFINITION OF TERMS
°C
degrees Celsius
°F
degrees Fahrenheit 
β-hCG
beta-human chorionic gonadotropin
μM
micromolar
ACPA
anti-citrullinated protein antibody
ACR
American College of Rheumatology
ACR 20/50/70 
American College of Rheumatology 20/50/70%  improvement
ADP
adenosine di-phosphate
AE
adverse event
AhR
aryl hydrocarbon receptor
AKT
protein kinase B
ALT
alanine aminotransferase
APC
antigen-presenting cell
APTT
activated partial thromboplastin time
AST
aspartate aminotransferase
ATP
adenosine triphosphate
AUC
area under the curve
AUC0-last
area under the plasma/serum concentration versus time curve from time zero to 
the last quantifiable concentration
BCR
B-cell receptor
BCRP
breast cancer resistance protein
BDC
bile duct-cannulated
bDMARD
biological disease modifying anti-rheumatic drug
BLNK
B-cell linker protein
BLQ
below the limit of quantitation
BTK
Bruton’s tyrosine kinase
BUN
blood urea nitrogen
CBC
complete blood count
CCP
cyclic citrullinated peptide
CDAI
Clinical Disease Activity Index
CFR
Code of Federal Regulations
CG
Cockcroft-Gault
CIA
collagen-induced arthritis 
Cmax
the maximum observed serum/plasma/peripheral blood mononuclear cell 
concentration of drug
CMH
Cochran–Mantel–Haenszel
CNS
central nervous system
CRO
contract research organization
CRP
C-reactive protein


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CTCAE
Common Toxicity Criteria for Adverse Events
CYP
cytochrome P450 
DAS28
Disease Activity Score for 28 joint count
DMARD
disease modifying anti-rheumatic drug
DMC
Data Monitoring Committee
DSPH
Drug Safety and Public Health
EC50
estimated concentration of drug for a half maximal response
ECG
electrocardiogram
eCRF
electronic case report form
EDC
electronic data capture
ERK
extracellular signal-regulated kinase
eSAE
electronic serious adverse event
ESR
erythrocyte sedimentation rate
ET
early termination
EU
European Union
FAS
Full Analysis Set
FDA
(United States) Food and Drug Administration
g
gram
GCP
Good Clinical Practice
Gilead
Gilead Sciences, Inc.
GLP
Good Laboratory Practice
HAQ-DI
Health Assessment Questionnaire – Disability Index
HBV
hepatitis B virus
HCQ
hydroxychloroquine
HCV
hepatitis C virus
HDPE
high density polyethylene
hERG
human ether-a-go-go-related gene
HIV
human immunodeficiency virus
HLGT
high-level group term
HLT
high-level term
IB
Investigator’s Brochure 
IC
immune complex
IC50
concentration that results in 50% inhibition
ICH
International Conference on Harmonization 
ICH E3
ICH Guideline for Structure and Content of Clinical Study Reports
ie
id est (that is)
IEC
Independent Ethics Committee
Ig
immunoglobulin
IL
interleukin
IMP
investigational medicinal product


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INR
International Normalized Ratio of prothrombin time
IR
inadequate response
IRB
Institutional Review Board
IU
international units
IUD
intrauterine device
IXRS
Interactive Web and Mobile Response System
kg
kilogram
L
liter
LAM
lactational amenorrhea method
LLT
lower-level term
MAPK
mitogen-activated protein kinase
MCV
mean corpuscular volume 
MedDRA
Medical Dictionary for Regulatory Activities
MEK
MAPK/ERK kinase
mg
milligram
MMRM
mixed model repeated measures
msec
millisecond
MTX
methotrexate
ng
nanogram
nM
nanomolar
NOEAL
no-observed-adverse-effect-level 
NSAID
nonsteroidal anti-inflammatory drug
OATP
organic anion transporting polypeptide
PAR-1
protease-activated receptor
PD
pharmacodynamics
PE
physical examination
P-gp
P-glycoprotein
PK
pharmacokinetics
PKC
protein kinase C
POC
proof-of-concept
prn
pro re nata (as needed)
PT
preferred term or prothrombin time
PTM
placebo-to-match
PTT
partial thromboplastin time
PXR
pregnane X receptor
Q1
first quartile
Q3
third quartile
QD
quaque die (each day)


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QT
electrocardiographic interval between the beginning of the Q wave and 
termination of the T wave, representing the time for both ventricular 
depolarization and repolarization to occur
QTc
corrected QT interval
QTcF
QT interval corrected for heart rate using the Fridericia formula
RA
rheumatoid arthritis
RBC
red blood cell
RF
rheumatoid factor
RNA
ribonucleic acid
s
second
SADR
serious adverse drug reaction
SAE
serious adverse event
SD
standard deviation 
SDAI
Simplified Disease Activity Index
SJC
swollen joint count
SOC
system organ class
SOP
standard operating procedure
SUSAR
suspected unexpected serious adverse reaction
TB
tuberculosis
TEAE
treatment-emergent adverse event
TJC
tender joint count
TNF
tumor necrosis factor
UGT
uridine disphosphate glucuronosyltransferase
ULN
upper limit of normal
US, USA
United States, United States of America
VAS
visual analog scale
WBC
white blood cell


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1.
INTRODUCTION
1.1.
Background
Rheumatoid Arthritis is a chronic, systemic inflammatory disease that affects approximately 
1.3 million adults in the United States (US) {Helmick et al 2008}. RA manifests principally as 
an attack on peripheral joints and may lead to marked destruction and deformity of joints, with 
considerable disability and impact on quality of life. It is characterized by the production of 
autoantibodies, synovial inflammation with formation of pannus tissue, and erosion of 
underlying cartilage and bone. Although people of any age can be affected, the onset of RA is 
most frequent between the age of 40 and 50 years, and women are affected 3 times more often 
than men. While the cause of RA is still not completely understood, aberrant B-cell activation, 
T-cell co-stimulation, osteoclast differentiation, and cytokine release all have been implicated in 
its pathogenesis. Patients with RA experience a high risk of disability and mortality {Arthritis 
Foundation 2008}.
Despite the currently available treatment options for RA, there is still a need for new treatments 
because not all patients respond adequately (or maintain response) to current therapies and some 
patients experience toxicities and/or intolerance that limit the use of such therapies. All currently 
available treatments have safety considerations that can develop during chronic use that may 
require a change to a different therapy. The unmet medical need for new therapeutic options with 
a favorable efficacy and safety profile that do not require injection/infusion have prompted 
efforts to develop oral small molecule inhibitors of protein kinases involved in cellular signaling 
associated with the underlying RA disease pathology. 
GS-9876 is a potent and selective inhibitor of SYK and is being developed by Gilead Sciences, 
Inc. (Gilead) as an oral agent for the treatment of inflammatory diseases. Spleen tyrosine kinase 
is a nonreceptor cytoplasmic tyrosine kinase primarily expressed in cells of hematopoietic 
lineage, where it functions as a key signaling molecule mediating immunoreceptor signaling in a 
range of cells involved in inflammatory disease. Given its central role in immune cell signaling, 
inhibition of SYK is expected to affect multiple steps in the pathogenesis of RA resulting in 
pleiotropic anti-inflammatory effects.
1.2.
GS-9876
1.2.1.
General Information
For further information on GS-9876, refer to the current Investigator’s Brochure (IB).
1.2.2.
Preclinical Pharmacology and Toxicology
1.2.2.1.
Preclinical Pharmacology and Safety Pharmacology
In biochemical assays, GS-9876 is a selective and potent ATP-competitive inhibitor of SYK with
an IC50 value of 9.5 nM. Overall, GS-9876 is at least 7-fold more selective biochemically for 


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SYK relative to all other protein kinases assayed. The potency of GS-9876 to inhibit SYK
activation was also assessed in human and rat whole blood. Levels of autophosphorylation and 
activation of SYK on tyrosines (Y)525/6 in blood samples preincubated with GS-9876 showed 
potent inhibition of phosphoSYK -Y525/6 levels in human and rat whole blood with EC50 values 
of 171 nM and 230 nM, respecitively. Studies with human whole blood also showed that 
GS-9876 inhibited anti-IgD/BCR-induced CD69 expression on B-cells (geometric mean 
EC50 = 301 nM) and anti-FceRI-stimulated CD63 expression on basophils (geometric mean 
EC50 = 73.2 nM in 25% human blood and 221.8 nM in 67% blood).
The ability of GS-9876 to inhibit SYK signaling in primary human B-cells, lymphocytes, and 
macrophages was assessed in vitro. GS-9876 inhibited anti-IgM-induced BCR/SYK-mediated 
phosphorylation and activation of multiple downstream signaling pathways in primary human 
B-cells including AKT, BLNK, BTK, ERK, MEK, and PKC with EC50 values ranging from 
24 to 51 nM. GS-9876 also suppressed anti-IgM-induced CD69 and CD86 expression on human 
peripheral blood B-cells with EC50 values of 112 nM and 164 nM, respectively. BCR and 
CD40 costimulation of B-cell proliferation and anti-CD3/anti-CD28 costimulation of T-cell 
proliferation was also inhibited by GS-9876 with EC50 values of 108 nM and 1291 nM, 
respectively, demonstrating a 12-fold relative functional selectivity of GS-9876 for B-cells 
compared to T-cells. In immune complex (IC)-stimulated cytokine release assays in primary 
human monocyte differentiated macrophages, GS-9876 inhibited IC-stimulated TNF-α, IL-1, and 
IL-6 secretion with geometric mean EC50 values of 121 nM, 93 nM, and 909 nM, respectively, 
demonstrating that GS-9876 inhibition of SYK blocks B-cell and macrophage receptor signaling 
in vitro with similar potencies.
In two independent rat collagen-induced arthritis (CIA) models in animals with established 
disease, treatment with GS-9876 caused significant and dose-dependent amelioration of clinical 
and histopathology parameters when dosed either early (at initiation of ankle swelling) or late (at 
time of peak ankle swelling) after disease onset. Histological evaluation of joints in the animals 
from the study demonstrated that GS-9876 treatment reduced pannus formation, cartilage 
damage, bone resorption, and periosteal bone formation with an effective dose inducing a 
50% inhibitory effect (ED50) of < 6.25 mg/kg, QD and 11.6 mg/kg, QD in the early and late CIA 
models, respectively.  Significant efficacy was seen with GS-9876 doses that produced 
Cave exposures that were calculated to inhibit Syk phosphorylation by 50% (EC50).  GS-9876 was 
well tolerated at all doses and there were no treatment-related adverse effects on body weight, 
food and drink intake, in-life observations or clinical pathology parameters.  
Safety pharmacology studies were conducted to examine the potential effects of GS-9876 on the
cardiovascular, respiratory, and CNS systems. There were no clinically-relevant effects on the 
respiratory, and CNS systems after single oral doses up to 300 mg/kg. Cardiovascular effects in 
telemetered cynomolgus monkeys at ≥ 20 mg/kg included prolonged QTc interval from 
5 through 25 hours postdose, slightly higher systolic, diastolic, and mean arterial pressure with 
lower heart rate through 6 hours postdose, and higher heart rate from 9 through 25 hours 
postdose. While differences in QTc interval were generally small, the changes were of sufficient 
magnitude to be considered biologically relevant. There were no inhibitory effects on the hERG 
potassium current when GS-9876 was tested up to a free drug concentration of 30 μM, 


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approximately 207-fold above the observed steady state Cmax at a 30 mg QD clinical dose. 
Further, no cardiovascular effects were observed in telemetered cynomolgus monkeys 
administered GS-9876 for 13 weeks at doses up to 15 mg/kg/day. The potential for GS-9876 to 
prolong the QTc interval was assessed with intensive time matched ECG monitoring in Gilead 
studies GS-US-379-1372 and GS-US-379-1900 (cohorts 1 and 2), and no clinical significant 
change in time matched QTc intervals was observed. No clinical significant changes in vital 
signs during serial vital sign measurements were observed.
1.2.2.2.
Preclinical Toxicology
In the repeat-dose studies, the toxicity profile of GS-9876 was assessed in rats and monkeys 
administered GS-9876 orally for up to 26 weeks. Dose-dependent effects on lymphocytes in both 
rats and monkeys were consistent with the expected pharmacology of SYK inhibition. Effects on 
hemostasis were observed in rats and monkeys, with increased erythrocyte turnover in rats at 
≥10 mg/kg/day, and hemorrhage and thrombosis in monkeys at ≥20 mg/kg/day. At higher doses 
in rats (≥30 mg/kg/day), mortality associated with bacterial infections, likely resulting from the 
immunomodulatory activity of GS-9876, was seen. Additional findings included lymphoid 
depletion in the thymus, changes in the pancreas, with secondary effects related to the 
immunomodulatory activity of GS-9876, and likely opportunistic bacterial infection, observed in 
several tissues. The no-observed-adverse-effect level (NOAEL) in rats was 10 mg/kg/day after 
26 weeks dosing. For the highest proposed dose 30 mg dose, estimated exposure margins are 
2.4-/5.9- fold based on exposures at the NOAELs in the 26 week study in male/female rats.  
Patients will be closely monitored for any infection and changes in the differential CBC.
In monkeys, the NOAEL in the 28-day study was identified at 10 mg/kg/day, which was 
associated with AUC0-24hr of 4290 ng•hr/mL. In the 13-week monkey study, there were no effects 
on hemostasis, and the NOAEL was the high dose of 15 mg/kg/day. However in the ongoing 
39-week study, one 15 mg/kg/day monkey was euthanized moribund during Week 22 with 
persistent fecal changes, weight loss, deteriorating clinical condition, and large bowel 
inflammation. All other animals survived to their scheduled necropsy after 39-weeks dosing. For 
the highest proposed dose 30 mg dose, the estimated exposure margin is 2.7-fold based on 
exposures at the 15 mg/kg/day NOAEL in the 13-week monkey study. Although the relationship 
of the moribund animal to GS-9876 treatment is uncertain, Gilead considers it prudent to limit 
exposures to mean exposures achieved in monkeys at the 10 mg/kg/day mid-dose at Week 13 of 
the 39-week study (6750 ng.h/mL), which were 1.8-fold above estimated exposures at the 
highest proposed dose 30 mg dose.
In GLP range-finding developmental toxicity studies in pregnant rats and rabbits, no 
Caesarean-sectioning, litter parameters, or gross external or visceral alterations were affected by 
GS-9876 at dose levels up to 100 mg/kg/day in rats, or up to 30 mg/kg/day in rabbits. In rabbits 
at 100 mg/kg/day, mortality, clinical observations, reduced body weights and food consumption
in does were associated with increased resorptions and reduced fetal body weights.  In rats, the 
maternal no-observed-effect level (NOEL) was 30 mg/kg/day, and the embryo-fetal development 
NOEL was 100 mg/kg/day. In rabbits, the maternal and embryo-fetal development NOEL was 
30 mg/kg/day.


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GS-9876 was negative in the bacterial reverse mutation (Ames) assay, in vitro chromosomal
aberration assay, and in vivo rat micronucleus assay and is therefore considered to be
nongenotoxic. In the in vitro chromosome aberration assay in human lymphocytes, slight, but
statistically significant increases in the number of polyploid cells was observed at the highest
GS-9876 dose level evaluated. GS-9876 did not induce structural chromosome breakage when
evaluated in the in vitro assay. 
Table 1-1.
Margins for GS-9876 Based on Systemic Exposure Relative to the 
Observed Human Exposure at 30 mg once daily (AUC)
Species
Duration
Route
NOAEL
(mg/kg/day)
AUC0-24
(ng•h/mL)a
Margin b
Rat
Once daily 
x 26 weeks
Oral
10 
8800/21,800
(male/female)
2.4/5.9
(male/female)
Cynomolgus Monkey
Once daily 
x 13 weeks
Oral
15c
10,100
2.7
a
NOAEL, no observed adverse effect level. Week 4 male and female rat AUC and week 13 Cynomolgus monkey AUC
(combined sex)
b
Margins of exposure were calculated using observed steady-state exposure (AUCtau) in humans of 3708 ng•h/mL at 30 mg 
once daily in study GS-US-379-1900.
c
One animal was euthanized moribund during Week 22 at the 15 mg/kg/day dose level.
1.2.2.3.
Preclinical Drug Metabolism and Pharmacokinetics
Consistent with the high absorption observed in nonclinical species, GS-9876 shows high
permeability and low efflux transport across human Caco-2 cell monolayers. Efflux is likely
mediated by P-gp and BCRP.
The whole blood to plasma ratios determined in rats, dogs, cynomolgus and rhesus monkeys, and
humans ranged from 0.83 in rats to 2.38 in cynomolgus monkeys. GS-9876 plasma protein
binding at 2 μM is moderate in all species with the free fraction ranging from 11.8% in rat to 
38.5% in dog. In human plasma, GS-9876 has an average free fraction of 20.4%.
The oral bioavailability of GS-9876 is high in rat, dog, and cynomolgus monkey and is
independent of the formulation used (F ≥ 60%). GS-9876 had low to intermediate clearance
relative to liver blood flow in rats, dogs, and cynomolgus and rhesus monkeys. Across species,
the in vivo clearance is similar to the predicted hepatic clearance obtained in primary hepatocytes
leading to confidence in the human prediction based on in vitro hepatocyte data. The volume of
distribution is approximately equal to (rat) or higher than (all other species) total body water
(0.7 L/kg).
After oral dosing to albino and pigmented rats, [14C]GS-9876-derived radioactivity was
distributed to most of the tissues by the first collection time point (0.25 hours postdose). Most
tissues reached maximum GS-9876 concentration by 1 hour postdose and concentrations of
radioactivity were below the limit of quantitation by 168 hours postdose. The tissues showing the
highest maximum concentrations of radioactivity included liver, adrenal glands, and kidney. The
lowest levels of radioactivity were observed in the brain, bone, adipose, and testis. Generally


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similar distribution patterns and tissue concentrations of [14C]GS-9876-derived radioactivity
were observed in albino and pigmented rats except for the pigmented skin and eye uveal tract
where higher tissue/blood ratios were seen in melanin-containing tissues. Binding was reversible.
In both strains, the brain/blood concentration ratio was low (< 0.1), suggesting
[14C]GS-9876-derived radioactivity was relatively excluded by the blood:brain barrier.
Recovery of radioactivity dosed orally to rats was high (≥ 97.8%). The main route of elimination
of GS-9876 is likely hepatobiliary with ≤ 5.1% orally dosed radioactivity found in rat urine and
69.4% in bile of BDC rats.
GS-9876 undergoes slow oxidative metabolism in human hepatocytes. Comparison of
metabolism in hepatocytes from rats, dogs, monkeys, and humans did not identify any
metabolites unique to humans, supporting the selection of rat and cynomolgus monkey as
toxicology species. No detectable turnover of GS-9876 by recombinant human CYP enzymes
(CYP1A2, CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6, or CYP3A4) was observed
confirming the high metabolic stability in human hepatocytes. The clearance of GS-9876 may be
increased by inducers of CYP enzymes.
GS-9876 had little inhibitory effect on the activities of human CYP1A2, CYP2B6, CYP2C8,
CYP2C9, CYP2C19, CYP2D6, or CYP3A. GS-9876 was a weak inhibitor of human UGT1A1 
(IC50 = 31.1 μM). The low systemic concentrations anticipated in the clinic for GS-9876 make it 
unlikely to cause drug-drug interactions in vivo through inhibition of human CYP enzymes or 
UGT1A1.
GS-9876 is a weak inhibitor of the efflux transporters P-gp (IC50 > 23.2 μM) and BCRP
(IC50 > 100 μM) as well as the hepatic uptake transporters OATP1B1 (IC50 = 10.3 μM) and
OATP1B3 (IC50 = 12.3 μM). The low dose and low systemic concentrations anticipated in the
clinic for GS-9876 suggest that the potential for clinically relevant drug-drug interactions with
GS-9876 as an inhibitor of these transporters is low.
GS-9876 is a substrate for P-gp and BCRP, but not OATP1B1 or OATP1B3. Inhibitors of
intestinal P-gp and BCRP are unlikely to have a marked effect on GS-9876 absorption due to its
high permeability and high oral bioavailability expected in the clinic.
It is unlikely that GS-9876 would activate PXR- or AhR-regulated genes at the maximum plasma
concentrations expected in the clinic. Thus, the potential of GS-9876 to cause drug-drug
interactions through induction is low.
1.2.3.
Clinical Trials of GS-9876
As of 08 April 2016, 62 healthy volunteers have been dosed with GS-9876 in two clinical 
studies.


GS-9876
Protocol GS-US-379-1582
Gilead Sciences, Inc. 
Original
CONFIDENTIAL
Page 20
08 April 2016
Completed Clinical Trial
GS-US-379-1372: This was a first-in-human, Phase 1, single-dose ranging study of GS-9876 in 
healthy adult volunteers to evaluate the safety, tolerability, PK, PD, food effect, and drug-drug 
interaction potential using a representative acid reducing agent (omeprazole). 
Ongoing Clinical Trial
GS-US-379-1900: This is a single- and multiple-dose Phase 1 study of GS-9876 in healthy 
volunteers to evaluate the safety, tolerability, PK and PD of GS-9876.
1.3.
Information about Methotrexate 
Subjects will continue to receive stable weekly doses of MTX. Further information regarding
side effects, dosage and administration is available in the current local prescribing information.
1.4.
Rationale for Current Study
Over the last decade, changes in RA treatment strategies accompanied by advances in drug 
development and the addition of targeted biological therapies have greatly improved the 
outcomes for subjects with RA. Despite these developments, therapeutic challenges remain. The 
current conventional and biological DMARDs may be ineffective, produce only partial responses 
or loose therapeutic response over time due to development of neutralizing antibodies in some 
subjects and are associated with significant safety and tolerabilityconcerns. There is an unmet 
medical need for simple, orally administered therapies with novel and targeted mechanisms of 
action that can effectively improve the disease course while being safe and well tolerated.
Given its central role in immune cell signaling, inhibition of SYK is expected to have pleiotropic
anti-inflammatory effects and affect multiple steps in RA pathogenesis. B cells have been
implicated as playing a critical role in the pathogenesis of RA as demonstrated by the clinical
activity of the anti-CD20 monoclonal antibody, rituximab, in RA patients {Leandro et al 2006, 
Navarro-Millan et al 2013}. B cells contribute to the pathogenesis of RA through their ability to 
act as antigen presenting cells (APCs) presenting self-antigens to auto-reactive T cells 
{Shlomchik 2008}, and through the production of autoantibodies and pro-inflammatory 
cytokines {Martin et al 2006, Song et al 2010}. As a critical mediator of BCR signaling, SYK
inhibition suppresses BCR-stimulated proliferation, co-stimulatory molecule expression, and 
autoantibody production in B cells {Braselmann et al 2006, Coffey et al 2012}. 
Additionally, SYK inhibition suppresses IC-stimulated cytokine release from 
monocytes/macrophages and prevents osteoclastogenesis {Liao et al 2013}. Spleen tyrosine 
kinase is expressed in the rheumatoid synovium {Cha et al 2006} and SYK inhibition reduces 
cellular infiltrates into synovial tissue {Coffey et al 2012}. Pharmacologic inhibition of SYK has 
been shown to inhibit disease progression and reduce inflammation in multiple animal models of 
RA, and has demonstrated disease modifying anti-rheumatic drug (DMARD) activity on
endpoints such as cartilage destruction and bone erosion {Coffey et al 2012, Liao et al 2013, 
Pine et al 2007}.  A consistent finding in these nonclinical studies is that significant efficacy can 
be achieved with minimum plasma concentrations (Cmin) that result in target coverage less than 
50% {Liao et al 2013}.


GS-9876 
Protocol GS-US-379-1582 
Gilead Sciences, Inc. 
Original 
Taken together, the in vitro and in vivo data suggest that inhibition of SYK may decrease several 
pathologically active mechanisms implicated in RA including B-cell activation, T -cell 
costimulation, and cytokine release. 
This study is designed to evaluate the efficacy, safety, tolerability, PK, and PPD 
1.5. 
Rationale for Dose Selection 
In the rat CIA model, predicted GS-9876 exposure at the 30 mg and 10 mg QD doses are 
estimated to provide 75% and 37% of the maximal treatment response observed with GS-9876, 
respectively. The maximal treatment response observed with GS-9876 in this model was similar 
to the positive control dexamethasone. In the multiple ascending dose study (GS-US-379-1900), 
doses up to 30 mg QD of GS-9876 for 7 days were well tolerated in healthy volunteers. 
Therefore both doses (10 mg QD and 30 mg QD) are expected to be safe and have the potential 
to be efficacious in RA. 
1.6. 
Risk/Benefit Assessment for the Study 
As of08 April 2016, GS-9876 has been well tolerated by 62 healthy subjects. In the clinical 
studies GS-US-379-1372 (single ascending dose) and GS-US-379-1900 (cohorts 1 and 2; 
multiple ascending dose over 7 days), no risks were identified, and observed AEs were mainly 
Grades 1 and 2 in severity. The majority of AEs were assessed by the investigator as not related 
to GS-9876. The majority of graded laboratory abnormalities was Grade 1 or Grade 2 and mostly 
related to cholesterol. No prolongation of bleeding time duration was noted during the study. No 
clinically significant changes in vital signs, physical findings, or ECGs were reported during this 
study and no clinically relevant QTcF interval prolongation was noted in time matched ECGs in 
cohort 1 and cohort 2. 
In the repeat dose toxicology studies, dose-dependent effects on lymphocytes in both rats and 
monkeys were consistent with the expected pharmacology of SYK inhibition. Effects on 
hemostasis were observed in rats and monkeys, with increased erythrocyte turnover in rats at 
2: 10 mg/kg/day, and hemorrhage and thrombosis in monkeys at 2: 20 mg/kg/day. At higher doses 
in rats (2: 30 mg/kg/day), mortality associated with bacterial infections, likely resulting from the 
immunomodulatory activity of GS-9876, was seen. Additional findings included lymphoid 
depletion in the thymus, changes in the pancreas, with secondary effects related to the 
immunomodulatory activity of GS-9876, and likely opportunistic bacterial infection, observed in 
several tissues. The NOAEL in rats was 10 mg/kg/day after 26 weeks dosing. For the proposed 
30 mg dose in planned Study GS-US-379-1582, estimated exposure margins are 2.4-/5.9- fold 
based on exposures at the NOAELs in the 26 week study in male/female rats. Patients will be 
closely monitored for any infection, changes in the differential CBC and cell subsets. 
In monkeys, the NOAEL in the 28-day study was identified at 10 mg/kg/day, which was 
associated with AUCo-24 hr of 4290 ng•hr/mL. In the 13-week monkey study, there were no 
effects on hemostasis, and the NOAEL was the high dose of 15 mg/kg/day. However in the 
ongoing 39-week study, one 15 mg/kg/day monkey was euthanized moribund during Week 22 
CONFIDENTIAL 
Page 21 
08 April2016 


GS-9876
Protocol GS-US-379-1582
Gilead Sciences, Inc. 
Original
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08 April 2016
with persistent fecal changes, weight loss, deteriorating clinical condition, and large bowel 
inflammation. Gilead considers it prudent to limit exposures in Study GS-US-379-1582 to mean 
exposures achieved in monkeys at the 10 mg/kg/day mid-dose at Week 13 of the 39-week study 
(6750 ng•h/mL). For the highest proposed dose of 30 mg in this study the estimated exposure 
margin is 2.7- fold based on exposures at the NOAEL in the 13-week monkey study.
In clinical studies GS-US-379-1372 and GS-US-379-1900 (cohorts 1 and 2) no change in 
platelets numbers, prothrombin time (PT), partial thromboplastin time (PTT), international 
normalized ration (INR) as well as bleeding time were observed. The risk for bleeding at the 
doses proposed for this POC study is therefore considered to be low.
An independent and experienced Data Monitoring Committee (DMC) appointed to monitor the 
study will provide an additional level of risk mitigation. Refer to Section 8.9 Data Monitoring 
Committee.
The overall risk:benefit balance of this study is considered favorable. For additional information 
about the risks of GS-9876, reference is made to the investigator brochure.
1.7.
Compliance
This study will be conducted in compliance with this protocol, GCP, and all applicable 
regulatory requirements.


GS-9876 
Protocol GS-US-379-1582 
Gilead Sciences, Inc. 
2. 
OBJECTIVES 
The primary objective of this study is: 
Original 
• 
To evaluate the effect of GS-987 6 versus placebo for the treatment of signs and symptoms of 
RAin subjects with active RA as measured by change from baseline in DAS28 (CRP) at 
Week 12 
The secondru.y objectives of this study are: 
• 
To evaluate the safety and tolerability of GS-9876 in subjects with RA 
• 
To explore the effect of GS-9876 on other disease-specific outcomes in RA 
The explorat01y objectives of this study are: 
IT 
I 
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CONFIDENTIAL 
Page23 
08 April2016 


GS-9876 
Protocol GS-US-379-1582 
Gilead Sciences, Inc. 
3. 
STUDY DESIGN 
3.1. 
Endpoints 
The primaty endpoint of this study is: 
• 
Change from baseline in DAS28 (CRP) at Week 12 
The secondaty endpoints of the study are: 
• 
The proportion of subjects who achieve ACR 20/50/70 at Week 12 
• 
Change from baseline in HAQ-DI score at Week 12 
The explorat01y endpoints include: 
IT 
I 
I 
I 
I 
I 
3.2. 
Study Design 
Original 
This is a randomized, double-blind, placebo-controlled, POC study evaluating the safety, 
tolerability, and efficacy of GS-9876 in adult male and female subjects with active RA despite 
MTX therapy who had an inadequate response to MTX (either alone or in combination with 
bDMARDs). 
A total of approximately 60 subjects will be randomized in this study. 
CONFIDENTIAL 
Page24 
08 April2016 


GS-9876
Protocol GS-US-379-1582
Gilead Sciences, Inc. 
Original
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Page 25
08 April 2016
Figure 3-1.
Study Schema
3.3.
Study Treatments
Following completion of Screening assessments, eligible subjects will be randomized in a 
blinded fashion in a 1:1:1 ratio as follows:
Group 1:
GS-9876 (30 mg QD) (N=20)
Group 2:
GS-9876 (10 mg QD) (N=20)
Group 3:
GS-9876 PTM (QD) (N=20)
Randomization will be stratified by prior inadequate response to biologic therapy and geographic 
region.  
3.4.
Duration of Treatment
Subjects will be treated for up to 12 weeks and then followed for 4 weeks after their last dose of 
study drug. 
3.5.
Discontinuation Criteria
When medically feasible, the Medical Monitor should be consulted prior to subject 
discontinuation. Study medication may be discontinued in the following instances:

Intercurrent illness that would, in the judgment of the investigator affect assessment of 
clinical status to a significant degree. Following resolution of intercurrent illness, the subject 
may resume study dosing at the discretion of the investigator.


GS-9876
Protocol GS-US-379-1582
Gilead Sciences, Inc. 
Original
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
Unacceptable toxicity, as defined in the toxicity management section of the protocol, or 
toxicity that, in the judgment of the investigator, compromises the ability to continue 
study-specific procedures or is considered not to be in the subject’s best interest

Subject request to discontinue for any reason

Subject noncompliance

Subjects use of non-permitted concurrent therapy

Serious infections (those requiring parenteral antimicrobial therapy or hospitalization)

Any opportunistic infections

Complicated herpes zoster infection (multi-dermatomal, disseminated, ophthalmic or CNS 
involvement)

Pregnancy during the study; refer to Appendix 5

Investigator discretion

Discontinuation of the study at the request of Gilead, regulatory agency or an Institutional 
Review Board (IRB)/Independent Ethics Committee (IEC)

Laboratory abnormalities:
■
2 sequential total WBCs <2000 cells/mm3 (SI: <2.0x109 cells/L).
■
2 sequential neutrophil counts <1000 neutrophils/mm3 (SI: <1.0x109 cells/L).
■
2 sequential lymphocyte counts <750 lymphocytes/mm3 (SI: <0.75x109 cells/L).
■
2 sequential hemoglobin values <8.0 g/dL (SI: <80 g/L).
■
2 sequential platelet counts <75,000 platelets/mm3 (SI: <75.0x109 cells/L).
■
2 sequential AST or ALT elevations >3xULN with ≥1 total bilirubin value >2xULN.1
■
2 sequential AST or ALT elevations >3xULN accompanied by elevated international 
normalized ratio (INR).1
                                                
1 In each case, there is a need for additional investigations, such as review of ethanol, recreational drug and dietary 
supplement consumption; testing for acute hepatitis A, B or C infection and biliary tract imaging should be promptly 
discussed with the study Medical Monitor.


GS-9876 
Protocol GS-US-379-1582 
Gilead Sciences, Inc. 
Original 
3.6. 
• 
2 sequential ASTor ALT elevations >5xULN, regardless of total bilimbin or 
accompanying symptoms.1 
• 
2 sequential increases in semm creatinine >50% over the average of Screening and 
Day 1 values. 2 
• 
After becoming aware of any of the above described abnonnallaborat01y changes 
occmTing at any one time, an unscheduled visit (i.e. second sequential) must occur to 
retest within 3 to 5 days. Subjects who stop study medication for any reason will not 
be replaced. Subjects withdrawing from the study will be encouraged to complete the 
same fmal evaluations as subjects completing the study according to the protocol, 
particularly safety evaluations in the subject's interest so that data can 
End of Study 
End of Study is defined as when the last patient has completed up to 12 weeks of treatment and 
4 weeks of follow-up. 
3.7. 
Post Study Care 
Subjects may be offered the opp01tunity to emoll into an open-label extension of GS-9876 at a 
future date. At this time there are no confmned post study care options to subjects that have 
patiicipated on this study and the long tenn care of subjects will remain the responsibility of their 
primaty treating physician. 
3.8. 
Pharmacokinetic (PK) Assessments 
Plasma concentrations ofGS-9876 will be measured and PK parameters detetmined. Plasma 
concentrations of GS-9876 metabolites may be detetmined and PK parameters may be explored, 
as applicable. PK sampling will occur relative to study dmg dosing at Weeks 2, 8, and 12 or ET, 
corresponding to a trough concentration taken approximately 24 hours after the previous dose of 
GS-9876, but prior to the next dose of GS-9876. At Week 4, PK sampling will occur at 2 hours 
postdose. The samples will be used to evaluate PK of GS-9876 and may also be used to measure 
protein binding of GS-9876. Plasma concentrations of GS-9876 metabolites and/or MTX may be 
detetmined. 
PPD 
2 At the time of study completion or discontinuation, if a subject should exhibit elevations in serum creatinine :;::33 % 
above the average of Screening and Day 1 values, they should be re-tested every 1 to 2 weeks until the senun 
creatinine elevation is fully reversed to within 10% of the average of Screening and Day 1 values. 
CONFIDENTIAL 
Page27 
08 April2016 


GS-9876 
Protocol GS-US-379-1582 
Gilead Sciences, Inc. 
3.9. 
Biomarker Testing 
PO 
Original 
Sampling for markers relevant to inflammation (including but not limited to disease-associated 
markers ofRA and/or the SYK pathway) may be perfonned at Baseline, Day 1, Week 4, and 
Week 12 or ET. Sampling time points may be modified by the Sponsor based upon emerging 
data and assay feasibility. Samples for CRP will be drawn at evety visit. 
The testing outlined in this protocol is based upon the cunent state of scientific knowledge. It 
may be modified dming or after the end of the study to remove tests no longer indicated and/or 
to add new tests based upon the growing state of knowledge. Samples may be stored at Gilead 
Sciences for a period of up to 15 years after the end of the study. 
3.9.1. 
Optional Genomic Research 
PO 
CONFIDENTIAL 
Page28 
08 April2016 


GS-9876
Protocol GS-US-379-1582
Gilead Sciences, Inc. 
Original
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08 April 2016
4.
SUBJECT POPULATION
4.1.
Number of Subjects and Subject Selection
Approximately 60 subjects will be enrolled in this study with active RA who have an inadequate 
response to MTX (either alone or in combination with bDMARDs). In order to manage the total 
study enrollment, Gilead, at its sole discretion, may suspend screening and/or enrollment at any 
site or study-wide at any time.
4.2.
Inclusion Criteria
Subjects must meet all of the following inclusion criteria to be eligible for participation in this 
study.
1)
Male or female subjects who are between 18 and 75 years of age, inclusive, on the day of 
signing informed consent
2)
Have a diagnosis of RA as defined by the 2010 American College of 
Rheumatology - European League Against Rheumatism Collaborative Initiative 
Classification Criteria for Rheumatoid Arthritis (Appendix 6)
3)
Active RA disease as defined by a TJC of ≥6 (out of 68), a SJC of  ≥6 (out of 66), and a 
CRP ≥ 5 mg/l
4)
Inadequate response to treatment with oral or parenteral MTX 7.5 to 25 mg/week 
continuously for at least 12 weeks, with at least 6 weeks at a stable dose prior to the first 
dose of study drug
5)
Subjects must be receiving a folic or folinic acid supplementation at a stable dose. Subjects 
who are not taking folic or folinic acid at Screening should be initiated on an adequate dose 
of folic acid (>5 mg/week total dose or as per local practice) or equivalent and maintained 
throughout the study.
6)
Use of oral corticosteroids of no more than 10 mg prednisone or its equivalent per day is 
allowed if the dose is stable for at least 28 days prior to the first dose of study drug  
7)
NSAIDs or other analgesics (including aspirin ≤ 100 mg daily) are allowed if doses are 
stable for at least 14 days prior to the first dose of study drug  
8)
Able and willing to sign the informed consent as approved by the IRB/IEC. Written consent 
must be provided before initiating any Screening evaluations. Subjects must have read and 
understood the informed consent form (ICF), must fully understand the requirements of the 
study, and must be willing to comply with all study visits and assessments.
9)
A negative serum pregnancy test is required for female subjects 


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Gilead Sciences, Inc. 
Original
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10) Lactating females must agree to discontinue nursing before the investigational medicinal 
product (IMP) is administered.
11) Male subjects and female subjects of childbearing potential who engage in heterosexual 
intercourse must agree to use protocol specified method(s) of contraception as described in 
Appendix 5.
4.3.
Exclusion Criteria
1) Prior treatment with B-cell depleting agents (eg, rituximab), unless more than 6 months prior 
and documented return of CD19+ cells
2) Prior treatment with any commercially available or investigational SYK inhibitor 
3) Current treatment with any other cDMARD other than MTX and/or HCQ (unless appropriate 
wash out as defined in Section 5.5)
4) Current treatment with any bDMARD (unless appropriate wash out as defined in 
Section 5.5). Prior failure to treatment with bDMARDs is not an exclusion criterion.
5) QT interval corrected for heart rate using the Fredericia formula (QTcF) > 450 msec 
determined by the average of values at the Screening visit
6) History of any major bleeding event defined as Grade 3 severity and above [as defined by 
modified the Common Terminology Criteria for Adverse Events (CTCAE) 4.03] within the 
last year or personal or family history of bleeding disorder
7) If no history of a documented negative TB test within the last 12 months or documented 
course of adequate therapy for either latent or active TB, a Quantiferon must be performed 
according to local standards. Subjects with a positive Quantiferon at Screening are not 
eligible
8) Ongoing treatment with moderate or strong CYP3A inducers or inhibitors or within 2 weeks 
prior to study drug administration
9) Joint injections within 4 weeks prior to the first dose of study drug
10) Administration of a live or attenuated vaccine within 30.
11) Participation in any investigational drug/device clinical study within 4 weeks or 5 half-lives 
prior to Screening, whichever is longer. Exposure to investigational biologics should be 
discussed with the sponsor. 
12) Have a diagnosis of any generalized musculoskeletal disorder (eg, generalized osteoarthritis, 
or systemic inflammatory condition other than RA such as, but not limited to: juvenile 
idiopathic arthritis, Felty’s syndrome, ankylosing spondylitis, reactive arthritis, psoriatic 
arthritis, inflammatory bowel disease associated arthropaties, systemic lupus erythematosus, 
scleroderma inflammatory myopathy, mixed connective tissue disease, any overlap 
syndrome, systemic vasculitis or gout [participants with secondary Sjogren's syndrome or 
secondary limited cutaneous vasculitis with RA are not excluded]).


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13) History of or current moderate to severe congestive heart failure (New York Heart 
Association [NYHA] class III or IV), or within the last 6 months, a cerebrovascular accident, 
myocardial infarction, unstable angina, unstable arrhythmia or any other cardiovascular 
condition which, in the opinion of the investigator, would put the subject at risk by 
participation in the study.
14) History of malignancy within the past 5 years prior to Screening (except for adequately 
treated or excised basal cell carcinoma or non-metastatic squamous cell carcinoma of the 
skin or cervical carcinoma in situ with no evidence of recurrence). 
15) History of lymphoproliferative disease or possible current lymphoproliferative disease
16) History of demyelinating disease or current signs and symptoms suggestive of demyelinating 
disease, or immediate family history of demyelinating disease.
17) History of organ or bone marrow transplant.
18) Positive serology for human immunodeficiency virus (HIV) 1 or 2, hepatitis B virus 
(i.e., surface antigen [Ag] or core antibody [Ab] positive) or hepatitis C virus (i.e., HCV Ab 
positive) or any history of infectious hepatitis from any cause with the exception of hepatitis 
A.
19) History of opportunistic infection or immunodeficiency syndrome.
20) Known active infection of any kind (excluding fungal infections of nail beds) or any major 
episode of infection requiring hospitalization or treatment with IV anti-infectives within 
4 weeks of Screening or 8 weeks of Day 1 visit or completion of oral anti-infectives within 
2 weeks of the Screening or 6 weeks of Day 1 visit.
21) Currently on any therapy for chronic infection (such as pneumocystis, cytomegalovirus, 
herpes zoster, and atypical mycobacteria). Past history of disseminated Staphylococcus 
aureus or disseminated Herpes simplex infection.
22) History of symptomatic herpes zoster or herpes simplex infection within 12 weeks prior to 
Screening or have history of disseminated/complicated herpes zoster infection 
(multi-dermatomal involvement, ophthalmic zoster, central nervous system involvement or 
postherpetic neuralgia).
23) History of an infected joint prosthesis or other implanted device with retention of the 
prosthesis or device in situ.
24) History within the previous 2 years or current evidence of drug or alcohol abuse.
25) Any condition including active fibromyalgia that based on the investigator’s opinion would 
make it difficult to appropriately assess RA activity for the purposes of this study.


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Protocol GS-US-379-1582
Gilead Sciences, Inc. 
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26) Any condition or circumstances which in the opinion of the investigator or sponsor may 
make a subject unlikely or unable to complete the study or comply with study procedures and 
requirements.
27) Significant blood loss (>450 mL) or transfusion of any blood product within 12 weeks prior 
to Day 1.
28) Male subjects must refrain from sperm donation throughout the study period and continuing 
for at least 90 days following the last dose of study drug.
29) Female subjects must refrain from egg donation or harvest throughout the study period and 
continuing for at least 30 days after last dose.
30) Subjects have not donated blood within 56 days of study entry or plasma within 7 days of 
study entry and must refrain from blood donation from clinic admission, throughout the study 
period, and continuing for at least 30 days following the last dose of study drug.
31) The results of the following laboratory tests performed at the central laboratory at Screening 
meet any of the criteria below:
a) Hemoglobin <8.0 g/dL (International System of Units [SI]: <80 g/L);
b) White blood cells <3.0 x 103 cells/mm3 (SI: <3.0 x 109 cells/L); 
c) Neutrophils <1.5 x 103 cells/mm3 (SI: <1.5 x 109 cells/L);
d) Lymphocytes <0.5 x 103 cells/mm3 (SI: <0.5 x 109 cells/L);
e) Platelets <100 x 103 cells/mm3 (SI: <100 x 109 cells/L);
f)
Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) ≥1.5x ULN;
g) Total bilirubin level ≥2x ULN unless the subject has been diagnosed with Gilbert’s  
disease and this is clearly documented;
h) Creatinine clearance < 60 mL/min based on the Cockcroft-Gault (CG) formula3
                                                
3 Creatinine clearance (mL/min) = [ (140 – age) * weight in kg] / [ 815 * serum creatinine in mmol/L ]


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Gilead Sciences, Inc. 
Original
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5.
INVESTIGATIONAL MEDICINAL PRODUCTS
5.1.
Randomization, Blinding and Treatment Codes
An Interactive Web and Mobile Response System (IXRS) will be employed to manage subject 
randomization and treatment assignments. It is the responsibility of the investigator to ensure that 
the subject is eligible for the study prior to enrollment. Subjects will be assigned a Screening 
number at the time of consent.
5.1.1.
Procedures for Breaking Treatment Codes
In the event of a medical emergency where breaking the blind is required to provide medical care 
to the subject, the investigator or qualified designee may obtain treatment assignment directly 
from the IXRS system for that subject. Gilead recommends but does not require that the 
investigator contact the Gilead medical monitor before breaking the blind. Treatment assignment 
should remain blinded unless that knowledge is necessary to determine subject emergency 
medical care. The rationale for unblinding must be clearly explained in source documentation 
and on the electronic case report form (eCRF), along with the date on which the treatment 
assignment was obtained. The investigator is requested to contact the Gilead medical monitor 
promptly in case of any treatment unblinding.
Blinding of study treatment is critical to the integrity of this clinical trial and therefore, if a 
subject’s treatment assignment is disclosed to the investigator, the subject will have study 
treatment discontinued. All subjects will be followed until study completion unless consent to do 
so is specifically withdrawn by the subject.
Gilead Drug Safety and Public Health (DSPH) may independently unblind cases for expedited 
reporting of suspected unexpected serious adverse reactions (SUSARs).
5.2.
Description and Handling of GS-9876 and Placebo-To-Match (PTM) GS-
9876
5.2.1.
Formulation
GS-9876 will be supplied as 10 or 30 mg tablets that are round, biconvex, plain-faced and film-
coated blue. Each tablet contains either 10 mg or 30 mg of GS-9876 free base as the succinate 
form (GS-9876-02). The GS-9876 tablets contain commonly used excipients including 
microcrystalline cellulose, mannitol, croscarmellose sodium, magnesium stearate, polyvinyl 
alcohol, polyethylene glycol, titanium dioxide, talc, and FD&C blue #2/indigo carmine 
aluminum lake. 
Matching placebo tablets will be supplied that are identical in physical appearance to the 
10 or 30 mg GS-9876 tablets and contain the following inactive ingredients: 
microcrystalline cellulose, lactose, croscarmellose sodium, magnesium stearate, 
polyvinyl alcohol, polyethylene glycol, titanium dioxide, talc, and FD&C blue #2/indigo carmine 
aluminum lake.


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Original
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5.2.2.
Packaging and Labeling
GS-9876 tablets, 10 mg or 30 mg, and PTM tablets are packaged in white, high-density
polyethylene (HDPE) bottles. Each bottle contains 30 tablets, silica gel desiccant and polyester 
packing material. Each bottle is enclosed with a white, continuous thread, child-resistant 
polypropylene screw cap with an induction-sealed and aluminum-faced liner.
Study drug(s) to be distributed to centers in the US and other participating countries shall be 
labeled to meet applicable requirements of the United States Food and Drug Administration 
(FDA), European Union (EU) Guideline to Good Manufacturing Practice - Annex 13 
(Investigational Medicinal Products), and/or other local regulations.
5.2.3.
Storage and Handling
GS-9876 tablets and PTM tablets should be stored at controlled room temperature of 25ºC 
(77ºF); excursions are permitted between 15ºC and 30ºC (59ºF and 86ºF). Storage conditions are 
specified on the label. Until dispensed to the subjects, all bottles of study drugs should be stored 
in a securely locked area, accessible only to authorized site personnel.
To ensure the stability and proper identification, study drugs should not be stored in a container 
other than the container in which they were supplied. 
Consideration should be given to handling, preparation, and disposal through measures that 
minimize drug contact with the body. Appropriate precautions should be followed to avoid direct 
eye contact or exposure when handling. 
5.3.
Dosage and Administration of GS-9876
GS-9876 30 mg (1 x 30 mg tablet), GS-9876 10 mg (1 x 10 mg tablet), or GS-9876 PTM
(1 tablet) will be provided by Gilead Sciences, Inc. and are to be administered orally once daily
with water. The study drug should be swallowed whole. GS-9876 may be taken with or without 
food. Each subject will be given instructions to maintain approximately the same daily dosing 
interval between study drug doses. Subjects will be instructed to take study drug at 
approximately the same time each morning. On Day 1, subjects will be instructed to take their 
dose in clinic as the last in-clinic study procedure (after all other procedures for that visit have 
been completed). At Weeks 2, 8 and 12, subjects will be instructed to take their dose after 
predose assessments have been completed (eg, PK sample collection). At Week 4, subjects will 
be instructed to take their dose in clinic as the first study procedure prior to any others scheduled 
for that visit. 
For missed dose(s) of study medication, subject should be instructed to take the missed dose(s) 
of study medication, as soon as possible, during the same day. If more than 8 hours has elapsed 
since the scheduled time of the missed dose, the subject should be instructed to wait and take the 
next dose at the regularly scheduled time. Subjects should be cautioned never to double the next 
dose with a missed dose of study drug under any circumstances. 


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5.4.
Other Medication Administered
Methotrexate should be administered weekly at a dose of 7.5 to 25 mg. 
5.5.
Prior and Concomitant Medications
At Screening, all medication taken up to 30 days prior to the Screening visit will be recorded on 
the eCRF. At each study visit, the site will capture any and all medications taken by the subject
since the last visit or during the visit (as applicable). Concomitant medications include
prescription, non-prescription medications, therapies, dietary supplements, and minerals.
Allowed Medications:

Subjects must have taken oral or parenteral MTX 7.5 to 25 mg/week continuously for at least 
12 weeks, with at least 6 weeks of stable dose prior to first study dose and throughout the 
duration of the study. Subjects will continue to receive stable weekly doses of MTX. Further 
information regarding side effects, dosage and administration is available in the current local 
prescribing information.

Subjects are allowed to remain on hydroxychloroquine, with at least 8 weeks of stable dose 
prior to first study dose

Chronic use of systemic corticosteroids up to a maximum of 10 mg/day of prednisone or 
equivalent is allowed if dose is stable for at least 28 days prior to first study dose and 
maintained at a stable dose throughout the study.

NSAIDs or other analgesics (including aspirin ≤100 mg) are allowed if doses are stable for 
at least 14 days prior to first study dose. 

For pain while on study, the patient may take acetaminophen or other non-NSAID pain 
medications as directed by the treated physician.  Any scheduled or pro re nata (prn) pain 
medication should be taken after the Baseline and Week 12 visits are completed.
Prohibited Medications:

Any herbal/natural supplements, unless approved by the Medical Monitor

Any and all illegal or illicit drug use, including use of prescription drugs outside the care of 
the prescribing physician

Changes in the doses of background MTX, anti-malarial therapy, corticosteroids and/or 
NSAIDS are not permitted during the study period except to avoid adverse effects

Use of moderate or strong CYP3A4 inhibitors or moderate or strong CYP3A4 inducers 
within 2 weeks prior to the first dose of study drug and while on study drug is prohibited


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
The following medications are prohibited from 4 weeks prior to the first dose of study drug 
and throughout the study: 
minocycline, penicillamine, sulfasalazine, anakinra, etanercept, etanercept biosimilar, 
azathioprine, cyclosporine, tacrolimus, sirolimus, everolimus, mycophenolate mofetil, 
tofacitinib

The following medications are prohibited within 10 weeks of the first dose of study drug and 
throughout the study: 
infliximab, infliximab biosimilar, golimumab, certolizumab pegol, abatacept, 
tocilizumab, adalimumab

Treatment with antibiotics for a clinical infection or other medical condition within 30 days
prior to first dose 

Previous treatment with B-cell depleting agents (ie, rituximab) within 6 months of treatment 

Treatment with any other investigational study drug within 1 month prior or within 
5 half-lives of the prior investigational agent (whichever is longer) prior to Screening

Prior treatment with any commercially available or investigational SYK inhibitor 

Joint injections during the course of the study are not permitted. If a joint injection has been 
used within 6 weeks of first dose, the joint will be considered unevaluable throughout the 
study.

Concurrent therapy with any anti-coagulant (eg, coumadin [warfarin], any Vitamin K 
antagonist, any novel oral anticoagulant, any heparin or low molecular heparins, inhibitors of 
factor Xa) 

Concurrent therapy with any anti-platelet therapy (eg, adenosine diphosphate [ADP] receptor 
inhibitors, phosphodiesterase inhibitors, PAR-1 antagonists, Glycoprotein 2b/3a inhibitors) 
with the exception of ≤ 100 mg daily of aspirin and other NSAIDs
Vaccine Guidelines:
Vaccination with live components is prohibited during the study and for 6 weeks after the last 
dose of study medication. Also routine household contact with persons vaccinated with live 
vaccine components should be avoided. These vaccines include varicella, oral polio and inhaled 
flu vaccine. General guidelines suggest that exposure should be avoided following vaccination 
with these vaccines for the stated time period:

varicella or attenuated typhoid fever vaccination for 4 weeks following vaccination

oral polio vaccination for 6 weeks following vaccination


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
attenuated rotavirus vaccine for 10 days following vaccination

inhaled flu vaccine for 1 week following vaccination
When inactivated flu vaccines are to be used during the study, it should be borne in mind that 
vaccination responses have not been studied during the administration of GS-9876. Currently, 
there are no available data on continuous use of IMP and its impact on immune responses 
following vaccination.
Examples of representative medications which are prohibited are listed below: 
Table 5-1.
Examples of Disallowed Medications
Drug Class
Agents Disallowed
Strong CYP3A4 Inhibitorsa
clarithromycin, conivaptan,  itraconazole, ketoconazole, nefazodone, 
posaconazole, telithromycin, voriconazole, ritonavir, cobicistat, telaprevir, 
boceprevir, grapefruit juice, idelalisib, 
Strong CYP3A4 Inducersb
carbamazepine, phenytoin, rifampin, fosphenytoin, pentobarbital, primidone, 
rifabutin, rifapentine, phenobarbital, mitotane, avasimibe, St. John’s Wort
Moderate CYP3A4 Inhibitorsa
fluconazole, erythromycin, diltiazem, dronedarone, aprepitant, imatinib, 
verapamil, tofisopam, ciprofloxacin, cimetidine, cyclosporine, Schisandra 
sphenanthera
Moderate CYP3A4 Inducersb
efavirenz, tipranavir/ritonavir, bosentan, thioridazine, nafcillin, talviraline, 
lopinavir, modafinil, etravirine, lersivirine, semagacestat, genistein
Immunosuppressants
mycophenolate mofetil, azathioprine, quinacrin, gold, leflunomide
Calcineurin inhibitor
cyclosporine, tacrolimus
mTOR inhibitor
sirolimus, everolimus
Herbal/Natural Supplementsd
grapefruit juicea, St. John’s Wortb, fish oil, borage oil, Schisandra 
sphenanthera
Anti-platelet
adenosine diphosphate(ADP) receptor inhibitors, phosphodiesterase 
inhibitors, PAR-1 antagonists, Glycoprotein 2b/3a inhibitorsc
Anti-coagulant
warfarin, any Vitamin K antagonist, any novel oral anticoagulant, any heparin 
or low molecular heparins, 
inhibitors of factor Xa
a
In vitro data indicate GS-9876 is a substrate of CYP3A4. Co-administration of CYP3A4 inhibitors may increase GS-9876
exposure. These agents are prohibited while subject is on study drug and 2 weeks prior to study drug administration.
b
In vitro data indicate GS-9876 is a substrate of CYP3A4. Co-administration of CYP3A4 inducers may decrease GS-9876
exposure. These agents are prohibited while subject is on study drug and 2 weeks prior to study drug administration.
c
≤ 100 mg aspirin and NSAIDs are permitted 
d
Herbal/Natural supplements not listed require Medical Monitor review and approval.


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5.6.
Investigational Medicinal Product Accountability and Disposal or Return
The investigator is responsible for ensuring adequate accountability of all used and unused IMP.
This includes acknowledgement of receipt of each shipment of IMP (quantity and condition). All 
used and unused IMP dispensed to subjects must be returned to the site.
GS-9876 accountability records will be provided to each study site to:

Record the date received and quantity of IMP; 

Record the date, subject number, subject initials, and the IMP number dispensed; and

Record the date, quantity of used and unused IMP returned, along with the initials of the 
person recording the information.
For additional information about study drug accountability and return, refer to Section 9.1.7.


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6.
STUDY PROCEDURES
The study procedures to be conducted for each subject enrolled are presented in tabular form in 
Appendix 2 and described in the text that follows. The investigator must document any 
deviation from protocol procedures and notify the sponsor or contract research organization 
(CRO).
The study center will not initiate dosing until:

The IRB and IEC and other applicable regulatory agencies have reviewed and approved the 
study and the informed consent document;

All requested regulatory documents have been submitted to and approved by Gilead;

A Master Services Agreement and/or Study Agreement is executed;

The study initiation meeting has been conducted by the Gilead (or designee).
The initiation meeting will include but is not limited to a review of the protocol, the IB, study 
drugs, and investigator responsibilities.
Documentation of the personally signed and dated informed consent of each subject, using the 
study-specific, IRB-approved Informed Consent Forms (ICF), is required before initiating the 
screening process. 
6.1.
Subject Enrollment and Treatment Assignment
It is the responsibility of the investigator to ensure that subjects are eligible to participate in the 
study prior to enrollment and continue to remain eligible throughout the study.
Once informed consent has been obtained, all screening tests and procedures have been assessed, 
and study eligibility has been confirmed, eligible subjects will be randomized to study treatment
as described in Section 5.1.
6.2.
Pretreatment Assessments
6.2.1.
Screening Visit (within 28 days prior to randomization)
Written informed consent must be obtained from each subject before initiation of any visit 
procedures. After a subject has provided informed consent, the investigator will determine if the 
subject is eligible for participation in the study.  Subjects will be screened within 28 days before 
randomization to determine eligibility for participation in the study. The assessment will include 
a review of the Inclusion/Exclusion criteria and completion of all Screening Visit procedures as 
outlined in Appendix 2. A sufficient number of subjects will be screened to identify
approximately 60 subjects for enrollment.


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The following will be performed and documented at Screening:

Obtain written informed consent

Obtain medical history including but not limited to RA, prior RA medication history any 
personal or family histories of bleeding disorders

Perform complete physical examination (refer to Appendix 9)

Obtain vital signs, to include height and weight at Screening (refer to Appendix 9)

Complete 12-lead ECG (refer to Appendix 9)

Perform 66 swollen and 68 tender joint count assessment (refer to Appendix 7 and 
Appendix 9)

Obtain blood samples for (refer to Appendix 3):
Hematology, Chemistry, and Coagulation
CRP
Leukocyte subsets
Serology (HIV, HCV, and HBV)
Serum pregnancy test
RNA

Perform Quantiferon test, as applicable (refer to exclusion criteria)

Obtain a CD19 count, as applicable (refer to exclusion criteria)

Obtain urine for urinalysis and urine drug screen (refer to Appendix 3)

Collect biomarker samples

Record any serious adverse events (SAEs) and all AEs related to protocol mandated 
procedures occurring after signing of the consent form (refer to Section 7).

Record any prior and concomitant medications
Subjects meeting all of the inclusion criteria and none of the exclusion criteria will return to the 
clinic after screening for randomization into the study.
From the time of obtaining informed consent through the first administration of investigational 
medicinal product, record all SAEs, as well as any AEs related to protocol-mandated procedures 


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on the adverse events eCRF. All other untoward medical occurrences observed during the 
screening period, including exacerbation or changes in medical history are to be captured on the 
medical history eCRF. See Section 7 Adverse Events and Toxicity Management for additional 
details.
Screening labs may be repeated once within 28 days prior to administration of study drug to rule 
out laboratory error.
6.3.
Randomization (Day 1)
Subjects who meet all inclusion and exclusion criteria and complete screening will return for 
randomization into one of the three treatments as described in Section 3.3. Randomization will 
be completed as described in Section 5.1.
6.4.
Treatment Assessments
6.4.1.
Day 1
Study procedures and assessments are outlined in Appendix 2. The HAQ-DI, Patient’s 
Assessment of Pain, and Patient’s Global Assessment of Disease Activity are recommended to 
be done prior to the 66 swollen and 68 tender joint count assessments and before any invasive 
study procedures. Blood draws should be done at the end of the study visit prior to dosing.
The following will be performed and documented on Day 1, within a + 3-day window:

Confirm study eligibility

Perform symptom driven physical examination 

Obtain vital signs 

Perform 12-lead ECG (predose)

Assess AEs and concomitant medications

Subject completes disease specific questionnaires and activity scales (refer to Appendix 9): 
HAQ-DI
Patient’s Assessment of Pain
Patient’s Global Assessment of Disease Activity   

Perform 66 swollen and 68 tender joint count assessment (refer to Appendix 9)

Investigator completes Physician’s Global Assessment of Disease Activity (refer to 
Appendix 9)


GS-9876 
Protocol GS-US-379-1582 
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• 
Obtain blood samples for: 
-
Hematology, Chemistiy, and Coagulation 
-
CRP 
-
Leukocyte subsets 
-
RF/CCP 
-
IgA, IgG, and IgM 
-
RNA 
Original 
• 
Obtain urine sample for urine pregnancy test for females of childbearing potential only 
• 
Collect biomarker samples 
• PPD 
• 
Dmg Administration 
-
Dispense study chugs as directed by the IXRS 
-
Instluct the subject on the packaging, storage and administration of all study ch·ugs 
-
Observe the subject taking the first dose of study ch11g and record the time of the 
first dose. Study chug should be administered as the last study procedure on Day 1. 
-
Inst111ct subjects not to take study <hug until after predose assessments at Week 2, Week 
8, and Week 12 visits. Instmct subjects not to take study ch11g until in clinic and 
instmcted to do so at Week 4. 
6.4.2. 
Week 2 (±3 days) 
Study procedures and assessments are outlined in Appendix 2. The following will be perfonned 
and documented at Week 2, within a± 3-day window: 
• 
Perfmm symptom ch·iven physical examination 
• 
Obtain vital signs 
• 
Perfmm 12-lead ECG 
• 
Assess AEs and concomitant medications 
• 
Subject completes disease specific questionnaires and activity scales: 
CONFIDENTIAL 
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-
HAQ-DI 
-
Patient's Assessment of Pain 
-
Patient's Global Assessment of Disease Activity 
• 
Perform 66 swollen and 68 tender joint count assessment 
• 
Investigator completes Physician's Global Assessment of Disease Activity 
• 
Obtain blood samples for: 
-
Hematology, Chemistry, and Coagulation 
-
CRP 
Original 
• 
Obtain urine sample for urine pregnancy test for females of childbearing potential only 
• 
Collect PK sample (predose) 
• 
Study drug administration after predose assessments completed (eg, PK sample collection). 
• 
Complete medication pill count 
• 
Review study drug compliance and drug administration instructions with subject. 
6.4.3. 
Week 4 (± 3 days) 
Study procedures and assessments are outlined in Appendix 2. The following will be performed 
and documented at Week 4, within a± 3-day window: 
• 
Study drug administration Qrior to other study procedures ~PPD 
) 
------------------~ 
~--------------------------~ 
• 
Perform symptom driven physical examination 
• 
Obtain vital signs 
• 
Perform 12-lead ECG 
• 
Assess AEs and concomitant medications 
• 
Subject completes disease specific questionnaires and activity scales: 
-
HAQ-DI 
-
Patient's Assessment of Pain 
-
Patient's Global Assessment of Disease Activity 
CONFIDENTIAL 
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08 April2016 


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Perf01m 66 swollen and 68 tender joint cmmt assessment 
• 
Investigator completes Physician's Global Assessment of Disease Activity 
• 
Obtain blood samples for: 
-
Hematology, Chemistly, and Coagulation 
-
CRP 
-RNA 
Original 
• 
Obtain urine sample for mine pregnancy test for females of childbearing potential only 
• 
Collect biomarker samples 
• 
Collect PK sample (2 hours postdose) 
• PPD 
• 
Study dmg will be dispensed as directed by IXRS. 
• 
Complete medication pill cmmt 
• 
Review study d.mg compliance and dmg adminisn·ation instluctions with subject. 
6.4.4. 
Week 8 (± 3 days) 
Study procedures and assessments are outlined in Appendix 2. The following will be perf01med 
and documented at Week 8, within a± 3-day window: 
• 
Perf01m symptom driven physical examination 
• 
Obtain vital signs 
• 
Perf01m 12-lead ECG 
• 
Assess AEs and concomitant medications 
• 
Subject completes disease specific questionnaires and activity scales: 
-
HAQ-DI 
-
Patient's Assessment of Pain 
-
Patient's Global Assessment of Disease Activity 
• 
Perf01m 66 swollen and 68 tender joint count assessment 
CONFIDENTIAL 
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GS-9876 
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• 
Investigator completes Physician's Global Assessment of Disease Activity 
• 
Obtain blood samples for: 
-
Hematology, Chemist1y, and Coagulation 
-
CRP 
Original 
• 
Obtain urine sample for urine pregnancy test for females of childbearing potential only 
• 
Collect PK sample (predose) 
• PPD 
• 
Study drug administration after predose assessments completed (eg, PK sample collection). 
• 
Study dmg will be dispensed as directed by IXRS. 
• 
Complete medication pill cmmt 
• 
Review study dmg compliance and dmg administration instmctions with subject. 
6.4.5. 
Week 12 (±3 days) 
Study procedures and assessments are outlined in Appendix 2. The HAQ-DI, Patient's 
Assessment of Pain, and Patient's Global Assessment of Disease Activity are recommended to 
be done prior to the 66 swollen and 68 tender joint count assessments and before any invasive 
study procedures. Blood draws should be done at the end of the study visit. 
The following will be perf01med and documented on Day I, within a± 3-day window: 
• 
Perf01m symptom driven physical examination 
• 
Obtain vital signs 
• 
Perf01m 12-lead ECG 
• 
Assess AEs and concomitant medications 
• 
Subject completes disease specific questionnaires and activity scales: 
-
HAQ-DI 
-
Patient's Assessment of Pain 
-
Patient's Global Assessment of Disease Activity 
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• 
Perf01m 66 swollen and 68 tender joint cmmt assessment (prior to Physician's Global 
Assessment of Disease Activity) 
• 
Investigator completes Physician's Global Assessment of Disease Activity 
• 
Obtain blood samples for: 
-
Hematology, Chemistty, and Coagulation 
-
CRP 
-
Leukocyte subsets 
-
RF/CCP 
-
IgA, IgG, and IgM 
-RNA 
Original 
• 
Obtain urine sample for mine pregnancy test for females of childbearing potential only 
• 
Collect biomarker samples 
• 
Collect PK sample (predose) 
• 
PD 
• 
Study drug administt·ation after predose assessments completed (eg, PK sample collection). 
• 
All study drug must be retumed by subject. Study dmg not previously retumed by the subject 
should also be collected. 
• 
Complete medication pill count 
• 
Review study dmg compliance and dmg administration insttu ctions with subject. 
6.5. 
Early Termination(± 3 days) 
If a subject discontinues study dosing (for example, as a result of an AE), eve1y attempt should 
be made to perf01m the required study-related follow-up and procedures (see Section 3.5, 
Discontinuation Criteria). 
Evaluations indicating abn01mal results believed to be possibly or probably related to study 
treatment at the ET visit should be repeated weekly or as often as deemed appropriate by the 
investigator tmtil the abn01mality resolves, retums to baseline visit levels, or is othe1w ise 
explained. 
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If the subject discontinues prematurely from the study, the ET evaluations and/or procedures 
should be completed as outlined in Appendix 2 within 72 hours of subject’s early termination 
from the study. The following will be performed and documented at ET, within a + 3-day 
window:

Perform symptom driven physical examination 

Obtain vital signs 

Perform 12-lead ECG

Assess AEs and concomitant medications

Subject completes disease specific questionnaires and activity scales: 
HAQ-DI
Patient’s Assessment of Pain 
Patient’s Global Assessment of Disease Activity    

Perform 66 swollen and 68 tender joint count assessment 

Investigator completes Physician’s Global Assessment of Disease Activity   

Obtain blood samples for:
Hematology, Chemistry, and Coagulation
CRP
RF/CCP
IgA, IgG, and IgM
RNA

Obtain urine sample for urine pregnancy test for females of childbearing potential only

Collect biomarker samples 

Collect PK sample
6.6.
Post-Treatment Assessments (+ 5 days)
Study procedures and assessments are outlined in Appendix 2. The 4 Weeks Post-Treatment 
Follow-Up Visit will occur 28 days (+ 5 days) from the last administration of study drug. The 
following will be performed and documented:


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
Perform symptom driven physical examination 

Obtain vital signs 

Perform 12-lead ECG

Assess AEs and concomitant medications

Obtain blood samples for:
Hematology, Chemistry, and Coagulation
CRP

Obtain urine sample for urine pregnancy test for females of childbearing potential only
6.7.
Sample Storage
From subjects who provide additional consent, residual samples from blood drawn at all visits 
will be frozen and stored. These stored samples may be used by Gilead or our research partners 
to help answer questions about the RA and related diseases, study drug, or clinical laboratory 
testing to provide additional safety data. No human genetic testing will be performed without 
express consent of the study subjects. At the conclusion of this study, these samples and samples 
collected for RNA may be retained in storage for Gilead for a period of up to 15 years.


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7.
ADVERSE EVENTS AND TOXICITY MANAGEMENT
7.1.
Definitions of Adverse Events, Adverse Reactions, and Serious Adverse 
Events
7.1.1.
Adverse Events
An AE is any untoward medical occurrence in a clinical study subject administered a medicinal 
product, which does not necessarily have a causal relationship with the treatment. An AE can 
therefore be any unfavorable and/or unintended sign, symptom, or disease temporally associated 
with the use of a medicinal product, whether or not considered related to the medicinal product.
AEs may also include pre- or post-treatment complications that occur as a result of protocol 
specified procedures, lack of efficacy, overdose, drug abuse/misuse reports, or occupational 
exposure. Preexisting events that increase in severity or change in nature during or as a 
consequence of participation in the clinical study will also be considered AEs.
An AE does not include the following:

Medical or surgical procedures such as surgery, endoscopy, tooth extraction, and transfusion.
The condition that led to the procedure may be an adverse event and must be reported.

Pre-existing diseases, conditions, or laboratory abnormalities present or detected before the 
Screening visit that do not worsen

Situations where an untoward medical occurrence has not occurred (eg, hospitalization for 
elective surgery, social and/or convenience admissions)

Overdose without clinical sequelae (see Section 7.7.2.2)

Any medical condition or clinically significant laboratory abnormality with an onset date 
before the consent form is signed and not related to a protocol-associated procedure is not an 
AE. It is considered to be pre-existing and should be documented on the medical history 
eCRF.
7.1.2.
Serious Adverse Events
An SAE is defined as an event that, at any dose, results in the following:

Death

Life-threatening (Note: The term “life-threatening” in the definition of “serious” refers to an 
event in which the subject was at risk of death at the time of the event; it does not refer to an 
event that hypothetically might have caused death if it were more severe.)

In-patient hospitalization or prolongation of existing hospitalization


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
Persistent or significant disability/incapacity

A congenital anomaly/birth defect

A medically important event or reaction: such events may not be immediately 
life-threatening or result in death or hospitalization but may jeopardize the subject or may 
require intervention to prevent one of the other outcomes constituting SAEs. Medical and 
scientific judgment must be exercised to determine whether such an event is a reportable 
under expedited reporting rules. Examples of medically important events include intensive 
treatment in an emergency room or at home for allergic bronchospasm; blood dyscrasias or 
convulsions that do not result in hospitalization; and development of drug dependency or 
drug abuse. For the avoidance of doubt, infections resulting from contaminated medicinal 
product will be considered a medically important event and subject to expedited reporting 
requirements.
7.1.3.
Clinical Laboratory Abnormalities and Other Abnormal Assessments as 
Adverse Events or Serious Adverse Events
Laboratory abnormalities without clinical significance are not recorded as AEs or SAEs. 
However, laboratory abnormalities (eg, clinical chemistry, hematology, and urinalysis) that 
require medical or surgical intervention or lead to IMP interruption, modification, or 
discontinuation must be recorded as an AE, as well as an SAE, if applicable. In addition, 
laboratory or other abnormal assessments (eg, electrocardiogram, x-rays, vital signs) that are 
associated with signs and/or symptoms must be recorded as an AE or SAE if they meet the 
definition of an AE or SAE as described in Sections 7.1.1 and 7.1.2. If the laboratory 
abnormality is part of a syndrome, record the syndrome or diagnosis (eg, anemia), not the 
laboratory result (ie, decreased hemoglobin).
For specific information on handling of clinical laboratory abnormalities in this study, please
refer to Section 7.5.
7.2.
Assessment of Adverse Events and Serious Adverse Events
The investigator or qualified sub-investigator is responsible for assessing AEs and SAEs for 
causality and severity, and for final review and confirmation of accuracy of event information 
and assessments.
7.2.1.
Assessment of Causality for Study Drugs and Procedures
The investigator or qualified sub-investigator is responsible for assessing the relationship to IMP
therapy using clinical judgment and the following considerations:

No: Evidence exists that the adverse event has an etiology other than the IMP. For SAEs, an 
alternative causality must be provided (eg, pre-existing condition, underlying disease, 
intercurrent illness, or concomitant medication).

Yes: There is reasonable possibility that the event may have been caused by the 
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It should be emphasized that ineffective treatment should not be considered as causally related in 
the context of adverse event reporting. 
The relationship to study procedures (eg, invasive procedures such as venipuncture or biopsy) 
should be assessed using the following considerations:

No: Evidence exists that the adverse event has an etiology other than the study procedure.

Yes: The adverse event occurred as a result of protocol procedures (eg, venipuncture)
7.2.2.
Assessment of Severity
The severity grading of AEs will be assessed as Grade 1, 2, 3 or 4 using the Common 
Terminology Criteria for Adverse Events (CTCAE) version 4.03. For AEs associated with 
laboratory abnormalities, the event should be graded on the basis of the clinical severity in the 
context of the underlying conditions; this may or may not be in agreement with the grading of 
the laboratory abnormality. 
The only modification to the CTCAE criteria is the addition of a Grade 1 upper respiratory, as 
described in Appendix 4.
7.3.
Investigator Requirements and Instructions for Reporting Adverse Events 
and Serious Adverse Events to Gilead
7.3.1.
Requirements for collection prior to study drug initiation:
After informed consent, but prior to initiation of study medication, the following types of events 
should be reported on the eCRF: all SAEs and adverse events related to protocol-mandated 
procedures.
7.3.1.1.
Adverse Events
Following initiation of study medication, collect all AEs, regardless of cause or relationship, 
until 30 days after last administration of study drug must be reported to the eCRF database as 
instructed.
All AEs should be followed up until resolution or until the adverse event is stable, if possible. 
Gilead Sciences may request that certain AEs be followed beyond the protocol defined follow up 
period.
7.3.1.2.
Serious Adverse Events
All SAEs, regardless of cause or relationship, that occurs after the subject first consents to 
participate in the study (ie, signing the informed consent) and throughout the duration of the 
study, including the protocol-required post treatment follow-up period, must be reported to the 
eCRF database and Gilead DSPH as instructed. This also includes any SAEs resulting from 
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Any SAEs and deaths that occur after the post treatment follow-up visit but within 4 weeks of 
the last dose of study drug, regardless of causality, should also be reported. 
Investigators are not obligated to actively seek SAEs after the protocol defined follow up period; 
however, if the investigator learns of any SAEs that occur after study participation has concluded 
and the event is deemed relevant to the use of IMP, he/she should promptly document and report 
the event to Gilead DSPH.

All AEs and SAEs will be recorded in the eCRF database within the timelines outlined in the 
eCRF completion guideline.
7.3.1.3.
Electronic Serious Adverse Event (eSAE) Reporting Process 

Site personnel record all SAE data in the eCRF database and from there transmit the SAE 
information to Gilead DSPH within 24 hours of the investigator’s knowledge of the event. 
Detailed instructions can be found in the eCRF completion guidelines.

If for any reason it is not possible to record the SAE information electronically, ie, the eCRF 
database is not functioning, record the SAE on the paper serious adverse event reporting 
form and submit within 24 hours to:
Gilead DSPH
Email: Safety_FC@gilead.com
Fax: +1 650-522-5477

As soon as it is possible to do so, any SAE reported via paper must be transcribed into the 
eCRF Database according to instructions in the eCRF completion guidelines.

If an SAE has been reported via a paper form because the eCRF database has been locked, no 
further action is necessary.

All AEs and SAEs will be recorded in the eCRF database within the timelines outlined in the
eCRF completion guideline. 

For fatal or life-threatening events, copies of hospital case reports, autopsy reports, and other 
documents are also to be submitted by e-mail or fax when requested and applicable. 
Transmission of such documents should occur without personal subject identification, 
maintaining the traceability of a document to the subject identifiers.

Additional information may be requested to ensure the timely completion of accurate safety 
reports.

Any medications necessary for treatment of the SAE must be recorded onto the concomitant 
medication section of the subject’s eCRF and the event description section of the SAE form.


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7.4.
Gilead Reporting Requirements
Depending on relevant local legislation or regulations, including the applicable US FDA Code of 
Federal Regulations, the EU Clinical Trials Directive (2001/20/EC) and relevant updates, and 
other country-specific legislation or regulations, Gilead may be required to expedite to 
worldwide regulatory agencies reports of SAEs, serious adverse drug reactions (SADRs), or 
SUSARs. In accordance with the EU Clinical Trials Directive (2001/20/EC), Gilead or a 
specified designee will notify worldwide regulatory agencies and the relevant IEC in concerned 
Member States of applicable SUSARs as outlined in current regulations.
Assessment of expectedness for SAEs will be determined by Gilead using reference safety 
information specified in the investigator’s brochure or relevant local label as applicable. 
All investigators will receive a safety letter notifying them of relevant SUSAR reports associated 
with any study IMP. The investigator should notify the IRB/IEC of SUSAR reports as soon as is 
practical, where this is required by local regulatory agencies, and in accordance with the local 
institutional policy. 
7.5.
Clinical Laboratory Abnormalities and Other Abnormal Assessments as 
Adverse Events or Serious Adverse Events
Laboratory abnormalities are usually not recorded as AEs or SAEs. However, laboratory 
abnormalities (eg, clinical chemistry, hematology, and urinalysis) independent of the 
underlying medical condition that require medical or surgical intervention or lead to 
investigational medicinal product interruption or discontinuation must be recorded as an AE, as 
well as an SAE, if applicable. In addition, laboratory or other abnormal assessments 
(eg, electrocardiogram, X-rays, vital signs) that are associated with signs and/or symptoms must 
be recorded as an AE or SAE if they meet the definition of an AE (or SAE) as described in 
Sections 7.3.1.1 and 7.3.1.2. If the laboratory abnormality is part of a syndrome, record the 
syndrome or diagnosis (ie, anemia) not the laboratory result (ie, decreased hemoglobin).
Severity should be recorded and graded according to the modified CTCAE Grading Scale as 
described in Appendix 4. For AEs associated with laboratory abnormalities, the event should be 
graded on the basis of the clinical severity in the context of the underlying conditions; this may 
or may not be in agreement with the grading of the laboratory abnormality.
7.5.1.
Grades 1 and 2 Laboratory Abnormality or Clinical Event
Continue study drug at the discretion of the investigator.
7.5.2.
Grades 3 and 4 Laboratory Abnormality or Clinical Event
For a Grade 3 and 4 clinical event or clinically significant Grade 3 and 4 laboratory abnormality 
confirmed by repeat testing (preferably within 3 calendar days after receipt of the original 
test results), study drug should be permanently discontinued and the subject managed according 
to local practice. The subject should be followed as clinically indicated until the laboratory 
abnormality returns to baseline or is otherwise explained, whichever occurs first. A clinically 


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significant Grade 3 and 4 laboratory abnormality that is not confirmed by repeat testing should 
be managed according to the algorithm for the new toxicity grade.
7.6.
Toxicity Management 
Treatment-emergent toxicities will be noted by the investigator and brought to the attention of 
the Gilead Sciences Medical Monitor or designee. Whether or not considered treatment-related, 
all subjects experiencing AEs must be monitored periodically until symptoms subside, any 
abnormal laboratory values have resolved or returned to baseline levels or they are considered 
irreversible, or until there is a satisfactory explanation for the changes observed.
Grade 3 or 4 clinically significant laboratory abnormalities should be confirmed by repeat testing 
as soon as possible, and preferably within 3 calendar days after receipt of the original test results.
Grade 3 or 4 clinically significant laboratory abnormalities should be managed as outlined in 
Section 7.5.2.
Any questions regarding toxicity management should be directed to the Gilead Sciences Medical 
Monitor or designee.
7.7.
Special Situations Reports
7.7.1.
Definitions of Special Situations
Special situation reports include all reports of medication error, abuse, misuse, overdose, reports 
of adverse events associated with product complaints, and pregnancy reports regardless of an 
associated AE.  
Medication error is any unintentional error in the prescribing, dispensing, or administration of a 
medicinal product while in the control of the health care provider, subject, or consumer.
Abuse is defined as persistent or sporadic intentional excessive use of a medicinal product by a 
subject.
Misuse is defined as any intentional and inappropriate use of a medicinal product that is not in 
accordance with the protocol instructions or the local prescribing information.
An overdose is defined as an accidental or intentional administration of a quantity of a medicinal 
product given per administration or cumulatively which is above the maximum recommended 
dose as per protocol or in the product labelling (as it applies to the daily dose of the subject in 
question). In cases of a discrepancy in drug accountability, overdose will be established only 
when it is clear that the subject has taken the excess dose(s). Overdose cannot be established 
when the subject cannot account for the discrepancy except in cases in which the investigator has 
reason to suspect that the subject has taken the additional dose(s).
Product complaint is defined as complaints arising from potential deviations in the manufacture, 
packaging, or distribution of the medicinal product.  


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7.7.2.
Instructions for Reporting Special Situations
7.7.2.1.
Instructions for Reporting Pregnancies
The investigator should report pregnancies in female study subjects that are identified after 
initiation of study medication and throughout the study, including the post study drug follow-up 
period, to Gilead DSPH using the pregnancy report form within 24 hours of becoming aware of 
the pregnancy.
Refer to Section 7.3 and the eCRF completion guidelines for full instructions on the mechanism 
of pregnancy reporting.
The pregnancy itself is not considered an AE nor is an induced elective abortion to terminate a 
pregnancy without medical reasons.
Any premature termination of pregnancy (eg, a spontaneous abortion, an induced therapeutic 
abortion due to complications or other medical reasons) must be reported within 24 hours as an 
SAE. The underlying medical reason for this procedure should be recorded as the AE term.
A spontaneous abortion is always considered to be an SAE and will be reported as described in 
Section 7.3. Furthermore, any SAE occurring as an adverse pregnancy outcome post study must 
be reported to Gilead DSPH.
The subject should receive appropriate monitoring and care until the conclusion of the 
pregnancy. The outcome should be reported Gilead DSPH using the pregnancy outcome report 
form. If the end of the pregnancy occurs after the study has been completed, the outcome should 
be reported directly to Gilead DSPH. Gilead DSPH contact information is as follows: 
Email: Safety_FC@gilead.com and Fax: +1 (650) 522-5477. 
Pregnancies of female partners of male study subjects exposed to Gilead or other study drugs 
must also be reported and relevant information should be submitted to Gilead DSPH using the 
pregnancy and pregnancy outcome forms within 24 hours. Monitoring of the subject should 
continue until the conclusion of the pregnancy. If the end of the pregnancy occurs after the study 
has been completed, the outcome should be reported directly to Gilead DSPH, fax number 
+1 650 522-5477 or email Safety_FC@gilead.com.
Refer to Appendix 5 for Pregnancy Precautions, Definition for Female of Childbearing Potential, 
and Contraceptive Requirements.
7.7.2.2.
Reporting Other Special Situations
All other special situation reports must be reported on the special situations report form and 
forwarded to Gilead DSPH within 24 hours of the investigator becoming aware of the situation. 
These reports must consist of situations that involve study IMP and/or Gilead concomitant 
medications, but do not apply to non-Gilead concomitant medications. 


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Special situations involving non-Gilead concomitant medications does not need to be reported on 
the special situations report form; however, for special situations that result in AEs due to a 
non-Gilead concomitant medication, the AE should be reported on the AE form. 
Any inappropriate use of concomitant medications prohibited by this protocol should not be 
reported as “misuse,” but may be more appropriately documented as a protocol deviation.
Refer to Section 3 and the eCRF completion guidelines for full instructions on the mechanism of 
special situations reporting.
All clinical sequelae in relation to these special situation reports will be reported as AEs or SAEs 
at the same time using the AE eCRF and/or the SAE report form. Details of the symptoms and 
signs, clinical management, and outcome will be reported, when available.


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8. 
STATISTICAL CONSIDERATIONS 
8.1. 
Analysis Objectives and Endpoints 
8.1.1. 
Analysis Objectives 
The primaty objective is: 
Original 
• 
To evaluate the effect of GS-987 6 versus placebo for the treatment of signs and symptoms of 
RA in subjects with active RA as measured by change from baseline in DAS28 (CRP) at 
Week 12 
The secondaty objectives are: 
• 
To evaluate the safety and tolerability of GS-9876 in subjects with RA 
• 
To explore the effect of GS-9876 on other disease-specific outcomes in RA 
The exploratmy objectives are: 
IT 
I 
I 
8.1.2. 
Primary Endpoint 
The primaty endpoint is change from baseline in DAS28 (CRP) at Week 12. 
8.1.3. 
Secondary Endpoint 
The secondaty endpoints include: 
• 
The proportion of subjects who achieve ACR 20/50/70 at Week 12 
• 
Change from baseline in HAQ-DI score at Week 12 
8.1.4. 
Exploratory Endpoints 
PPD 
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8.2. 
8.2.1. 
8.2.1.1. 
Analysis Conventions 
Analysis Sets 
All Randomized 
Original 
The all randomized analysis set includes all subjects who are randomized in the study. This is the 
primary analysis set for by-subject listings. 
8.2.1.2. 
Efficacy 
The primary analysis set for efficacy analyses will be the Full Analysis Set (F AS), which 
includes all randomized subjects who received at least 1 dose of study drug. 
8.2.1.3. 
Safety 
The primary analysis set for safety analyses will be the Safety Analysis Set, which includes all 
subjects who received at least 1 dose of study drug. 
8.2.1.4. 
Pharmacokinetics 
8.2.1.4.1. 
PK Substudy Analysis Set 
The primary analysis set for intensive PK analyses will be the PK substudy analysis set, which 
includes all subjects in the Safety Analysis Set who have enrolled into the PK substudy, and have 
intensive PK concentration data to provide interpretable results for the specific parameters of 
interest for the analyte under evaluation. 
8.2.1.4.2. 
PK Analysis Set 
The primary analysis set for general PK analyses will be the PK analysis set, which includes all 
subjects in the Safety Analysis Set who have at least 1 non-missing PK concentration data for 
GS-9876 and/or its metabolite(s). 
8.3. 
Data Handling Conventions 
PK concentration values and PK parameter values below the limit of quantitation (BLQ) will be 
presented as "BLQ" in the data listings. BLQ values that occur prior to the first dose will be 
treated as 0, BLQ values at all other time points will be treated as 112 of the lower limit of 
quantitation (LLOQ). 
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Laboratory data that are continuous in nature but are less than the lower limit of quantitation or 
above the upper limit of quantitation will be imputed to the value of the lower or upper limit 
minus or plus one significant digit, respectively (eg, if the result of a continuous laboratory test is 
< 20, a value of 19 will be assigned; if the result of a continuous laboratory test is < 20.0, a value 
of 19.9 will be assigned).
8.4.
Demographic Data and Baseline Characteristics
Demographic and baseline characteristics will be summarized using standard descriptive 
methods including sample size, mean, SD, median, Q1, Q3, minimum, and maximum for 
continuous variables and frequency and percentages for categorical variables.
Demographic data will include sex, race, ethnicity, and age.
Baseline characteristics will include DAS28 (CRP), HAQ-DI, SDAI, and CDAI.
8.5.
Efficacy Analysis
The primary endpoint for the study is change from baseline in DAS28 (CRP) at Week 12, which 
will be analyzed using a mixed model repeated measures (MMRM) approach. The model may 
include the fixed effects of treatment, visit, treatment by visit interaction, and baseline value.  
Subjects will be included as a random effect. 
Secondary endpoints include proportion of subjects who achieve ACR20/50/70 at Week 12 and 
change from baseline in HAQ-DI score at Week 12. The ACR20/50/70 response rates between 
each of the 2 GS-9876 treated groups and the placebo group will be compared using a stratified 
Cochran-Mantel-Haenszel (CMH) Chi-square test adjusting for stratification factor in 
randomization.  The difference in response rates between treatment groups and the 
corresponding 95% confidence intervals will be presented. The difference in change from 
baseline in HAQ-DI between treatment groups will be analyzed using a similar MMRM 
approach.
Sensitivity analyses may be performed for the efficacy assessment.
Details on efficacy analyses will be described in the statistical analysis plan.
8.6.
Safety Analysis
All safety analyses will be performed using the safety analysis set.
Safety will be evaluated by assessment of clinical laboratory tests, physical examinations, vital 
signs measurements at various time points during the study, and by the documentation of AEs.
All safety data collected on or after the first dose of study drug administration up to 30 days after 
the last dose of study drug, unless specified otherwise, will be summarized by treatment group 
according to the study drug received.


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8.6.1.
Extent of Exposure
A subject’s extent of exposure to study drug will be generated from the study drug
administration page of the eCRF. Exposure data will be summarized by treatment group.
Duration of exposure to study drug will be expressed as the number of weeks between the first 
and last dose of the study drug, inclusive, regardless of temporary interruptions in study drug 
administration and summarized by treatment group.
8.6.2.
Adverse Events
Clinical and laboratory adverse events will be coded using the Medical Dictionary for 
Regulatory Activities (MedDRA). System Organ Class (SOC), High-Level Group Term 
(HLGT), High-Level Term (HLT), Preferred Term (PT), and Lower-Level Term (LLT) will be 
attached to the clinical database.
Treatment-emergent adverse events (TEAEs) are defined as one or both of the following:

Any AEs with an onset date on or after the study drug start date and no later than 30 days 
after permanent discontinuation of study drug.

Any AEs leading to premature discontinuation of study drug.
Summaries (number and percentage of subjects) of TEAEs by SOC and PT will be provided. 
Treatment-emergent AEs will also be summarized by relationship to study drug and severity. In 
addition, TEAEs leading to premature discontinuation of study drug and study will be 
summarized and listed.
8.6.3.
Laboratory Evaluations
Selected laboratory data will be summarized (n, mean, SD, median, Q1, Q3, minimum, and 
maximum) by treatment group. Absolute values and change from baseline at all scheduled 
timepoints will be summarized.
Graded laboratory abnormalities will be defined using CTCAE 4.03 grading scale (Appendix 4).
Incidence of treatment-emergent laboratory abnormalities, defined as values that increase at least
one toxicity grade from baseline at any time post baseline up to the date of last dose of study 
drug plus 30 days, will be summarized by treatment.
8.6.4.
Other Safety Evaluations
Individual data for physical examination findings, prior and concomitant medications and 
medical history will be provided. Twelve-lead ECGs and vital signs will be listed by subject or 
summarized by descriptive statistics as appropriate.


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8.7. 
Pharmacokinetic Analysis 
Original 
Plasma concentrations of GS-9876 will be listed and smmnarized using descriptive statistics 
( eg, sample size, arithmetic mean, geometric mean, % coefficient of variation, standard 
deviation, median, minimum, and maximum). 
PD 
Plasma concentrations ofGS-9876 metabolite(s) and/or MTX may also be detennined and 
analyzed. 
8.8. 
Biomarker Analysis 
PD 
8.9. 
Data Monitoring Committee 
An extemal multidisciplinruy DMC will review the progress of the study and perf01m interim 
reviews of safety data in order to protect subject welfare and preserve study integrity. The DMC 
is to recommend to the sponsor whether the nature, frequency, and severity of adverse effects 
associated with treatment watTant the eru·ly termination of the study, whether the study should 
continue as planned, or the study should continue with modifications. 
DMC will review unblinded safety data. The initial DMC review will be conducted after the 
21st subject in the study has been treated for 4 weeks. Unblinded safety data will be reviewed 
quarterly thereaft.er. 
The DMC will provide recommendations as needed regarding study design, conduct and the 
need for additional meetings or an altemative meeting schedule. While the DMC will be asked to 
advise Gilead regarding future conduct of the study, including possible early study tennination, 
Gilead retains fmal decision-making authority on all aspects of the study. 
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8.10.
Sample Size
Sample size is determined based on the superiority test of one dose of GS-9876 compared to 
placebo based on the change from baseline in DAS28 (CRP) at Week 12. When assuming a 
difference of 1.2 between the two groups and a common standard deviation of 1.35, 20 subjects 
in each of the GS-9876 groups and 20 in the placebo group are required to obtain 78 percent 
power at a 2-sided 0.05-level. Therefore, the total sample size will be 60 (20 per treatment 
group).


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9.
RESPONSIBILITIES
9.1.
Investigator Responsibilities
9.1.1.
Good Clinical Practice
The investigator will ensure that this study is conducted in accordance with the principles of the 
Declaration of Helsinki (as amended in Edinburgh, Tokyo, Venice, Hong Kong, and 
South Africa), International Conference on Harmonisation (ICH) guidelines, or with the laws and 
regulations of the country in which the research is conducted, whichever affords the greater 
protection to the study subject. These standards are consistent with the EU Clinical Trials 
Directive 2001/20/EC and Good Clinical Practice Directive 2005/28/EC.
The investigator will ensure adherence to the basic principles of Good Clinical Practice, as 
outlined in 21 Code of Federal Regulations (CFR) 312, subpart D, “Responsibilities of Sponsors 
and Investigators,” 21 CFR, part 50, 1998, and 21 CFR, part 56, 1998.
The investigator and all applicable sub-investigators will comply with 21 CFR, Part 54, 1998, 
providing documentation of their financial interest or arrangements with Gilead, or proprietary 
interests in the investigational drug under study. This documentation must be provided prior to 
the investigator’s (and any sub-investigator’s) participation in the study. The investigator and 
sub-investigator agree to notify Gilead of any change in reportable interests during the study and 
for 1 year following completion of the study. Study completion is defined as the date when the 
last subject completes the protocol-defined activities.
9.1.2.
Institutional Review Board (IRB)/Independent Ethics Committee (IEC) 
Review and Approval
The investigator (or sponsor as appropriate according to local regulations) will submit this 
protocol, informed consent form, and any accompanying material to be provided to the subject 
(such as advertisements, subject information sheets, or descriptions of the study used to obtain 
informed consent) to an IRB/IEC. The investigator will not begin any study subject activities 
until approval from the IRB/IEC has been documented and provided as a letter to the 
investigator.
Before implementation, the investigator will submit to and receive documented approval from 
the IRB/IEC any modifications made to the protocol or any accompanying material to be 
provided to the subject after initial IRB/IEC approval, with the exception of those necessary to 
reduce immediate risk to study subjects.
9.1.3.
Informed Consent
The investigator is responsible for obtaining written informed consent from each individual 
participating in this study after adequate explanation of the aims, methods, objectives, and 
potential hazards of the study and before undertaking any study-related procedures. The 


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investigator must use the most current IRB/IEC approved consent form for documenting written 
informed consent. Each informed consent (or assent as applicable) will be appropriately signed 
and dated by the subject or the subject’s legally authorized representative and the person 
conducting the consent discussion, and also by an impartial witness if required by IRB/IEC or
local requirements. The consent form will inform subjects about pharmacogenomics testing and 
sample retention, and their right to receive clinically relevant pharmacogenomics analysis 
results.
9.1.4.
Confidentiality
The investigator must assure that subjects’ anonymity will be strictly maintained and that their 
identities are protected from unauthorized parties. Only subject initials, date of birth, another 
unique identifier (as allowed by local law), and an identification code will be recorded on any 
form or biological sample submitted to the Sponsor, IRB/IEC, or laboratory. Laboratory 
specimens must be labeled in such a way as to protect subject identity while allowing the results 
to be recorded to the proper subject. Refer to specific laboratory instructions. NOTE: The 
investigator must keep a screening log showing codes, names, and addresses for all subjects 
screened and for all subjects enrolled in the trial. Subject data will be processed in accordance 
with all applicable regulations. 
The investigator agrees that all information received from Gilead, including but not limited to the 
investigator brochure, this protocol, eCRF, the IMP, and any other study information, remain the 
sole and exclusive property of Gilead during the conduct of the study and thereafter. This 
information is not to be disclosed to any third party (except employees or agents directly 
involved in the conduct of the study or as required by law) without prior written consent from
Gilead. The investigator further agrees to take all reasonable precautions to prevent the 
disclosure by any employee or agent of the study site to any third party or otherwise into the 
public domain.
9.1.5.
Study Files and Retention of Records
The investigator must maintain adequate and accurate records to enable the conduct of the study 
to be fully documented and the study data to be subsequently verified. These documents should 
be classified into at least the following two categories: (1) investigator’s study file, and 
(2) subject clinical source documents.
The investigator’s study file will contain the protocol/amendments, eCRF and query forms, IRB 
/IEC and governmental approval with correspondence, informed consent, drug records, staff 
curriculum vitae and authorization forms, and other appropriate documents and correspondence.
The required source data should include sequential notes containing at least the following 
information for each subject:

Subject identification (name, date of birth, gender);


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
Documentation that subject meets eligibility criteria, ie, history, physical examination, and 
confirmation of diagnosis (to support inclusion and exclusion criteria);

Documentation of the reason(s) a consented subject is not enrolled

Participation in study (including study number);

Study discussed and date of informed consent;

Dates of all visits;

Documentation that protocol specific procedures were performed;

Results of efficacy parameters, as required by the protocol;

Start and end date (including dose regimen) of IMP, including dates of dispensing and return;

Record of all adverse events and other safety parameters (start and end date, and including 
causality and severity);

Concomitant medication (including start and end date, dose if relevant; dose changes);

Date of study completion and reason for early discontinuation, if it occurs.
All clinical study documents must be retained by the investigator until at least 2 years or 
according to local laws, whichever is longer, after the last approval of a marketing application in 
an ICH region (ie, United States, Europe, or Japan) and until there are no pending or planned 
marketing applications in an ICH region; or, if no application is filed or if the application is not 
approved for such indication, until 2 years after the investigation is discontinued and regulatory 
authorities have been notified. Investigators may be required to retain documents longer if 
specified by regulatory requirements, by local regulations, or by an agreement with Gilead. The 
investigator must notify Gilead before destroying any clinical study records.
Should the investigator wish to assign the study records to another party or move them to another 
location, Gilead must be notified in advance.
If the investigator cannot provide for this archiving requirement at the study site for any or all of 
the documents, special arrangements must be made between the investigator and Gilead to store 
these records securely away from the site so that they can be returned sealed to the investigator 
in case of an inspection. When source documents are required for the continued care of the 
subject, appropriate copies should be made for storage away from the site.
9.1.6.
Case Report Forms
For each subject consented, an eCRF will be completed by an authorized study staff member 
whose training for this function is documented according to study procedures. Electronic CRFs


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should be completed on the day of the subject visit to enable the sponsor to perform central 
monitoring of safety data.  The Eligibility Criteria eCRF should be completed only after all data 
related to eligibility have been received.  Subsequent to data entry, a study monitor will perform 
source data verification within the electronic data capture (EDC) system. Original entries as well 
as any changes to data fields will be stored in the audit trail of the system.  Prior to database lock 
(or any interim timepoints as described in the clinical data management plan), the investigator 
will use his/her log in credentials to confirm that the forms have been reviewed, and that the 
entries accurately reflect the information in the source documents. The eCRF captures the data 
required per the protocol schedule of events and procedures. System-generated or manual 
queries will be issued to the investigative site staff as data discrepancies are identified by the 
monitor or internal Gilead staff, who routinely review the data for completeness, correctness, and 
consistency. The site coordinator is responsible for responding to the queries in a timely manner, 
within the system, either by confirming the data as correct or updating the original entry, and 
providing the reason for the update (eg, data entry error). At the conclusion of the trial, Gilead 
will provide the site with a read-only archive copy of the data entered by that site. This archive 
must be stored in accordance with the records retention requirements outlined in Section 9.1.5.
9.1.7.
Investigational Medicinal Product Accountability and Return
Where possible, IMP should be destroyed at the site. At the start of the study, the study monitor 
will evaluate each study center’s IMP disposal procedures and provide appropriate instruction for 
disposal or return of unused IMP supplies. If the site has an appropriate standard operating 
procedure (SOP) for drug destruction as determined by Gilead Sciences, the site may destroy 
used (empty or partially empty) and unused IMP supplies as long as performed in accordance 
with the site’s SOP. This can occur only after the study monitor has performed drug 
accountability during an on-site monitoring visit. 
A copy of the site’s IMP Disposal SOP or written procedure (signed and dated by the PI 
or designee) will be obtained for Gilead site files. If the site does not have acceptable 
procedures in place, arrangements will be made between the site and Gilead Sciences 
(or Gilead Sciences’ representative) for return of unused study drug supplies. 
If IMP is destroyed on site, the investigator must maintain accurate records for all IMPs
destroyed. Upon study completion, copies of the IMP accountability records must be filed at the 
site. Another copy will be returned to Gilead.
The study monitor will review IMP supplies and associated records at periodic intervals.
9.1.8.
Inspections
The investigator will make available all source documents and other records for this trial to 
Gilead’s appointed study monitors, to IRBs or IECs, or to regulatory authority or health authority 
inspectors.


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9.1.9.
Protocol Compliance
The investigator is responsible for ensuring the study is conducted in accordance with the 
procedures and evaluations described in this protocol.
9.2.
Sponsor Responsibilities
9.2.1.
Protocol Modifications
Protocol modifications, except those intended to reduce immediate risk to study subjects, may be 
made only by Gilead. The investigator must submit all protocol modifications to the IRB/IEC in 
accordance with local requirements and receive documented IRB/IEC approval before 
modifications can be implemented.
9.2.2.
Study Report and Publications
A clinical study report (CSR) will be prepared and provided to applicable regulatory agencies.
Gilead will ensure that the report meets the standards set out in the ICH Guideline for Structure 
and Content of Clinical Study Reports (ICH E3). Note that an abbreviated report may be 
prepared in certain cases.
Investigators in this study may communicate, orally present, or publish in scientific journals or 
other scholarly media only after the following conditions have been met:
The results of the study in their entirety have been publicly disclosed by or with the consent of 
Gilead in an abstract, manuscript, or presentation form or the study has been completed at all 
study sites for at least 2 years
The investigator will submit to Gilead any proposed publication or presentation along with the 
respective scientific journal or presentation forum at least 30 days before submission of the 
publication or presentation. 
No such communication, presentation, or publication will include Gilead’s confidential 
information (see Section 9.1.4).
The investigator will comply with Gilead’s request to delete references to its confidential 
information (other than the study results) in any paper or presentation and agrees to withhold 
publication or presentation for an additional 60 days in order to obtain patent protection if 
deemed necessary.
9.3.
Joint Investigator/Sponsor Responsibilities
9.3.1.
Payment Reporting
Investigators and their study staff may be asked to provide services performed under this 
protocol, eg, attendance at Investigator's Meetings.  If required under the applicable statutory and 
regulatory requirements, Gilead will capture and disclose to Federal and State agencies any 
expenses paid or reimbursed for such services, including any clinical trial payments, meal, travel 
expenses or reimbursements, consulting fees, and any other transfer of value.


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9.3.2.
Access to Information for Monitoring
In accordance with regulations and guidelines, the study monitor must have direct access to the 
investigator’s source documentation in order to verify the accuracy of the data recorded in the 
eCRF.
The monitor is responsible for routine review of the eCRF at regular intervals throughout the 
study to verify adherence to the protocol and the completeness, consistency, and accuracy of the 
data being entered on them. The monitor should have access to any subject records needed to 
verify the entries on the eCRF. The investigator agrees to cooperate with the monitor to ensure 
that any problems detected through any type of monitoring (central, on site) are resolved.
9.3.3.
Access to Information for Auditing or Inspections
Representatives of regulatory authorities or of Gilead may conduct inspections or audits of the 
clinical study. If the investigator is notified of an inspection by a regulatory authority the 
investigator agrees to notify the Gilead medical monitor immediately. The investigator agrees to 
provide to representatives of a regulatory agency or Gilead access to records, facilities, and 
personnel for the effective conduct of any inspection or audit.
9.3.4.
Study Discontinuation
Both the sponsor and the investigator reserve the right to terminate the study at any time. Should 
this be necessary, both parties will arrange discontinuation procedures and notify the appropriate 
regulatory authority(ies), IRBs, and IECs. In terminating the study, Gilead and the investigator 
will assure that adequate consideration is given to the protection of the subjects’ interests.


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10.
REFERENCES
Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO, 3rd, et al. 2010 
Rheumatoid arthritis classification criteria: an American College of 
Rheumatology/European League Against Rheumatism collaborative initiative. 
Arthritis Rheum 2010;62 (9):2569-81.
Arthritis Foundation. Rheumatoid Arthritis Fact Sheet.  2008.
Braselmann S, Taylor V, Zhao H, Wang S, Sylvain C, Baluom M, et al. R406, an orally available 
spleen tyrosine kinase inhibitor blocks fc receptor signaling and reduces immune 
complex-mediated inflammation. J Pharmacol Exp Ther 2006;319 (3):998-1008.
Cha HS, Boyle DL, Inoue T, Schoot R, Tak PP, Pine P, et al. A novel spleen tyrosine kinase 
inhibitor blocks c-Jun N-terminal kinase-mediated gene expression in 
synoviocytes. J Pharmacol Exp Ther 2006;317 (2):571-8.
Coffey G, DeGuzman F, Inagaki M, Pak Y, Delaney SM, Ives D, et al. Specific inhibition of 
spleen tyrosine kinase suppresses leukocyte immune function and inflammation in 
animal models of rheumatoid arthritis. J Pharmacol Exp Ther 2012;340 (2):350-9.
Felson DT, Anderson JJ, Boers M, Bombardier C, Furst D, Goldsmith C, et al. American College 
of Rheumatology. Preliminary definition of improvement in rheumatoid arthritis. 
Arthritis Rheum 1995;38 (6):727-35.
Helmick CG, Felson DT, Lawrence RC, Gabriel S, Hirsch R, Kwoh CK, et al. Estimates of the 
prevalence of arthritis and other rheumatic conditions in the United States. Part I. 
Arthritis Rheum 2008;58 (1):15-25.
Leandro MJ, Cambridge G, Ehrenstein MR, Edwards JC. Reconstitution of peripheral blood B 
cells after depletion with rituximab in patients with rheumatoid arthritis. Arthritis 
Rheum 2006;54 (2):613-20.
Liao C, Hsu J, Kim Y, Hu DQ, Xu D, Zhang J, et al. Selective inhibition of spleen tyrosine 
kinase (SYK) with a novel orally bioavailable small molecule inhibitor, RO9021, 
impinges on various innate and adaptive immune responses: implications for SYK 
inhibitors in autoimmune disease therapy. Arthritis research & therapy 2013;15 
(5):R146.
Martin F, Chan AC. B cell immunobiology in disease: evolving concepts from the clinic. Annu 
Rev Immunol 2006;24:467-96.
Navarro-Millan I, Curtis JR. Newest clinical trial results with antitumor necrosis factor and 
nonantitumor necrosis factor biologics for rheumatoid arthritis. Current opinion in 
rheumatology 2013;25 (3):384-90.


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Pine PR, Chang B, Schoettler N, Banquerigo ML, Wang S, Lau A, et al. Inflammation and bone 
erosion are suppressed in models of rheumatoid arthritis following treatment with 
a novel Syk inhibitor. Clin Immunol 2007;124 (3):244-57.
Prevoo ML, van 't Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL. 
Modified disease activity scores that include twenty-eight-joint counts. 
Development and validation in a prospective longitudinal study of patients with 
rheumatoid arthritis. Arthritis Rheum 1995;38 (1):44-8.
Shlomchik MJ. Sites and stages of autoreactive B cell activation and regulation. Immunity 
2008;28 (1):18-28.
Song YW, Kang EH. Autoantibodies in rheumatoid arthritis: rheumatoid factors and 
anticitrullinated protein antibodies. QJM 2010;103 (3):139-46.


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11.
APPENDICES
Appendix 1.
Investigator Signature Page
Appendix 2.
Study Procedures Tables
Appendix 3.
Laboratory Assessments Table
Appendix 4.
Common Terminology Criteria for Adverse Events (CTCAE) v4.03
Appendix 5.
Pregnancy Precautions, Definition for Female of Childbearing Potential, and 
Contraceptive Requirements
Appendix 6.
The 2010 American College of Rheumatology –European League Against 
Rheumatism Collaborative Initiative Classification Criteria for Rheumatoid 
Arthritis {Aletaha et al 2010}
Appendix 7.
American College of Rheumatology Response Evaluations/ Preliminary Definition 
of Improvement in Rheumatoid Arthritis {Felson et al 1995}
Appendix 8.
Disease Activity Score for 28 Joint Count (DAS28) {Prevoo et al 1995}
Appendix 9.
Procedures and Specifications


GS-9876 
Protocol GS-US-379-1582 
Gilead Sciences, Inc. 
Appendix 1. 
Original 
Investigator Signature Page 
GILEAD SCIENCES, INC. 
STUDY ACKNOWLEDGEMENT 
A Randomized, Double-Blind, Placebo-Controlled, Multicenter, Proof-of-Concept Study to 
Evaluate Safety, Tolerability, and Efficacy of GS-9876 in Subjects with Active Rheumatoid 
Arthritis on Background Therapy with Methotrexate 
GS-US-379-1582, Original Protocol, 08 April2016 
~!sa~;~:~ has been approved by Gilead Scien ~p
unc_Ilp
l~folJ.outD
ina Ri.QU::tture documents 
Franziska Matzkies, MD 
Medical Monitor Name (Printed) 
~plr,Q - Ill - 2iJ I c 
Date 
INVESTIGATOR STATEMENT 
I have read the protocol, including all appendices, and I agree that it contains all necessary 
details for me and my staff to conduct this study as described. I will conduct this study as 
outlined herein and will make a reasonable effort to complete the study within the time 
designated. 
I will provide all study personnel under my supervision copies of the protocol and access to all 
information provided by Gilead Sciences, Inc. I will discuss this material with them to ensure 
that they are fully informed about the drugs and the study. 
Principal Investigator Name (Printed) 
Signature 
Date 
Site Number 
CONFIDENTIAL 
Page 72 
08 April2016 


GS-9876 
Protocol GS-US-379-1582 
Gilead Sciences, Inc. 
Appendix 2. 
Study Procedures Tables 
Visit 
Screeninga 
Window in Days 
-28 
Written Infonned Consent for Main Study 
X 
lPPD 
I 
X 
Medical History d 
X 
Physical Examination e 
X 
Vital Signs f 
X 
12-LeadECG 
X 
66 swollen and 68 tender joint count assessment h 
X 
Hematology, chemistry and coagulation h,i,j 
X 
CRPh,i,i 
X 
Serum or Urine Pregnancy Test h,i,j,k 
X 
Biomarkers h,j,I 
X 
RNA Sample h, i,i 
X 
Leukocyte subsets h, i,j 
X 
Serology i 
X 
Urinalysis and Urine Drug Screen i 
X 
Quantiferon i, m 
X 
CD19 Count i,m 
X 
Randomization 
Disease-specific questionnaires and activity scores h, n 
CONFIDENTIAL 
Dayl 
X 
X 
xg 
X 
X 
X 
X 
X 
X 
X 
X 
X 
Page 73 
Original 
4-weeks Post-
Treatment 
Week2 
Week4 
WeekS 
Week12 
ETb 
Follow-Up< 
±3 
±3 
±3 
±3 
±3 
±5 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
X 
08 April 2016 


GS-9876 
Protocol GS-US-379-1582 
Gilead Sciences, Inc. 
Visit 
Screeninga 
Dayl 
Week2 
Week4 
Week8 
Window in Days 
-28 
±3 
±3 
±3 
RF /CCP h, i, i 
X 
h .. 
IgA, IgG, and IgM ''· J 
X 
-~ 
X 
PK SamplesP 
X 
X 
X 
-
rr 
X 
Study Drug Dispensation 
X 
X 
X 
Study Drug Administration (In-Clinic) r 
X 
X 
X 
X 
Adverse Events' 
Continuous 
Concomitant Medications 1 
Continuous 
a 
Prospective subjects should be screened no more than 28 days prior to administration of the first dose of study drug. 
b 
Early Termination assessments should be performed within 72 hours of early termination from the study. 
c 
28 (±5) days after the last administration of study drug, all subjects will return for an in-clinic follow-up visit. 
Week12 
±3 
X 
X 
X 
X 
d 
Medical history, including but not limited to, RA, prior RA medication history, and any personal or family histories of bleeding disorders 
Original 
4-weeks Post-
Treatment 
ETb 
Follow-Upc 
±3 
±5 
X 
X 
X 
e 
Screening visit includes complete PEas outlined in Appendix 9. All other PEs are symptom driven. A symptom driven PE should be performed after Screening when a 
subject reports a new symptom or a worsening symptom at a study visit. If a subject reports no change in symptoms, then noPE is necessary. 
f 
Vital signs include resting blood pressure, pulse, respiration rate, temperature (obtained orally), height and weight. Height and weight will be collected at Screening only. 
g 
Conduct Day 1 ECG predose (prior to study drug administration). 
h 
At Day 1 and Week 12 visits, the HAQ-DI, Patient's Assessment of Pain, and Patient's Global Assessment of Disease Activity are recommended to be done prior to the 66 
swollen and 68 tender joint count assessments and before any invasive study procedures. Blood draws should be done at the end of the study visit. 
Refer to Appendix 3 for complete laboratory assessments. 
J 
Samples to be collected prior to dosing, except at Week 4 visit. 
k 
At Screening, a serum pregnancy test will be collected. At all other visits, a urine pregnancy test will be collected. If a urine pregnancy test is positive, a serum pregnancy test 
will also be collected. 
Samples will be collected at Day 1, Week 4, and Week 12 or ET visits for exploratory disease and/or pathway markers relevant to rheumatoid arthritis. Sampling timepoints 
and assessments may be modified during the study based on assay availability and/or emerging data. 
m 
As needed per exclusion criteria (refer to Section 4.3) 
n 
Disease-specific questionnaires and activity scales include the HAQ-DI, Patient's Assessment of Pain, Patient's Global Assessment of Disease Activity, and Physician's 
Global Assessment of Disease Activi!Y:..;.·----------------------------------. 
0 
I PD 
CONFIDENTIAL 
Page 74 
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Original 
p 
PK samples will be collected prior to study drug administration (pre·-dose at Weeks 2, 8, and 12 or ET. At Week 4, PK samples will be collected 2 hours ost dose. 
q 
PPD 
r 
On Day 1, study diug adnumstratiOii'"(iil-Clilli.Cj"ShOUid betile"Iast study procedw·e pet'lonued. On Week 4, study dmg administJ·ation (in-clinic) should be the first study 
procedtu-e perfom1ed (with the exception of predose PK for[PPD 
I subjects only). At all other tJ·eatJuent visits, study drug administJ·ation should occur after 
predose assessments are completed. 
s 
After infonued consent, but prior to initiation of study medication, all SAEs and adverse events related to protocol-mandated procedw·es shall be collected. Following 
initiation of study medication, all SAEs and all AEs, regardless of cause or relationship, shall be collected. Refer to Section 7.3 for more detail. 
At Screening, all medication taken up to 30 days prior to the Screening visit will be recorded on the eCRF. 
CONFIDENTIAL 
Page 75 
08 April2016 


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Appendix 3.
Laboratory Assessments Table
Hematology
Chemistry
Urinalysis
Other
Hematocrit
Hemoglobin
Platelet count
Red blood cell (RBC) 
count
White blood cell (WBC) 
count
Differentials (absolute 
and percentage), 
including:
Leukocytes
Monocytes
Neutrophils
Eosinophils
Basophils
Reticulyte count
Mean corpuscular 
volume (MCV)
Alkaline phosphatase
Aspartate aminotransferase
(AST)
Alanine aminotransferase
(ALT)
Total bilirubin
Direct and indirect 
bilirubin
Total protein
Albumin
Bicarbonate
Blood urea nitrogen 
(BUN)
Calcium
Chloride
Serum creatinine
Glucose
Phosphorus
Magnesium
Potassium
Sodium
Amylase
Lipase 
Appearance
Blood
Color
Glucose
Leukocyte esterase
pH
Protein
Urobilinogen
Reflex to microscopic 
urinalysis if dipstick result 
is abnormal.
Urine drug screen for:
Amphetamines
Cocaine
Methadone
Opiates
Leukocyte subsets
IgA, IgG, IgM
C-reactive protein (CRP)
Rheumatoid factor and cyclic 
citrullinated peptide (RF/CCP)
Quantiferon (if required per 
exclusion criteria)
CD19 (if required per 
exclusion criteria)
RNA
Coagulation
Serology
Pregnancy
Activated partial 
thromboplastin time 
(aPTT)
Prothrombin time (PT)
International normalized 
ratio (INR)
Hepatitis BsAg and core 
Ab 
Hepatitis C Ab
HIV
In females of childbearing 
potential:
Serum β-hCG (Screening and 
if positive urine β-hCG)
Urine β-hCG (all other visits)
Ab = antibody
β-hCG = beta-human chorionic gonadotropin
BsAg = B surface antigen
IgA, IgG, IgM = immunoglobulins A, G, M


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Appendix 4.
Common Terminology Criteria for Adverse Events (CTCAE) v4.03
CTCAE v4.03 can be accessed from the below link:
http://evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4.03_2010-06-14_QuickReference_8.5x11.pdf
The only modification to the CTCAE criteria is the addition of a Grade 1 upper respiratory 
infection as follows:
CTCAE 
v4.0 Term
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
CTCAE v4.03 
AE Term 
Definition
Upper 
respiratory 
infection
Mild 
symptoms; 
symptomatic 
relief (eg, 
cough 
suppressant, 
decongestant)
Moderate 
symptoms; 
oral 
intervention 
indicated 
(eg, antibiotic, 
antifungal, 
antiviral)
IV antibiotic, 
antifungal, or 
antiviral 
intervention 
indicated; 
radiologic, 
endoscopic, or 
operative 
intervention 
indicated
Life-
threatening 
consequences; 
urgent 
intervention 
indicated
Death
A disorder 
characterized by 
an infectious 
process involving 
the upper 
respiratory tract 
(nose, paranasal 
sinuses, pharynx, 
larynx, or 
trachea).


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Appendix 5.
Pregnancy Precautions, Definition for Female of Childbearing 
Potential, and Contraceptive Requirements
1) Definitions
a) Definition of Childbearing Potential
For the purposes of this study, a female born subject is considered of childbearing potential 
following the initiation of puberty (Tanner stage 2) until becoming post-menopausal, unless 
permanently sterile or with medically documented ovarian failure.  
Women are considered to be in a postmenopausal state when they are > 54 years of age with 
cessation of previously occurring menses for > 12 months without an alternative cause.  
Permanent sterilization includes hysterectomy, bilateral oophorectomy, or bilateral 
salpingectomy in a female subject of any age.
b) Definition of Male Fertility
For the purposes of this study, a male born subject is considered fertile after the initiation of 
puberty unless permanently sterile by bilateral orchidectomy or medical documentation.
2) Contraception Requirements for Female Subjects
a) Study Drug Effects on Pregnancy and Hormonal Contraception
GS-9876 is contraindicated in pregnancy as its teratogenicity/fetotoxicity profile is unknown. 
GS-9876 has insufficient data to exclude the possibility of a clinically relevant interaction with 
hormonal contraception that results in reduced contraception efficacy.  Therefore, contraceptive 
steroids are not recommended as a contraceptive method either solely or as a part of a 
contraceptive regimen. Subjects may remain on their hormonal contraception if they prefer to do 
so, but will still be required to choose from contraceptive methods delineated below as the 
efficacy of their hormonal contraception during study dosing is unknown. 
Please refer to the latest version of the investigator’s brochure for additional information.
b) Contraceptive Methods Permitted for Female Subjects of Childbearing Potential
The inclusion of female subjects of childbearing potential requires the use of highly effective
contraceptive measures.  Women must also not rely on hormone-containing contraceptives as a 
form of birth control during the study, though they may continue hormonal contraception if they 
prefer to do so.  Women must have a negative serum pregnancy test at Screening and a negative 
pregnancy test on the Day 1 visit prior to first dose of study drug.  Pregnancy tests will be 
performed as defined by the schedule of assessments (Appendix 2).
Female subjects of childbearing potential must agree to one of the following from Screening 
until 30 days following the last dose of study drug.

Complete abstinence from intercourse of reproductive potential.  Abstinence is an acceptable 
method of contraception only when it is in line with the subject’s preferred and usual 
lifestyle.


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Or

Consistent and correct use of 1 of the following methods of birth control listed below. 
Intrauterine device (IUD) with a failure rate of <1% per year
Tubal sterilization
Essure micro-insert system (provided confirmation of success 3 months after procedure)
Vasectomy in the male partner (provided that the partner is the sole sexual partner and 
had confirmation of surgical success 3 months after procedure)
Female subjects must also refrain from egg donation and in vitro fertilization during treatment 
and until at least 30 days after the last dose of study drug.
3) Contraception Requirements for Male Subjects
It is theoretically possible that a relevant systemic concentration may be achieved in a female 
partner from exposure of the male subject’s seminal fluid.  Therefore, male subjects with female 
partners of childbearing potential must use condoms during treatment and until 90 days after the 
last dose of study drug.  Additional contraception recommendations should also be considered if 
the female partner is of childbearing potential.
Male subjects must also refrain from sperm donation during treatment and until at least 90 days 
after the last dose of study drug
4) Unacceptable Birth Control Methods
Birth control methods that are unacceptable include periodic abstinence (eg, calendar, ovulation, 
symptothermal, post-ovulation methods), withdrawal (coitus interruptus), spermicides only, and 
lactational amenorrhea method (LAM).  Female condom and male condom should not be used 
together.
5) Procedures to be Followed in the Event of Pregnancy
Subjects will be instructed to notify the investigator if they become pregnant at any time during 
the study, or if they become pregnant within 30 days of last study drug dose. Subjects who 
become pregnant or who suspect that they are pregnant during the study must report the 
information to the investigator and discontinue study drug immediately. Subjects whose partner 
has become pregnant or suspects she is pregnant during the study must report the information to 
the investigator.  Instructions for reporting pregnancy, partner pregnancy, and pregnancy 
outcome are outlined in Section 7.7.2.1.


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Appendix 6.
The 2010 American College of Rheumatology –European League
Against Rheumatism Collaborative Initiative Classification Criteria 
for Rheumatoid Arthritis {Aletaha et al 2010}
Target population (Who should be tested?): Patients who have at least 1 joint with 
definite clinical synovitis (swelling)a with the synovitis not better explained by 
another diseaseb
Classification criteria for RA (score-based algorithm: add score of categories A - D;
a score of ≥6/10 is needed for classification of a patient as having definite RA)c
A. Joint involvementd
1 large jointe
0
2-10 large joints
1
1-3 small joints (with or without involvement of large joints)f
2
4-10 small joints (with or without involvement of large joints)
3
>10 joints (at least 1 small joint)g
5
B. Serology (at least 1 test result is needed for classification)h
Negative RF and negative ACPA
0
Low-positive RF or low-positive ACPA
2
High-positive RF or high-positive ACPA
3
C. Acute-phase reactants (at least 1 test result is needed for classification)i
Normal CRP and normal ESR
0
Abnormal CRP or abnormal ESR
1
D. Duration of symptomsj
<6 weeks
0
≥6 weeks
1
a
The criteria are aimed at classification of newly presenting patients. In addition, patients with erosive disease typical of 
rheumatoid arthritis (RA) with a history compatible with prior fulfillment of the 2010 criteria should be classified as having 
RA. Patients with longstanding disease, including those whose disease is inactive (with or without treatment) who, based on 
retrospectively available data, have previously fulfilled the 2010 criteria should be classified as having RA.
b
Differential diagnoses vary among patients with different presentations, but may include conditions such as systemic lupus 
erythematosus, psoriatic arthritis, and gout. If it is unclear about the relevant differential diagnoses to consider, an expert 
rheumatologist should be consulted.
c
Although patients with a score of <6/10 are not classifiable as having RA, their status can be reassessed and the criteria 
might be fulfilled cumulatively over time.
d
Joint involvement refers to any swollen or tender joint on examination, which may be confirmed by imaging evidence of 
synovitis. Distal interphalangeal joints, first carpometacarpal joints, and first metatarsophalangeal joints are excluded from 
assessment. Categories of joint distribution are classified according to the location and number of involved joints, with 
placement into the highest category possible based on the pattern of joint involvement.
e
"Large joints" refers to shoulders, elbows, hips, knees, and ankles.
f
"Small joints" refers to the metacarpophalangeal joints, proximal interphalangeal joints, second through 
fifth metatarsophalangeal joints, thumb interphalangeal joints, and wrists.
g
In this category, at least 1 of the involved joints must be a small joint; the other joints can include any combination of large 
and additional small joints, as well as other joints not specifically listed elsewhere (eg, temporomandibular, 
acromioclavicular, sternoclavicular).


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h
Negative refers to IU values that are less than or equal to the ULN for the laboratory and assay; low-positive refers to IU 
values that are higher than the ULN but ≤3 times the ULN for the laboratory and assay; high-positive refers to IU values that 
are >3 times the ULN for the laboratory and assay. Where rheumatoid factor (RF) information is only available as positive 
or negative, a positive result should be scored as low-positive for RF. ACPA = anti-citrullinated protein antibody.
i
Normal/abnormal is determined by local laboratory standards. CRP = C-reactive protein; ESR = erythrocyte sedimentation 
rate.
j
Duration of symptoms refers to patient self-report of the duration of signs or symptoms of synovitis (eg, pain, swelling, 
tenderness) of joints that are clinically involved at the time of assessment, regardless of treatment status.


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Appendix 7.
American College of Rheumatology Response Evaluations/ 
Preliminary Definition of Improvement in Rheumatoid Arthritis 
{Felson et al 1995}
ACR 20/50/70 Requires
≥20%/50%/70% improvement in tender joint count, AND
≥20%/50%/70% improvement in swollen joint count, AND
≥20%/50%/70% improvement in at least 3 of the following 5:

Patient’s Assessment of Pain

Patient’s Global Assessment of Disease Activity

Physician’s Global Assessment of Disease Activity

Patient’s assessment of physical  function (HAQ-DI)

Acute-phase reactant (CRP)
The following lists the disease activity measure followed by the method of assessment
1.
Tender joint count
ACR tender joint count is an assessment of 68. The joint count should be done by scoring several 
different aspects of tenderness, as assessed by pressure and joint manipulation on physical 
examination. The information on various types of tenderness should then be collapsed into a 
single tender-versus-nontender dichotomy.
2.
Swollen joint count
ACR swollen joint count is an assessment of 66. Joints are classified as either swollen or not 
swollen.
3.
Patient’s Assessment of Pain
A horizontal visual analog scale (VAS) will be used to assess the patient’s current level of pain.4
How much pain have you had because of your condition over the past week? Place a mark on the 
line below to indicate how severe your pain has been: 
No Pain
Unbearable Pain
                                                
4 Visual analog scales provided in this protocol are not to scale and should not be utilized for assessments.


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4.
Patient’s Global Assessment of Disease Activity
A horizontal VAS will be used to provide the patient’s overall assessment of how the arthritis is 
doing.
Place a mark on the line below to indicate how you assess your current arthritis disease 
activity:
No arthritis activity
Extremely active arthritis
5.
Physician’s Global Assessment of Disease Activity
A horizontal VAS will be used to measure the physician’s assessment of the patient’s current 
disease activity.
Place a mark on the line below to indicate disease activity (independent of the subject’s 
self-assessment):
No Disease Activity
Maximum Disease Activity
6.
Patient’s Assessment of Physical Function
The HAQ-DI will be used to provide a patient’s self-assessment of physical function.
7.
Acute-phase reactant value
C-reactive protein level


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Appendix 8.
Disease Activity Score for 28 Joint Count (DAS28) {Prevoo et al 1995}
Assessments of RA in patients by the Disease Activity Score (modified to include the 28 joint 
counts according to Smolen* 1995) will be conducted at the measured timepoints. The DAS28 
consists of a composite score of the following variables: tender joint count, swollen joint count, 
CRP, and Patient’s Global Assessment of Disease Activity score. The following equation will be 
used to calculate the DAS28 (CRP)

DAS28 (CRP) 0.56 √TJC28 0.28√SJC28 0.36ln(CRP 1) 0.014×(Patient’s Global 
Assessment of Disease Activity) 0.96
TJC28 = number of joints tender out of 28
SJC28 = number of joints swollen out of 28
CRP = C-reactive protein
Patient’s Global Assessment of Disease Activity on a 100 mm VAS recorded by the 
patient


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Appendix 9.
Procedures and Specifications 
Complete Physical Examination
A complete physical examination must include source documentation of general appearance, and 
the following body systems: Head, neck and thyroid; eyes, ears, nose, throat, mouth and tongue; 
chest (excluding breasts); respiratory; cardiovascular; lymph nodes, abdomen; skin, hair, nails; 
musculoskeletal; neurological (must be performed at Screening). 
Vital Signs
Assessment of vital signs will include measurement of resting blood pressure, pulse, respiratory 
rate, and temperature. Body weight and height will also be included at Screening only.
Blood pressure will be measured using the following standardized process:

Subject should sit for 5 minutes with feet flat on the floor and measurement arm supported 
so that the midpoint of the manometer cuff is at heart level;

Use a mercury sphygmomanometer or automatic blood pressure device with an appropriately 
sized cuff with the bladder centered over the brachial artery;

Measure and record the blood pressure to the nearest 2 mmHg mark on the manometer or to 
the nearest whole number on an automatic device.
12-Lead ECG
Subjects will be required to rest in a supine position for 5 minutes prior to making a recording.
The investigator (or qualified designee) should review the ECG traces recorded in real time for 
clinically significant abnormalities.  On treatment ECGs should be compared to the subject’s 
Baseline as part of routine safety monitoring.  
Fredericia Formula (QTcF)
QTc = QT/(RR^0.33) 
Health Assessment Questionnaire – Disability Index
The HAQ-DI is a patient reported questionnaire specific for RA.  It consists of 20 questions 
referring to 8 component sets:  dressing/grooming, arising, eating, walking, hygiene, reach, grip, 
and activities.  
Physician’s and Patient’s Global Assessment of Disease Activity and Patient’s Global 
Assessment of Pain
The physician’s and the patient’s global assessment of disease activity will be recorded on a 
100-mm horizontal VAS that ranges from “none” (0 mm, symptom free and no RA symptoms) 
to “maximum” (100 mm, maximum RA activity).  The patient’s global assessment of pain will 
be recorded on a 100-mm horizontal VAS that ranges from “none” (0 mm) to “unbearable” 
(100 mm).


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Joint Assessment
An assessment of 66 joints for swelling and 68 joints for tenderness will be performed. Joints 
will be assessed and classified as swollen or not swollen and tender or not tender by pressure and 
joint manipulation upon physical examination.  Joint exams should be performed by a trained 
and experienced joint assessor.   Every effort should be made for the same joint assessor to 
perform the joint exams on the same subject particularly during the blinded phase of the study.