A Study to Evaluate the Pharmacokinetics, Safety, and Tolerability of Upadacitinib in Pediatric Subjects With Polyarticular Course Juvenile Idiopathic Arthritis

Study Overview
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Brief Summary
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This is a study to evaluate pharmacokinetics, safety and tolerability of upadacitinib in pediatric participants with polyarticular course juvenile idiopathic arthritis. This study consists of three parts: Part 1 is multiple-cohort study that consists of two sequential multiple dose groups. Participants benefiting from the study drug with no ongoing adverse events of special interest or serious adverse events will have option to enroll in Part 2. Part 2 is open-label, long term extension study to evaluate safety and tolerability. Part 3 is an additional safety cohort to evaluate long-term safety and tolerability.

Official Title
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An Open-Label Multiple-Dose Study to Evaluate the Pharmacokinetics, Safety, and Tolerability of Upadacitinib in Pediatric Subjects With Polyarticular Course Juvenile Idiopathic Arthritis

Conditions
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Juvenile Idiopathic Arthritis (JIA)

Intervention / Treatment
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* Drug: Upadacitinib


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Participant have total body weight of 10 kg or higher at the time of screening. Participant diagnosed with pcJIA (rheumatoid factor-positive or rheumatoid factor-negative polyarticular JIA, extended oligoarticular JIA, or systemic JIA with active arthritis and without active systemic features) with a history of arthritis affecting at least 5 joints within the first 6 months of disease (for extended oligoarticular JIA: <=4 joints within first 6 months of disease and >4 joints thereafter). Participant have 5 or more active joints at the time of screening, defined as the presence of swollen joints (not due to deformity) or, in the absence of swelling, joints with the limitation of movement (LOM) plus pain on motion and/or tenderness with palpitation, with LOM present in at least three of the active joints. If receiving methotrexate (MTX), have been taking MTX for at least 12 weeks immediately before and including Study Day 1 on a stable dose of <=20 mg/m2 for at least 8 weeks before and including Study Day 1; in addition, participants should take either folic acid or folinic acid according to local standard of care. If on oral glucocorticosteroids, must have been taking oral glucocorticosteroids at a stable dose (no greater than 10 mg/day or 0.2 mg/kg/day, whatever is lower) for at least 1 week before and including Study Day 1. Exclusion Criteria: Participant with diagnosis of enthesitis-related arthritis (ERA) or juvenile psoriatic arthritis (JPSA). Participant have prior exposure to JAK inhibitor.

Ages Eligible for Study
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Minimum Age: 2 Years
Maximum Age: 17 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Participants of age group 12 to <18 years receiving dose A<br>Participants of age group 12 to <18 years administered with upadacitinib dose A (weight dependent) as described in the protocol. | Drug: Upadacitinib<br>* Upadacitinib is administered as an oral solution or tablet as described in protocol.<br>* Other names: ABT-494;|
| Experimental: Participants of age group 12 to <18 years receiving dose B<br>Participants of age group 12 to <18 years administered with upadacitinib dose B (weight dependent) as described in the protocol. | Drug: Upadacitinib<br>* Upadacitinib is administered as an oral solution or tablet as described in protocol.<br>* Other names: ABT-494;|
| Experimental: Participants of age group 6 to <12 years receiving dose A<br>Participants of age group 6 to <12 years administered with upadacitinib dose A (weight dependent) as described in the protocol. | Drug: Upadacitinib<br>* Upadacitinib is administered as an oral solution or tablet as described in protocol.<br>* Other names: ABT-494;|
| Experimental: Participants of age group 2 to <6 years receiving dose A<br>Participants of age group 2 to <6 years administered with upadacitinib dose A (weight dependent) as described in the protocol. | Drug: Upadacitinib<br>* Upadacitinib is administered as an oral solution or tablet as described in protocol.<br>* Other names: ABT-494;|
| Experimental: Participants of age group 2 to <18 years receiving dose A<br>Participants of age group 2 to <18 years administered with upadacitinib dose A as described in the protocol. | Drug: Upadacitinib<br>* Upadacitinib is administered as an oral solution or tablet as described in protocol.<br>* Other names: ABT-494;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Treatment Emergent Adverse Events (TEAEs) | Adverse Event is defined as any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product. | Up to approximately 156 weeks | 
| Part 1: Maximum observed plasma concentration (Cmax) | Cmax is defined as the maximum observed plasma concentration for upadacitinib. | Day 7 | 
| Part 1: Time to maximum observed plasma concentration (Tmax) | Tmax is defined as the time to maximum plasma concentration (Cmax) of upadacitinib. | Day 7 | 
| Part 1: Area under plasma concentration versus time curve during a dosing interval (AUCtau) | The area under the plasma concentration-time curve is a method of measurement of the total exposure of a drug in plasma. | Day 7 | 
| Part 1: Apparent oral clearance at steady state (CL/F) | Clearance is defined as the volume of plasma cleared of the drug per unit time. | Day 7 | 
| Part 1: Half-life | Half life of updadacitinib will be determined using non-compartmental method. | Day 7 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Upadacitinib, ABT-494, Polyarticular Course Juvenile Idiopathic Arthritis (pcJIA)