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Upadacitinib

Phase 3

Systemic Lupus Erythematosus | Small molecule | Immunology |AbbVie Inc.|Last Updated: Jul 21, 2026

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Trial Design
RandomizedDouble-BlindPLACEBO_CONTROLLEDDMC
Total Trials1
Total Enrollment1,014
FDA Designations
No designations recorded
Clinical trial landscape

Upadacitinib · 45 trials · 24 indications

Phase 3 34Phase 2 8Phase 1 3
NCT07023302A Study to Evaluate the Safety and Effectiveness of Upadacitinib Tablets in Adult and Adolescent Participants in Japan With Alopecia AreataAlopecia Areata
RECRUITING123 Analytics
NCT06701331Safety and Efficacy of Upadacitinib in Combination With Topical Corticosteroids in Children From 2 to Less Than 12 Years of Age in Japan With Moderate to Severe Atopic DermatitisAtopic Dermatitis
ACTIVE NOT_RECRUITING99 Analytics
NCT06461897A Study to Assess Adverse Events and Change in Disease Activity Comparing Oral Upadacitinib to Subcutaneous Dupilumab in Children From 2 to Less Than 12 Years of Age With Moderate to Severe Atopic DermatitisAtopic Dermatitis
RECRUITING675 Analytics
NCT06332534Crohn's Disease: Efficacy, Safety, and Pharmacokinetics of Upadacitinib in Pediatric Subjects With Moderately to Severely Active Crohn's DiseaseCrohn's Disease
RECRUITING110 Analytics
NCT06389136A Study of Upadacitinib in Adult Participants With Moderate-to-Severe Atopic Dermatitis and Inadequate Response to DupilumabAtopic Dermatitis
RECRUITING200 Analytics
NCT06118411A Study To Assess Adverse Events and Effectiveness of Upadacitinib Oral Tablets in Adult and Adolescent Participants With VitiligoVitiligo
ACTIVE NOT_RECRUITING614 Analytics
NCT05782907Study to Assess Adverse Events, Change in Disease Activity, and How Oral Upadacitinib Moves Through the Body of Pediatric Participants With Moderately to Severely Active Ulcerative Colitis.Ulcerative Colitis
ACTIVE NOT_RECRUITING122 Analytics
NCT06012240A Study to Evaluate the Safety and Effectiveness of Upadacitinib Tablets in Adult and Adolescent Participants With Severe Alopecia AreataAlopecia Areata
RECRUITING1,500 Analytics
NCT05609630Study of Oral Upadacitinib and Subcutaneous/Intravenous Tocilizumab to Evaluate Change in Disease Activity, Adverse Events and How Drug Moves Through the Body of Pediatric and Adolescent Participants With Active Systemic Juvenile Idiopathic Arthritis.Juvenile Idiopathic Arthritis
RECRUITING90 Analytics
NCT05843643Program to Assess Adverse Events and Change in Disease Activity of Oral Upadacitinib in Adult Participants With Moderate to Severe Systemic Lupus ErythematosusSystemic Lupus Erythematosus
ACTIVE NOT_RECRUITING1,014 Analytics
PHASE3RECRUITING
A Study to Evaluate the Safety and Effectiveness of Upadacitinib Tablets in Adult and Adolescent Participants in Japan With Alopecia Areata
Alopecia AreataUnlock trial analytics
PHASE3ACTIVE NOT_RECRUITING
Safety and Efficacy of Upadacitinib in Combination With Topical Corticosteroids in Children From 2 to Less Than 12 Years of Age in Japan With Moderate to Severe Atopic Dermatitis
Atopic DermatitisUnlock trial analytics
PHASE3RECRUITING
A Study to Assess Adverse Events and Change in Disease Activity Comparing Oral Upadacitinib to Subcutaneous Dupilumab in Children From 2 to Less Than 12 Years of Age With Moderate to Severe Atopic Dermatitis
Atopic DermatitisUnlock trial analytics
PHASE3RECRUITING
Crohn's Disease: Efficacy, Safety, and Pharmacokinetics of Upadacitinib in Pediatric Subjects With Moderately to Severely Active Crohn's Disease
Crohn's DiseaseUnlock trial analytics
PHASE3RECRUITING
A Study of Upadacitinib in Adult Participants With Moderate-to-Severe Atopic Dermatitis and Inadequate Response to Dupilumab
Atopic DermatitisUnlock trial analytics
PHASE3ACTIVE NOT_RECRUITING
A Study To Assess Adverse Events and Effectiveness of Upadacitinib Oral Tablets in Adult and Adolescent Participants With Vitiligo
VitiligoUnlock trial analytics
PHASE3ACTIVE NOT_RECRUITING
Study to Assess Adverse Events, Change in Disease Activity, and How Oral Upadacitinib Moves Through the Body of Pediatric Participants With Moderately to Severely Active Ulcerative Colitis.
Ulcerative ColitisUnlock trial analytics
PHASE3RECRUITING
A Study to Evaluate the Safety and Effectiveness of Upadacitinib Tablets in Adult and Adolescent Participants With Severe Alopecia Areata
Alopecia AreataUnlock trial analytics
PHASE3RECRUITING
Study of Oral Upadacitinib and Subcutaneous/Intravenous Tocilizumab to Evaluate Change in Disease Activity, Adverse Events and How Drug Moves Through the Body of Pediatric and Adolescent Participants With Active Systemic Juvenile Idiopathic Arthritis.
Juvenile Idiopathic ArthritisUnlock trial analytics
PHASE3ACTIVE NOT_RECRUITING
Program to Assess Adverse Events and Change in Disease Activity of Oral Upadacitinib in Adult Participants With Moderate to Severe Systemic Lupus Erythematosus
Systemic Lupus ErythematosusUnlock trial analytics
Study Endpoints
Primary Endpoints
Percentage of Participants with the Achievement of Severity of Alopecia Tool (SALT) Score <= 10
Week 24

The SALT is a global alopecia areata (AA) severity score based on the combination of extent and density of scalp hair loss. The score is determined by visually defining the amount of terminal hair loss in each of the 4 views of the scalp (left and right side each accounting for 18% of scalp area, the top for 40%, and the back for 24%) and adding these together with a maximum score of 100%. A SALT score of \<= 10 is defined as less than or equal to 10% hair loss.

Number of Participants with Adverse Events (AEs)
Up to approximately 108 weeks

An AE is defined as any untoward medical occurrence in a patient or clinical investigation in which a participant is administered a pharmaceutical product which does not necessarily have a causal relationship with this treatment.

Percentage of Participants Achieving Eczema Area and Severity Index (EASI) 75
At Week 12

EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored as none \[0\], mild \[1\], An EASI 75 response is defined as a 75% reduction (improvement) from Baseline in EASI score.

Number of Participants With Adverse Events
From first dose of study drug until 30 days following last dose of study drug (up to approximately 56 weeks)

An adverse event (AE) is defined as any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product and which does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not the event is considered causally related to the use of the product.

Percentage of Participants Achieving a 75% Reduction from Baseline in Eczema Area and Severity Index 75 (EASI 75) Score (other than US)
At Week 16

EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored as none \[0\], mild \[1\], moderate \[2\], or severe \[3\]) for redness (erythema, inflammation), thickness (induration, papulation, swelling - acute eczema), scratching (excoriation), and lichenification (lined skin, prurigo nodules - chronic eczema). The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease.

Percentage of participants achieving validated Investigator Global Assessment for Atopic Dermatitis (vIGA-AD) 0 or 1 with a reduction from Baseline of ≥ 2 points (US and China only, descriptive)
Week 16

The vIGA-AD is a validated assessment instrument to rate the severity of atopic dermatitis globally, based on the following scale: * 0 - Clear: No inflammatory signs of AD; * 1 - Almost clear: Barely perceptible erythema, induration/papulation and/or lichenification; * 2 - Mild: Slight but definite erythema, induration/papulation and/or minimal lichenification. No oozing or crusting; * 3 - Moderate: Clearly perceptible erythema, induration/papulation and/or lichenification, oozing or crusting may be present; * 4 - Severe: Marked erythema, induration/papulation and/or lichenification; Oozing or crusting may be present.

Percentage of participants who achieved clinical response per the Pediatric Crohn's Disease Activity Index (PCDAI) at Week 12, with clinical remission per the PCDAI at Week 64
At Week 64

PCDAI is an index used to measure disease activity of pediatric patients with Crohn's disease assessing abdominal pain, stool frequency, patient functioning, hematocrit, erythrocyte sedimentation rate, albumin, weight, height, abdomen, perirectal disease, and extraintestinal manifestations. It ranges from 0 to 100; higher scores indicate more active disease. Clinical remission was defined as PCDAI ≤ 10.

Achievement of endoscopic response at Week 64 in participants who achieved clinical response per PCDAI at Week 12.
At Week 64

Endoscopic response is defined as \> 50% reduction in Simple Endoscopic Score for Crohn's Disease (SES-CD) score from Baseline (or for participants with a Baseline SES-CD of 4, at least a 2-point reduction from Baseline), as scored by a central reader.

Participants who achieve at least a 90% reduction in Eczema Area and Severity Index from Baseline (EASI 90)
At Week 8

The EASI is a validated measure used to assess the severity and extent of AD. Four AD disease characteristics (erythema, thickness \[induration, papulation, edema\], scratching \[excoriation\], and lichenification) are each assessed for severity by the investigator on a scale of "0" (absent) through "3" (severe). In addition, the area of AD involvement is assessed as a percentage by body area of head, trunk (including the genital area), upper extremities, and lower extremities (including the buttocks), and converted to a score of 0 to 6. In each body region, the area is expressed as 0, 1 (1% to 9%), 2 (10% to 29%), 3 (30% to 49%), 4 (50% to 69%), 5 (70% to 89%), or 6 (90% to 100%). The EASI score ranges from 0-72 points with an MCID of 6.6 points.

Percentage of Participants Achieving Total Vitiligo Area Scoring Index (T-VASI) 50 (≥ 50% Improvement in T-VASI From Baseline)
Week 48

The vitiligo area scoring index (VASI) is a validated scoring method used to assess the areas of depigmentation due to vitiligo. It is based on a composite estimate of the overall area of vitiligo patches, measured by the number of hand units (palm plus 5 digits = 1% body surface area \[BSA\]) multiplied by the degree of depigmentation within each affected area (0%, 10%, 25%, 50%, 75%, 90%, or 100%). The T-VASI is calculated using a formula that includes contributions from all body regions, with a possible range from 0 to 100.

Percentage of Participants Achieving Facial-Vitiligo Area Scoring Index (F-VASI) 75 (≥ 75% Improvement in F-VASI From Baseline)
Week 48

The vitiligo area scoring index (VASI) is a validated scoring method used to assess the areas of depigmentation due to vitiligo. The F-VASI includes contributions from the face, with a possible range from 0 to 3.

Percentage of Participants Achieving T-VASI 75 (≥ 75% Improvement in T-VASI From Baseline)
Study 4 Week 28

The vitiligo area scoring index (VASI) is a validated scoring method used to assess the areas of depigmentation due to vitiligo. It is based on a composite estimate of the overall area of vitiligo patches, measured by the number of hand units (palm plus 5 digits = 1% body surface area \[BSA\]) multiplied by the degree of depigmentation within each affected area (0%, 10%, 25%, 50%, 75%, 90%, or 100%). The T-VASI is calculated using a formula that includes contributions from all body regions, with a possible range from 0 to 100.

Percentage of Participants Achieving Adapted Mayo score (AMS) Clinical Remission (Period 1)
Week 8

The Mayo score is a tool designed to measure disease activity for ulcerative colitis. The AMS is a composite of the following subscores: stool frequency subscore (SFS), rectal bleeding subscore (RBS) and endoscopy subscore (MES). AMS ranges from 0 to 9 where higher scores represent more severe disease. Clinical remission is defined as an AMS \< or = 2, with SFS \< or = 1 and not higher than baseline, RBS of 0, and MES \< or = 1.

Percentage of Participants Achieving AMS Clinical Remission Among Week 8 Responders per AMS (Period 1)
Week 52

The Mayo score is a tool designed to measure disease activity for ulcerative colitis. AMS ranges from 0 to 9 where higher scores represent more severe disease. Clinical remission is defined as an AMS ≤ 2, with SFS ≤ 1 and not higher than Baseline, RBS of 0, and MES ≤ 1.

Percentage of Participants with the Achievement of Severity of Alopecia Tool (SALT) Score <= 20
Week 24

The SALT is a global AA severity score based on the combination of extent and density of scalp hair loss. The score is determined by visually defining the amount of terminal hair loss in each of the 4 views of the scalp (left and right side each accounting for 18% of scalp area, the top for 40%, and the back for 24%) and adding these together with a maximum score of 100%.

Percentage of Participants Achieving Adapted systemic Juvenile Idiopathic Arthritis (sJIA) American College of Rheumatology (ACR) 30 Response
At Week 12

ACR criteria measure improvements in tender and swollen joint counts, patient assessments of pain, global disease activity and physical function, physician global assessment of disease activity and acute phase reactant. ACR 30 Response is defined as absence of fever \[\> 38°C\] in the previous 1 week preceding evaluation and improvement of ≥ 30% of the 6 variables of the JIA core set with no more than 1 variable worsening by \> 30%.

Percentage of Participants Achieving British Isles Lupus Assessment Group Based Combined Lupus Assessment (BICLA) Response
At Week 52

BICLA is a composite responder index based on improvement in organ systems without worsening of the overall condition and improvement in disease activity.

Percentage of Participants Achieving Hidradenitis Suppurative Clinical Response (HiSCR) 50
Baseline to Week 16

HiSCR 50 is defined as at least a 50% reduction in the total abscess and inflammatory nodule (AN) count with no increase in abscess count and no increase in draining fistula count relative to Baseline.

Percentage of Participants Achieving Disease Activity Score 28 C-reactive Protein [DAS28-CRP]) <= 3.2
Week 12

The DAS28-CRP is a composite index used to assess rheumatoid arthritis disease activity, calculated based on the tender joint count (out of 28 evaluated joints), swollen joint count (out of 28 evaluated joints), Patient's Global Assessment of Disease Activity (NRS), and high-sensitivity C-reactive protein (hsCRP; in mg/L). Scores on the DAS28-CRP range from 0 to approximately 10, where higher scores indicate more disease activity. Low Disease Activity (LDA) based on DAS28 (CRP) is defined as achieving a DAS28 (CRP) of less than or equal to 3.2.

Time to First Relapse of Takayasu Arteritis (TAK) From Baseline through End of the Double-Blind (DB) Period
Up to occurrence of 40 events (approximately 52 months)

Relapse of TAK is defined as the presence of signs or symptoms as judged by the investigator for at least 2 of the following categories: objective systemic symptoms, subjective systemic symptoms, elevated inflammation markers, vascular signs and symptoms, or ischemic symptoms OR where the criteria are met based on one category per protocol definition of relapse of TAK.

Number of Participants With Treatment-Emergent Adverse Events
UPA/UPA arm: BL visit in Lead-In M16-046 to last dose in Long-Term Extension M19-850 (median time on follow-up is 536 days); DUPI/UPA arm: BL visit in Long-Term Extension M19-850 to last dose plus a 30-day follow-up (median time on follow-up is 399 days).

Treatment-emergent adverse events (TEAEs) are defined as any adverse events that begin or worsen in severity after initiation of upadacitinib during Lead-In Study M16-046 for the UPA/UPA arm or this Study M19-850 DUPI/UPA arm through 30 days following the last dose of upadacitinib.

Number of Participants With Treatment-Emergent Adverse Events of Special Interest (AESI)
UPA/UPA arm: BL visit in Lead-In M16-046 to last dose in Long-Term Extension M19-850 (median time on follow-up is 536 days); DUPI/UPA arm: BL visit in Long-Term Extension M19-850 to last dose plus a 30-day follow-up (median time on follow-up is 399 days).

Treatment-emergent adverse events were monitored throughout the study to identify any adverse events of special interest that may indicate a trend or risk to participants. AESIs are defined as any adverse events that begin or worsen in severity after initiation of upadacitinib during Study M16-046 for the UPA/UPA arm or Study M19-850 for the DUPI/UPA arm through 30 days following the last dose of upadacitinib.

Percentage of Participants With Potentially Clinically Important (PCI) Laboratory Values as Assessed by the Investigator
From Baseline to 30 days following last dose of study drug (Week 52)

Clinical laboratory test values are considered PCI if they meet either the lower-limit or higher-limit PCI criteria defined in the categories below. Percentage of participants with PCI laboratory values are summarized for hematology and chemistry. The Number Analyzed is defined as the number of participants with at least one post-baseline value for the specific criteria. Post-baseline grade must also be more extreme (worse) than the baseline grade in order to be included in the count. If a participant does not have a baseline value then the participant would be counted in the numerator if the participant had at least one post-baseline. xULN = Times upper limit of the normal range.

Percentage of Participants With Potentially Clinically Important (PCI) Vital Sign Measurements and Physical Examination Findings as Assessed by the Investigator
From Baseline to 30 days following last dose of study drug (Week 52)

PCI post-baseline vital sign values are summarized for categories: systolic and diastolic blood pressures \[sitting\], pulse rate \[sitting\], and weight. Only those categories where at least 1 person had a non-PCI value at Baseline and met the PCI criterion at least once during post-baseline are reported. The Number Analyzed is defined as the number of participants with at least one post-baseline value for the specific criteria. Post-baseline grade must also be more extreme (worse) than the baseline grade in order to be included in the count. If a participant does not have a baseline value then the participant would be counted in the numerator if the participant had at least one post-baseline.

Study 1: Percentage of Participants Achieving Assessment of SpondyloArthritis International Society 40 (ASAS40) Response at Week 14
Baseline and Week 14

ASAS40 response was defined as improvement of ≥ 40% relative to Baseline and absolute improvement of ≥ 2 units (on a scale from 0 to 10) in ≥ 3 of the following 4 domains with no deterioration (defined as a net worsening of \> 0 units) in the potential remaining domain: * Patient's global assessment of disease activity, measured on a numeric rating scale (NRS) from 0 (no activity) to 10 (severe activity); * Pain, measured by the total back pain NRS from 0 (no pain) to 10 (most severe pain); * Function, measured by the Bath Ankylosing Spondylitis Functional Index (BASFI) which consists of 10 items assessing participants' ability to perform activities on an NRS ranging from 0 (easy) to 10 (impossible); * Inflammation, measured by the mean of the 2 morning stiffness-related Bath AS Disease Activity Index (BASDAI) NRS scores (items 5 \[level of stiffness\] and 6 \[duration of stiffness\]) each on a scale from 0 (none/0 hours) to 10 (very severe/2 hours or more duration).

Study 2: Percentage of Participants Achieving an ASAS40 Response at Week 14
Baseline and Week 14

ASAS40 response was defined as improvement of ≥ 40% relative to Baseline and absolute improvement of ≥ 2 units (on a scale from 0 to 10) in ≥ 3 of the following 4 domains with no deterioration (defined as a net worsening of \> 0 units) in the potential remaining domain: * Patient's global assessment of disease activity, measured on a numeric rating scale (NRS) from 0 (no activity) to 10 (severe activity); * Pain, measured by the total back pain NRS from 0 (no pain) to 10 (most severe pain); * Function, measured by the Bath Ankylosing Spondylitis Functional Index (BASFI) which consists of 10 items assessing participants' ability to perform activities on an NRS ranging from 0 (easy) to 10 (impossible); * Inflammation, measured by the mean of the 2 morning stiffness-related Bath AS Disease Activity Index (BASDAI) NRS scores (items 5 \[level of stiffness\] and 6 \[duration of stiffness\]) each on a scale from 0 (none/0 hours) to 10 (very severe/2 hours or more duration).

Percentage of Participants Achieving a 75% Reduction From Baseline in Eczema Area and Severity Index Score (EASI 75) at Week 16
Baseline and Week 16

EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored as none \[0\], mild \[1\], moderate \[2\], or severe \[3\]) for redness (erythema, inflammation), thickness (induration, papulation, swelling - acute eczema), scratching (excoriation), and lichenification (lined skin, prurigo nodules - chronic eczema). The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease.

Percentage of Participants Achieving Sustained Remission at Week 52
From Week 12 to Week 52

Sustained remission is defined as having achieved absence of giant cell arteritis (GCA) signs and symptoms from Week 12 through Week 52, and adherence to the protocol-defined corticosteroid (CS) taper regimen.

Percentage of Participants Who Achieved Clinical Remission Per Adapted Mayo Score at Week 8
Week 8

The Adapted Mayo Score is a composite score of UC disease activity based on the following 3 subscores: 1. Stool frequency subscore (SFS), scored from 0 (normal number of stools) to 3 (5 or more stools more than normal). 2. Rectal bleeding subscore (RBS), scored from 0 (no blood seen) to 3 (blood alone passed). 3. Endoscopic subscore, scored from 0 (normal or inactive disease) to 3 (severe disease, spontaneous bleeding, ulceration). The overall Adapted Mayo score ranges from 0 to 9 where higher scores represent more severe disease. Clinical remission is defined as an Adapted Mayo score ≤ 2, with SFS ≤ 1 and not higher than Baseline, RBS of 0, and endoscopic subscore ≤ 1.

Number of participants experiencing adverse events
Up to 141 Weeks

Adverse events are defined as those that began or worsened in severity after the first dose of study drug but within 30 days after the last dose of study drug.

Main Study: Percentage of Participants Achieving at Least a 75% Reduction in Eczema Area and Severity Index Score (EASI 75) From Baseline at Week 16
Baseline and Week 16

EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored as none \[0\], mild \[1\], moderate \[2\], or severe \[3\]) for redness (erythema, inflammation), thickness (induration, papulation, swelling - acute eczema), scratching (excoriation), and lichenification (lined skin, prurigo nodules - chronic eczema). The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease.

Main Study: Percentage of Participants Achieving Validated Investigator Global Assessment for Atopic Dermatitis (vIGA-AD) of 0 or 1 With a Reduction From Baseline of ≥ 2 Points at Week 16
Baseline and Week 16

The vIGA-AD is a validated assessment instrument to rate the severity of atopic dermatitis globally, based on the following scale: * 0 - Clear: No inflammatory signs of AD; * 1 - Almost clear: Barely perceptible erythema, induration/papulation and/or lichenification; * 2 - Mild: Slight but definite erythema, induration/papulation and/or minimal lichenification. No oozing or crusting; * 3 - Moderate: Clearly perceptible erythema, induration/papulation and/or lichenification, oozing or crusting may be present; * 4 - Severe: Marked erythema, induration/papulation and/or lichenification; Oozing or crusting may be present.

Sub-Study 1: Percentage of Participants with Clinical Remission per Crohn's Disease Activity Index (CDAI)
Week 52

Clinical remission per CDAI is defined as CDAI \<150.

Sub-Study 1: Percentage of Participants with Endoscopic Response
Week 52

Endoscopic response is defined as decrease in Simple Endoscopic Score for Crohn's Disease (SES-CD) from Baseline.

Percentage of Participants With an American College of Rheumatology 20% (ACR20) Response at Week 12
Baseline and Week 12

Participants who met the following 3 conditions for improvement from Baseline were classified as meeting the ACR20 response criteria: 1. ≥ 20% improvement in 68-tender joint count; 2. ≥ 20% improvement in 66-swollen joint count; and 3. ≥ 20% improvement in at least 3 of the 5 following parameters: * Physician global assessment of disease activity * Patient global assessment of disease activity * Patient assessment of pain * Health Assessment Questionnaire - Disability Index (HAQ-DI) * High-sensitivity C-reactive protein (hsCRP).

Percentage of Participants With Clinical Remission Per Crohn's Disease Activity Index (CDAI) at Week 12
Week 12

The co-primary endpoint for United States (US)/Food and Drug Administration (FDA) regulatory purposes was clinical remission based on CDAI at Week 12. CDAI is a composite instrument that includes participant symptoms evaluated over 7 days (abdominal pain, stool frequency and general well-being), as well as presence of complications (arthritis/arthralgia, iritis/uveitis, erythema nodosum/pyoderma gangrenosum/aphthous stomatitis, anal fissure/fistula/abscess, other fistula, and fever), the use of antidiarrheal medicines, presence of an abdominal mass, hematocrit, and body weight. These items are scored individually, weighted, and do not contribute equally to the overall score. The CDAI is derived from summing up the weighted individual scores of eight items. CDAI approximately ranges from 0 to 600 with higher scores indicating more severe disease. Clinical remission is defined as a CDAI score less than 150.

Percentage of Participants With Clinical Remission Per Patient-Reported Outcomes (PROs) at Week 12
Week 12

The co-primary endpoint for European Union (EU)/European Medicines Agency (EMA) regulatory purposes was clinical remission defined based on two patient reported outcomes, average daily stool frequency (SF) and average daily abdominal pain score (APS). Clinical remission per PROs was defined as average daily very soft or liquid SF ≤ 2.8 and average daily APS ≤ 1.0 and neither worse than Baseline. Participants recorded APS and the number of very soft or liquid SF daily in an electronic diary. Abdominal pain was rated on a scale from 0 (none) to 3 (severe). The average daily very soft or liquid SF and APS were calculated using the 4-7 most recent useable days of patient-report outcomes (i.e., excluding days with missing entries or associated with endoscopy procedures) out of the last 14 days prior to the Week 12 visit.

Percentage of Participants With Endoscopic Response at Week 12
Baseline and Week 12

Endoscopic response at Week 12 was a co-primary endpoint for both the US/FDA and EU/EMA regulatory purposes. Endoscopic response was defined as greater than 50% decrease in Simple Endoscopic Score for Crohn's Disease (SES-CD) from Baseline of the induction study (or for participants with an SES-CD of 4 at Baseline, at least a 2-point reduction from Baseline), as scored by independent external and blinded central readers. The SES-CD evaluates 4 endoscopic variables (ulcer size, ulcerated surface, affected surface, and narrowing, each on a scale from 0 (none) to 3 in 5 segments assessed during ileocolonoscopy (ileum, right colon, transverse colon, sigmoid and left colon, and rectum). The total score is the sum of the 4 endoscopic variable scores and ranges from 0 to 56, where higher scores indicate more severe disease.

Assessing Treatment-Emergent Adverse Events
Up to 288 Weeks

Treatment-emergent adverse events are defined as events that begin or worsen either on or after the first dose of the study drug and within 30 days after the last dose of the study drug in the analysis period.

Percentage of Participants With an American College of Rheumatology 20% (ACR20) Response at Week 14
Baseline and week 14

The primary endpoint for United States (US)/Food and Drug Administration (FDA) regulatory purposes was ACR 20% response (ACR20) at Week 14. Participants who met the following 3 conditions for improvement from baseline were classified as meeting the ACR20 response criteria: 1. ≥ 20% improvement in 68-tender joint count; 2. ≥ 20% improvement in 66-swollen joint count; and 3. ≥ 20% improvement in at least 3 of the 5 following parameters: * Physician global assessment of disease activity * Patient global assessment of disease activity * Patient assessment of pain * Health Assessment Questionnaire - Disability Index (HAQ-DI) * High-sensitivity C-reactive protein (hsCRP).

Percentage of Participants Achieving Low Disease Activity (LDA) Based on DAS28(CRP) at Week 14
Week 14

The primary endpoint for European Union (EU)/European Medicines Agency (EMA) regulatory purposes was low disease activity, based on a Disease Activity Score 28 (DAS28)-CRP score of ≤ 3.2 at Week 14. The DAS28 is a composite index used to assess rheumatoid arthritis disease activity, calculated based on the tender joint count (out of 28 evaluated joints), swollen joint count (out of 28 evaluated joints), Patient's Global Assessment of Disease Activity (0-100 mm), and hsCRP (in mg/L). Scores on the DAS28 range from 0 to approximately 10, where higher scores indicate more disease activity. A DAS28 score less than or equal to 3.2 indicates low disease activity.

Percentage of Participants Achieving Low Disease Activity (LDA) Based on DAS28(CRP) at Week 12
Week 12

The primary endpoint for European Union (EU)/European Medicines Agency (EMA) regulatory purposes was low disease activity, based on a Disease Activity Score 28 (DAS28)-CRP score of ≤ 3.2 at Week 12. The DAS28 is a composite index used to assess rheumatoid arthritis disease activity, calculated based on the tender joint count (out of 28 evaluated joints), swollen joint count (out of 28 evaluated joints), Patient's Global Assessment of Disease Activity (0-100 mm), and hsCRP (in mg/L). Scores on the DAS28 range from 0 to approximately 10, where higher scores indicate more disease activity. A DAS28 score less than or equal to 3.2 indicates low disease activity.

Percentage of Participants With an American College of Rheumatology 50% (ACR50) Response at Week 12 - Global Analysis
Baseline and Week 12

The primary endpoint for United States (US)/Food and Drug Administration (FDA) regulatory purposes was ACR 50% response (ACR50) at Week 12. Participants who met the following 3 conditions for improvement from Baseline were classified as meeting the ACR50 response criteria: 1. ≥ 50% improvement in 68-tender joint count; 2. ≥ 50% improvement in 66-swollen joint count; and 3. ≥ 50% improvement in at least 3 of the 5 following parameters: * Physician global assessment of disease activity * Patient global assessment of disease activity * Patient assessment of pain * Health Assessment Questionnaire - Disability Index (HAQ-DI) * High-sensitivity C-reactive protein (hsCRP).

Percentage of Participants Achieving Clinical Remission (CR) Based on DAS28(CRP) at Week 24 - Global Analysis
Week 24

The primary endpoint for European Union (EU)/European Medicines Agency (EMA) regulatory purposes was clinical remission, based on a Disease Activity Score 28 (DAS28)-CRP score of \< 2.6 at Week 24. The DAS28 is a composite index used to assess rheumatoid arthritis disease activity, calculated based on the tender joint count (out of 28 evaluated joints), swollen joint count (out of 28 evaluated joints), Patient's Global Assessment of Disease Activity (0-100 mm), and hsCRP (in mg/L). Scores on the DAS28 range from 0 to approximately 10, where higher scores indicate more disease activity. A DAS28 score less than 2.6 indicates clinical remission.

Percentage of Participants With an American College of Rheumatology 20% (ACR20) Response at Week 12 - Global Analysis
Baseline and Week 12

The primary endpoint for Japan/Pharmaceuticals and Medical Devices Agency (PMDA) regulatory purposes was ACR 20% response (ACR20) at Week 12. Participants who met the following 3 conditions for improvement from Baseline were classified as meeting the ACR20 response criteria: 1. ≥ 20% improvement in 68-tender joint count; 2. ≥ 20% improvement in 66-swollen joint count; and 3. ≥ 20% improvement in at least 3 of the 5 following parameters: * Physician global assessment of disease activity * Patient global assessment of disease activity * Patient assessment of pain * Health Assessment Questionnaire - Disability Index (HAQ-DI) * High-sensitivity C-reactive protein (hsCRP).

Change From Baseline in Modified Total Sharp Score (mTSS) at Week 24 - Global Analysis
Baseline to Week 24

The second primary endpoint for Japan/PMDA regulatory purposes was change from baseline in mTSS at Week 24. The mTSS measures the level of joint damage from radiographs of the hands and feet. Joint erosion and joint space narrowing (JSN) were assessed by two independent, blinded readers. Joint erosion was assessed in 16 joints in each hand/wrist and 6 joints in each foot. Each joint was scored from 0 (no erosion) to 5 for hands/wrists or to 10 for feet (complete collapse). The total erosion score ranges from 0 to 280 (worst). JSN was assessed in 15 joints of each hand and wrist, and 6 joints of each foot, including subluxation, from 0 (normal) to 4 (complete loss of joint space, bony ankylosis, or luxation). The total JSN score ranges from 0 to 168 (worst). The mTSS is the sum of the joint erosion and JSN scores and ranges from 0 (normal) to 448 (worst). A change from Baseline greater than 0 indicates progression.

Percentage of Participants Achieving Clinical Remission (CR) Based on DAS28(CRP) at Week 12
Week 12

The primary endpoint for European Union (EU)/European Medicines Agency (EMA) regulatory purposes was clinical remission, based on a Disease Activity Score 28 (DAS28)-CRP score of \< 2.6 at Week 12. The DAS28 is a composite index used to assess rheumatoid arthritis disease activity, calculated based on the tender joint count (out of 28 evaluated joints), swollen joint count (out of 28 evaluated joints), Patient's Global Assessment of Disease Activity (0-100 mm), and hsCRP (in mg/L). Scores on the DAS28 range from 0 to approximately 10, where higher scores indicate more disease activity. A DAS28 score less than 2.6 indicates clinical remission.

Percent Change From Baseline in Facial-Vitiligo Area Scoring Index (F-VASI) at Week 24
Baseline, Week 24

The vitiligo area scoring index (VASI) is a validated scoring method used to assess the areas of depigmentation due to vitiligo. The F-VASI includes contributions from the face, with a possible range from 0 to 3, with higher scores indicating more severe disease. Negative changes from baseline indicate improvement.

Percentage of Participants Achieving Hidradenitis Suppurativa Clinical Response (HiSCR) at Week 12
Baseline and Week 12

HiSCR is defined as at least a 50% reduction in the total abscess and inflammatory nodule (AN) count with no increase in abscess count and no increase in draining fistula count relative to Baseline.

Percentage of Participants With Assessment of SpondyloArthritis International Society (ASAS) 40 Response at Week 14
Baseline and Week 14

ASAS 40 response was defined as improvement of ≥ 40% relative to Baseline and absolute improvement of ≥ 2 units (on a scale from 0 to 10) in ≥ 3 of the following 4 domains with no deterioration (defined as a net worsening of \> 0 units) in the potential remaining domain: * Patient's global assessment of disease activity, measured on a numeric rating scale (NRS) from 0 (no activity) to 10 (severe activity); * Pain, measured by the total back pain NRS from 0 (no pain) to 10 (most severe pain); * Function, measured by the Bath Ankylosing Spondylitis Functional Index (BASFI) which consists of 10 items assessing participants' ability to perform activities on an NRS ranging from 0 (easy) to 10 (impossible); * Inflammation, measured by the mean of the 2 morning stiffness-related Bath AS Disease Activity Index (BASDAI) NRS scores (items 5 \[level of stiffness\] and 6 \[duration of stiffness\]) each on a scale from 0 (none/0 hours) to 10 (very severe/2 hours or more duration).

Percent Change From Baseline in Eczema Area and Severity Index (EASI) Score at Week 16
Baseline and Week 16

EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored as none \[0\], mild \[1\], moderate \[2\], or severe \[3\]) for Redness (erythema, inflammation), Thickness (induration, papulation, swelling - acute eczema), Scratching (excoriation), and Lichenification (lined skin, prurigo nodules - chronic eczema). The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease; a negative change from baseline indicates improvement.

Substudy 1: Percentage Of Participants Who Achieved Clinical Remission Per Adapted Mayo Score at Week 8
At Week 8

The Adapted Mayo Score is a composite score of UC disease activity based on the following 3 subscores: 1. Stool frequency subscore (SFS), scored from 0 (normal number of stools) to 3 (5 or more stools more than normal) 2. Rectal bleeding subscore (RBS), scored from 0 (no blood seen) to 3 (blood alone passed) 3. Endoscopic subscore, scored from 0 (normal or inactive disease) to 3 (severe disease, spontaneous bleeding, ulceration) The overall Adapted Mayo score ranges from 0 to 9 where higher scores represent more severe disease. For Substudy 1, clinical remission is defined as SFS ≤ 1, RBS of 0, and endoscopic subscore ≤ 1.

Substudy 2: Percentage Of Participants Who Achieved Clinical Remission Per Adapted Mayo Score at Week 8
At Week 8

The Adapted Mayo Score is a composite score of UC disease activity based on the following 3 subscores: 1. Stool frequency subscore (SFS), scored from 0 (normal number of stools) to 3 (5 or more stools more than normal) 2. Rectal bleeding subscore (RBS), scored from 0 (no blood seen) to 3 (blood alone passed) 3. Endoscopic subscore, scored from 0 (normal or inactive disease) to 3 (severe disease, spontaneous bleeding, ulceration) The overall Adapted Mayo score ranges from 0 to 9 where higher scores represent more severe disease. For Substudy 2, clinical remission is defined as SFS ≤ 1 and not greater than Baseline, RBS of 0, and endoscopic subscore ≤ 1. In Substudy 2, evidence of friability during endoscopy in participants with otherwise "mild" endoscopic activity conferred an endoscopic subscore of 2.

Substudy 3: Percentage Of Participants Who Achieved Clinical Remission Per Adapted Mayo Score at Week 52
At Week 52

The Adapted Mayo Score is a composite score of UC disease activity based on the following 3 subscores: 1. Stool frequency subscore (SFS), scored from 0 (normal number of stools) to 3 (5 or more stools more than normal). 2. Rectal bleeding subscore (RBS), scored from 0 (no blood seen) to 3 (blood alone passed). 3. Endoscopic subscore, scored from 0 (normal or inactive disease) to 3 (severe disease, spontaneous bleeding, ulceration). The overall Adapted Mayo score ranges from 0 to 9 where higher scores represent more severe disease. For Substudy 3, clinical remission is defined as SFS ≤ 1 and not greater than Baseline, RBS of 0, and endoscopic subscore ≤ 1. In addition, evidence of friability during endoscopy in participants with otherwise "mild" endoscopic activity conferred an endoscopic subscore of 2.

Percentage of Participants With an American College of Rheumatology 20% (ACR20) Response Over Time
Baseline (of the preceding RCT study) and Weeks 6, 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, 180, 192, 204, 216, 228, 240, 252, 264, 276, 288, 300, and 312

Participants who met the following 3 conditions for improvement from Baseline were classified as meeting the ACR20 response criteria: 1. ≥ 20% improvement in 68-tender joint count; 2. ≥ 20% improvement in 66-swollen joint count; and 3. ≥ 20% improvement in at least 3 of the 5 following parameters: * Physician global assessment of disease activity * Patient global assessment of disease activity * Patient assessment of pain * Health Assessment Questionnaire - Disability Index (HAQ-DI) * High-sensitivity C-reactive protein (hsCRP).

Percentage of Participants With an American College of Rheumatology 50% (ACR50) Response Over Time
Baseline (of the preceding RCT study) and Weeks 6, 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, 180, 192, 204, 216, 228, 240, 252, 264, 276, 288, 300, and 312

Participants who met the following 3 conditions for improvement from Baseline were classified as meeting the ACR50 response criteria: 1. ≥ 50% improvement in 68-tender joint count; 2. ≥ 50% improvement in 66-swollen joint count; and 3. ≥ 50% improvement in at least 3 of the 5 following parameters: * Physician global assessment of disease activity * Patient global assessment of disease activity * Patient assessment of pain * Health Assessment Questionnaire - Disability Index (HAQ-DI) * High-sensitivity C-reactive protein (hsCRP).

Percentage of Participants With an American College of Rheumatology 70% (ACR70) Response Over Time
Baseline (of the preceding RCT study) and Weeks 6, 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, 180, 192, 204, 216, 228, 240, 252, 264, 276, 288, 300, and 312

Participants who met the following 3 conditions for improvement from Baseline were classified as meeting the ACR70 response criteria: 1. ≥ 70% improvement in 68-tender joint count; 2. ≥ 70% improvement in 66-swollen joint count; and 3. ≥ 70% improvement in at least 3 of the 5 following parameters: * Physician global assessment of disease activity * Patient global assessment of disease activity * Patient assessment of pain * Health Assessment Questionnaire - Disability Index (HAQ-DI) * High-sensitivity C-reactive protein (hsCRP).

Percentage of Participants With Satisfactory Humoral Response to PCV-13 Four Weeks After Vaccination
Vaccination Baseline (defined as the last non-missing observation on or before the date of receiving PCV-13 vaccination) and 4 weeks after vaccination

Satisfactory humoral response is defined as greater than or equal to 2-fold increase in antibody concentration from the vaccination Baseline in at least 6 out of the 12 pneumococcal antigens 1, 3, 4, 5, 6B, 7F, 9V, 14, 18C, 19A, 19F and 23F).

Treatment Efficacy - TIme to first occurrence of disease reactivation
During the 8 weeks of the randomized withdrawal phase

All patients that complete the open label dose-escalation phase and are randomized will be included in the efficacy analysis population. Efficacy of the Optimal Tolerated Dose (OTD) will be assessed by comparing the time to first occurrence of disease reactivation using Primary Immune Regulatory Deficiency (PIRD) score during the 8-week Randomized Withdrawal (RW) phase between the Upadacitinib and placebo groups. The PIRD score is a disease scoring method that capture the clinical manifestations of all PIRDs including JAK/STAT GOF disorders. The presence of a disease state and its severity is graded on a scale of 1-5. 1 indicates the absence of the disease. Disease flare is defined as an increase in PIRD score by ≥1 in disease manifestations.

Safety and Tolerability - Percentage of Patients with Adverse Events of Special Interest
Throughout the whole treatment period (1 year)

All patients that receive at least one dose of study drug will be included in the analyses to evaluate safety and tolerability of the study drug. Safety and tolerability will be summarized for each phase of the study and will be assessed primarily based on adverse events of special interest. Assessment of safety and tolerability will primarily be done by calculating the percentage of patients with adverse events of special interest.

Safety and Tolerability - Percentage of Patients with Organ Toxicity
Throughout the whole treatment period (1 year)

All patients that receive at least one dose of study drug will be included in the analyses to evaluate safety and tolerability of the study drug. Safety and tolerability will be summarized for each phase of the study and will be assessed based on organ toxicity. Organ toxicity will be assessed by clinical labs. Assessment of safety and tolerability will primarily be done by calculating the percentage of patients with organ specific toxicities.

Treatment Emergent Adverse Events (TEAEs)
Up to approximately 156 weeks

Adverse Event is defined as any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product.

Part 1: Maximum observed plasma concentration (Cmax)
Day 7

Cmax is defined as the maximum observed plasma concentration for upadacitinib.

Part 1: Time to maximum observed plasma concentration (Tmax)
Day 7

Tmax is defined as the time to maximum plasma concentration (Cmax) of upadacitinib.

Part 1: Area under plasma concentration versus time curve during a dosing interval (AUCtau)
Day 7

The area under the plasma concentration-time curve is a method of measurement of the total exposure of a drug in plasma.

Part 1: Apparent oral clearance at steady state (CL/F)
Day 7

Clearance is defined as the volume of plasma cleared of the drug per unit time.

Part 1: Half-life
Day 7

Half life of updadacitinib will be determined using non-compartmental method.

Maximum Plasma Concentration (Cmax)
Up to 7 days

It is defined as the maximum observed plasma concentration (Cmax) for upadacitinib.

Time to Maximum Observed Plasma Concentration (Tmax)
Up to 7 days

It is defined as the time to maximum plasma concentration (Tmax) of upadacitinib.

Area under the plasma concentration-time curve within a dosing interval (AUCtau)
Up to 7 days

The area under the plasma concentration-time curve (AUCtau) is a method of measurement of the total exposure of a drug in plasma.

Oral Clearance
Up to 7 days

Clearance is defined the volume of plasma cleared of the drug per unit time.

Number of Participants With Treatment Emergent Adverse Events (TEAE)
Up to 2 years

An adverse event (AE) is defined as any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product which does not necessarily have a causal relationship with this treatment. The investigator assesses the relationship of each event to the use of study drug as either probably related, possibly related, probably not related or not related. A serious adverse event (SAE) is an event that results in death, is life-threatening, requires or prolongs hospitalization, results in a congenital anomaly, persistent or significant disability/incapacity or is an important medical event that, based on medical judgment, may jeopardize the participant and may require medical or surgical intervention to prevent any of the outcomes listed above. Treatment-emergent adverse events (TEAEs) are defined as any event that began or worsened in severity after the first dose of study drug.

Secondary Endpoints
Percentage of Participants with the Achievement of Patient-Reported Outcome (PRO) for Scalp Hair Assessment of 0 or 1
Week 24
Percentage of Participants with the Achievement of Patients' Global Impression of Change of Alopecia Areata (PaGIC-AA) Score of 1 "Much Better" or 2 "Moderately Better"
Week 24
Percentage of participants achieving validated Investigator Global Assessment scale for Atopic Dermatitis (vIGA-AD) 0/1 with a reduction from Baseline of ≥ 2 points
At Week 12
Unlock Study Endpoints
Study Design & Arms
AllocationRANDOMIZED
MaskingDOUBLE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
Group 1A: Upadacitinib Dose AEXPERIMENTALParticipants will receive upadacitinib dose A once daily for 52 weeks in Period A and Period B.
Group 2A: Upadacitinib Dose BEXPERIMENTALParticipants will receive upadacitinib dose B once daily for 52 weeks in Period A and Period B.
Group 3A: Upadacitinib PlaceboPLACEBO_COMPARATORParticipants will receive upadacitinib placebo once daily for 24 weeks in Period A.
Group 1B: Upadacitinib Dose AEXPERIMENTALParticipants initially randomized to placebo (Period A) will be re-randomized to receive upadacitinib dose A once daily for 28 weeks in Period B.
Group 2B: Upadacitinib Dose BEXPERIMENTALParticipants initially randomized to placebo (Period A) will be re-randomized to receive upadacitinib dose B once daily for 28 weeks in Period B.
Period C: Upadacitinib Dose A Remains Dose AEXPERIMENTALFor participants initially randomized to dose A in Periods A and B and participants initially randomized to placebo who switched to dose A in Period B: participants with a Severity of Alopecia Tool (SALT) score \<= 10 at Week 52 (end of Period B) will remain on blinded upadacitinib dose A once daily in Period C for 52 weeks.
Period C: Upadacitinib Dose A to Dose BEXPERIMENTALFor participants initially randomized to dose A in Periods A and B and participants initially randomized to placebo who switched to dose A in Period B: participants with a SALT score \> 10 at Week 52 (end of Period B) will dose escalate to blinded upadacitinib dose B once daily in Period C for 52 weeks.
Period C: Upadacitinib Dose B Non-Sustained RespondersEXPERIMENTALFor participants initially randomized to dose B in Periods A and B and participants initially randomized to placebo who switched to dose B in Period B: participants with a SALT score \> 10 at Week 40 or Week 52 will remain on blinded upadacitinib dose B once daily in Period C for 52 weeks.
Period C: Upadacitinib Dose B Sustained RespondersEXPERIMENTALFor participants initially randomized to dose B in Periods A and B and participants initially randomized to placebo who switched to dose B in Period B: participants with a SALT score \<= 10 at Week 40 and Week 52 will receive blinded upadacitinib dose A once daily in Period C for 52 weeks.
Period C: Open-Label Upadacitinib Dose BEXPERIMENTALParticipants with no improvement or worsening from Baseline in their SALT score at the Week 40 visit or any scheduled visit thereafter will receive open-label upadacitinib dose B once daily for 52 weeks.
Upadacitinib + Topical Corticosteroids (TCS)EXPERIMENTALParticipants will be randomized to receive the upadacitinib daily adult equivalent dose in combination with TCS once a day (QD) during the double-blind and open label treatment periods for a total of 52 weeks
Placebo / Upadacitinib + Topical Corticosteroids (TCS)PLACEBO_COMPARATORParticipants will receive placebo orally once a day (QD) in combination with TCS for 12 weeks in the double-blind treatment period. At Week 12 participants will then be switched to receive open-label upadacitinib daily adult equivalent dose in combination with TCS.
Dupi-IR CohortEXPERIMENTALParticipants in this cohort will receive upadacitinib medium dose.
Randomized CohortEXPERIMENTALParticipants in the Randomized Cohort will be randomized to receive either medium dose upadacitinib daily adult equivalent dose, low dose upadacitinib daily adult equivalent dose or dupilumab every 2 weeks or 4 weeks (at the label-indicated dose and frequency).
Period 1: Open Label Induction Phase (Dose A)EXPERIMENTALAll participants in the open label induction phase of Period 1 will receive upadacitinib Dose A for 12 weeks based on body weight.
Period 1: Double-Blind Maintenance Phase (Dose B)EXPERIMENTALClinical responders per PCDAI at the end of open label induction phase of Period 1 will be randomly assigned to receive Dose B or C for 52 weeks (oral solution dose will be based on body weight)
Period 1: Double-Blind Maintenance Phase (Dose C)EXPERIMENTALClinical responders per PCDAI at the end of open label induction phase of Period 1 will be randomly assigned to receive either upadacitinib Dose C or B for 52 weeks (oral solution dose will be based on body weight)
Period 2: Open Label Long-Term Extension Phase Cohort 1EXPERIMENTALParticipants receiving double-blind maintenance therapy with upadacitinib Dose B or upadacitinib Dose C daily in Period 1 who complete the Week 64 visit will receive upadacitinib Dose B daily for up to 156 weeks.
Period 2: Open Label Long-Term Extension Phase Cohort 2EXPERIMENTALParticipants who were receiving rescue therapy with open-label upadacitinib Dose C during maintenance phase in Period 1 and completed the Week 64 visit will continue to receive upadacitinib Dose C daily for up to 156 weeks.
Period 2: Open Label Long-Term Extension Phase Cohort 3EXPERIMENTALParticipants who did not achieve clinical response per PCDAI at Week 12 of Period 1 will receive an extended treatment with open-label upadacitinib Dose C daily for an additional 12 weeks. If they are responders after 12 weeks extended treatment, they will continue, otherwise they may be discontinued at the discretion of the investigator
Period 1: Upadacitinib Open Label TreatmentEXPERIMENTALParticipants randomly assigned to receive Upadacitinib 15mg tablet once per day. Based on clinical response, participants randomized to Upadacitinib 15mg may have their dose increased to Upadacitinib 30mg starting at Week 2.
Period 1: Dupilumab Open Label TreatmentEXPERIMENTALParticipants randomly assigned to receive Dupilumab 300mg SC injection once every other week for 8 weeks.
Period 2 Open Label: Upadacitinib < EASI 75 responseEXPERIMENTALParticipants that were receiving Upadacitinib 15mg or 30mg and completed Period 1, will be allocated or continue to receive oral doses of Upadacitinib 30mg in Period 2 with a clinical response of \< EASI 75 at Week 8
Period 2 Open Label: Upadacitinib ≥ EASI 75 ResponseEXPERIMENTALParticipants that were receiving Upadacitinib 15mg or 30mg and completed Period 1, will continue to receive the same oral doses of Upadacitinib in Period 2 with a clinical response of ≥ EASI 75 at Week 8
Period 2 Open Label: Dupilumab ≥ EASI 75 ResponseEXPERIMENTALParticipants that were receiving Dupilumab 300mg and completed Period 1, will continue to receive Dupilumab 300mg SC injection in Period 2 with a clinical response of ≥ EASI 75 at Week 8
Period 2 Open Label Period: Dupilumab < EASI 75 ResponseEXPERIMENTALParticipants that were receiving Dupilumab 300mg SC injections and completed Period 1, will receive oral doses of Upadacitinib 15mg in Period 2 with a clinical response of \< EASI 75 at Week 8
Study 1, Period A: Group 1EXPERIMENTALParticipants will receive upadacitinib 15 mg once daily for 48 weeks.
Study 1, Period A: Group 2PLACEBO_COMPARATORParticipants will receive placebo once daily for 48 weeks.
Study 2, Period A: Group 1EXPERIMENTALParticipants will receive upadacitinib 15 mg once daily for 48 weeks.
Study 2, Period A: Group 2PLACEBO_COMPARATORParticipants will receive placebo once daily for 48 weeks.
Study 1, Period B: Group 1 Open-Label Extension PeriodEXPERIMENTALParticipants that were randomized to receive upadacitinib in Period A Group 1, will continue to receive upadacitinib 15 mg once daily for 112 weeks in Period B.
Study 1, Period B: Group 2 Open-Label Extension PeriodEXPERIMENTALParticipants that were randomized to receive placebo in Period A Group 2, will receive upadacitinib 15 mg once daily for 112 weeks in Period B.
Study 2, Period B: Group 1 Open-Label Extension PeriodEXPERIMENTALParticipants that were randomized to receive upadacitinib in Period A Group 1, will continue to receive upadacitinib 15 mg once daily for 112 weeks in Period B.
Study 2, Period B: Group 2 Open-Label Extension PeriodEXPERIMENTALParticipants that were randomized to receive placebo in Period A Group 2, will receive upadacitinib 15 mg once daily for 112 weeks in Period B.
(Optional) Study 3: Open Label UpadacitinibEXPERIMENTALParticipants will receive upadacitinib 15 mg once daily for 112 weeks.
(Optional) Study 3: Open Label Upadacitinib + NB-UVBEXPERIMENTALParticipants will receive 15 mg upadacitinib once daily for 112 weeks and Narrow-band ultraviolet B (NB-UVB) for up to 28 weeks.
Study 4: Upadacitinib 15 mgEXPERIMENTALEligible participants will be re-randomized to receive upadacitinib 15 mg once daily for 56 weeks.
Study 4: Upadacitinib 30 mgEXPERIMENTALEligible participants will be re-randomized to receive upadacitinib 30 mg once daily for 56 weeks.
Period 1- Open Label Induction PhaseEXPERIMENTALAll participants in open label induction phase of Period 1 will receive upadacitinib Dose A for 8 weeks based on body weight.
Period 1- Double Blind Maintenance PhaseEXPERIMENTALClinical responders at the end of open label induction phase of Period 1 will be randomly assigned to receive either upadacitinib Dose B or Dose C for 44 weeks based on body weight.
Period 2- Open Label Long Term Extension Phase Arm AEXPERIMENTALClinical non-responders outside of US after Period 1 induction phase will receive upadacitinib Dose A daily for 8 week extended induction phase in open label long term extension (OLE) Period 2. Clinical responders from extended induction phase in OLE will receive upadacitinib Dose B daily for up to 252 weeks in OLE period 2.
Period 2- Open Label Long Term Extension Phase Arm BEXPERIMENTALClinical non-responders in US after Period 1 induction phase or clinical responders with loss of response during maintenance phase will receive upadacitinib Dose B daily for up to 260 weeks in OLE Period 2.
Period 2- Long Term Extension Phase Arm CEXPERIMENTALClinical responders who complete Period 1 through Week 52 will receive upadacitinib Dose C daily for up to 260 weeks in OLE Period 2.
Study 1: Group 1 Upadacitinib Dose AEXPERIMENTALParticipants will receive upadacitinib Dose A once daily for 52 weeks in Period A and Period B.
Study 1: Group 2 Upadacitinib Dose BEXPERIMENTALParticipants will receive upadacitinib Dose B once daily for 52 weeks in Period A and Period B.
Study 1: Group 3 PlaceboEXPERIMENTALParticipants will receive matching placebo once daily for 24 weeks in Period A.
Study 1: Group 4 Upadacitinib Dose AEXPERIMENTALParticipants initially randomized to placebo (Period A) with a SALT score \> 20 at Week 24 will be re-randomized to receive upadacitinib Dose A once daily for 28 weeks in Period B.
Study 1: Group 5 Upadacitinib Dose BEXPERIMENTALParticipants initially randomized to placebo (Period A) with a SALT score \> 20 at Week 24 will be re-randomized to receive upadacitinib Dose B once daily for 28 weeks in Period B.
Study 1: Group 6 PlaceboEXPERIMENTALParticipants initially randomized to placebo with a SALT score ≤ 20 at Week 24 will continue on placebo through Week 160.
Study 2: Group 1 Upadacitinib Dose AEXPERIMENTALParticipants will receive upadacitinib Dose A once daily for 52 weeks in Period A and Period B.
Study 2: Group 2 Upadacitinib Dose BEXPERIMENTALParticipants will receive upadacitinib Dose B once daily for 52 weeks in Period A and Period B.
Study 2: Group 3 PlaceboEXPERIMENTALParticipants will receive matching placebo once daily for 24 weeks in Period A.
Study 2: Group 4 Upadacitinib Dose AEXPERIMENTALParticipants initially randomized to placebo (Period A) with a SALT score \> 20 at Week 24 will be re-randomized to receive upadacitinib Dose A once daily for 28 weeks in Period B.
Study 2: Group 5 Upadacitinib Dose BEXPERIMENTALParticipants initially randomized to placebo (Period A) with a SALT score \> 20 at Week 24 will be re-randomized to receive upadacitinib Dose B once daily for 28 weeks in Period B.
Study 2: Group 6 PlaceboEXPERIMENTALParticipants initially randomized to placebo with a SALT score ≤ 20 at Week 24 will continue on placebo through Week 160.
Study 3: Group 1 Upadacitinib Dose B (SALT > 20)EXPERIMENTALParticipants receiving upadacitinib Dose A with a SALT score \> 20 at Week 52 (end of Period B) of Study 1 or Study 2 will dose escalate to upadacitinib Dose B once daily for 108 weeks.
Study 3: Group 2 Upadacitinib Dose A (SALT ≤ 20)EXPERIMENTALParticipants receiving upadacitinib Dose A with a SALT score ≤ 20 at Week 52 (end of Period B) of Study 1 or Study 2 will remain on upadacitinib Dose A once daily for 108 weeks.
Study 3: Group 3 Upadacitinib Dose B (Non-Sustained)EXPERIMENTALParticipants who end Period B on upadacitinib Dose B with a with a SALT score \> 20 at Week 40 or Week 52 of Study 1 or Study 2 will remain on upadacitinib Dose B once daily for 108 weeks.
Study 3: Group 4 Upadacitinib Dose B (Sustained)EXPERIMENTALParticipants who end Period B on upadacitinib Dose B with a with a SALT score ≤ 20 at Week 40 and Week 52 of Study 1 or Study 2 will be re-randomized to receive upadacitinib Dose B once daily for 108 weeks.
Study 3: Group 5 Upadacitinib Dose A (Sustained)EXPERIMENTALParticipants who end Period B on upadacitinib Dose B with a with a SALT score ≤ 20 at Week 40 and Week 52 of Study 1 or Study 2 will be re-randomized to receive upadacitinib Dose A once daily for 108 weeks.
Study 4: Group 1 Upadacitinib Dose AEXPERIMENTALUS only adolescent participants will receive upadacitinib Dose A once daily for 52 weeks in Period A and Period B.
Study 4: Group 2 Upadacitinib Dose BEXPERIMENTALUS only adolescent participants will receive upadacitinib Dose B once daily for 52 weeks in Period A and Period B.
Study 4: Group 3 PlaceboEXPERIMENTALUS only adolescent participants will receive matching placebo once daily for 24 weeks in Period A.
Study 4: Group 4 Upadacitinib Dose AEXPERIMENTALParticipants initially randomized to placebo (Period A) with a SALT score \> 20 at Week 24 will be re-randomized to receive upadacitinib Dose A once daily for 28 weeks in Period B.
Study 4: Group 5 Upadacitinib Dose BEXPERIMENTALParticipants initially randomized to placebo (Period A) with a SALT score \> 20 at Week 24 will be re-randomized to receive upadacitinib Dose B once daily for 28 weeks in Period B.
Study 4: Group 6 PlaceboEXPERIMENTALParticipants initially randomized to placebo with a SALT score ≤ 20 at Week 24 will continue on placebo through Week 160.
Cohort 1 UpadacitinibEXPERIMENTALParticipants will receive upadacitinib for 52 weeks.
Cohort 1 TocilizumabACTIVE_COMPARATORParticipants will receive tocilizumab for 52 weeks.
Cohort 2 UpadacitinibEXPERIMENTALParticipants will receive upadacitinib for 52 weeks.
Study 1- Upadacitinib Dose AEXPERIMENTALParticipants will receive upadacitinib dose A once daily for 52 weeks.
Study 1- PlaceboPLACEBO_COMPARATORParticipants will receive upadacitinib matching placebo once daily for 52 weeks.
Study 2- Upadacitinib Dose AEXPERIMENTALParticipants will receive upadacitinib dose A once daily for 52 weeks.
Study 2- PlaceboPLACEBO_COMPARATORParticipants will receive upadacitinib matching placebo once daily for 52 weeks.
Study 3- Low Disease Activity Upadacitinib (LDA) Dose AEXPERIMENTALParticipants in the upadacitinib arms from Study 1 or Study 2 with LDA will receive upadacitinib dose A once daily for 52 weeks.
Study 3- Low Disease Activity Upadacitinib Dose BEXPERIMENTALParticipants in the upadacitinib arms from Study 1 or Study 2 with LDA will receive upadacitinib dose B once daily for 52 weeks.
Study 3- No LDA Upadacitinib Dose AEXPERIMENTALParticipants in the upadacitinib arms from Study 1 or Study 2 with no LDA will receive upadacitinib dose A once daily for 52 weeks.
Study 3- Upadacitininb Dose AEXPERIMENTALParticipants in the placebo arms of Study 1 or Study 2 will receive upadacitinib Dose A once daily for 52 weeks.
Study 3- Open Label Upadacitinib Dose AEXPERIMENTALParticipants who experience a suspected systemic lupus erythematosus (SLE) flare may receive open label upadacitinib Dose A once daily for the remainder of the study.
Study 3- Open Label Upadacitinib Dose BEXPERIMENTALParticipants who reach \>= 65 years of age and are still on study drug may receive open-label upadacitinib Dose B once daily, and participants who experience a suspected SLE flare while on upadacitinib Dose B may receive upadacitinib Dose A for the remainder of the study.
Study 4- Upadacitinib Dose AEXPERIMENTALParticipants receiving upadacitinib Dose A in Study 3 will continue on this dose once daily for 104 weeks.
Study 4- Upadacitinib Dose BEXPERIMENTALParticipants receiving upadacitinib Dose B in Study 3 will continue on this dose once daily for 104 weeks.
Period 1: Upadacitinib Dose AEXPERIMENTALParticipants will receive Upadicitinib Dose A once daily for 16 weeks.
Period 1: PlaceboPLACEBO_COMPARATORParticipants will receive Placebo once daily for 16 weeks.
Period 2: Group 1 - Upadacitinib Dose AEXPERIMENTALParticipants who were randomized to placebo in Period 1 who did not achieve HiSCR 50 (clinical non-responder, CNR) at Week 16 will receive Upadacitinib Dose A once daily for 20 weeks.
Period 2: Group 2 - PlaceboPLACEBO_COMPARATORParticipants who were randomized to placebo in Period 1 who achieve HiSCR 50 (clinical responder, CR) at Week 16 will continue to receive placebo once daily for 20 weeks.
Period 2: Group 3 - Upadacitinib Dose AEXPERIMENTALParticipants who were randomized to upadacitinib Dose A in Period 1 who did not achieve HiSCR 50 (CNR) at Week 16 will continue to receive upadacitinib Dose A once daily for 20 weeks.
Period 2: Group 4 - Upadacitinib Dose AEXPERIMENTALParticipants who were randomized to upadacitinib Dose A in Period 1 who achieve HiSCR 50 (CR) at Week 16 will receive upadacitinib Dose A once daily for 20 weeks.
Period 2: Group 5 - Upadacitinib Dose BEXPERIMENTALParticipants who were randomized to upadacitinib Dose A in Period 1 who achieve HiSCR 50 (CR) at Week 16 will receive upadacitinib Dose B once daily for 20 weeks.
Period 2: Group 6 - PlaceboEXPERIMENTALParticipants who were randomized to upadacitinib Dose A in Period 1 who achieve HiSCR 50 (CR) at Week 16 will receive placebo once daily for 20 weeks.
Period 3: Long-Term ExtensionEXPERIMENTALEligible participants will continue to receive upadacitinib or placebo for 68 weeks. Participants will be followed-up for approximately 30 days.
Upadacitinib+ Adalimumab matching PlaceboEXPERIMENTALParticipants will receive upadacitinib once a day along with matching placebo for adalimumab at eow (every other week) in Period 1. Eligible participants will continue to receive same study treatment in Period 2 as assigned in Period 1.
Adalimumab + Upadacitinib matching PlaceboEXPERIMENTALParticipants will receive adalimumab at eow (every other week) along with matching placebo for upadacitinib once a day in Period 1. Eligible participants will continue to receive same study treatment in Period 2 as assigned in Period 1.
Arm 2: Placebo for UpadacitinibEXPERIMENTALParticipants will be administered placebo once daily (QD) along with prednisolone.
Arm 1: UpadacitinibEXPERIMENTALParticipants will be administered updadacitinib once daily (QD) along with prednisolone.
UpadacitinibEXPERIMENTALParticipants will be administered with upadacitinib once daily (QD)
Study 1: Upadacitinib 15 mgEXPERIMENTALParticipants receive 15 mg upadacitinib orally once a day for 104 weeks. Participants who flare after 104 weeks will receive open-label upadacitinib once daily from the time of flare for 24 weeks (re-treatment).
Study 1: PlaceboPLACEBO_COMPARATORParticipants receive matching placebo for 14 weeks and then switch to receive 15 mg upadacitinib orally once a day for 90 weeks. Participants who flare after 104 weeks will receive open-label upadacitinib once daily from the time of flare for 24 weeks (re-treatment).
Study 2: Upadacitinib 15 mgEXPERIMENTALParticipants receive 15 mg upadacitinib orally once a day for 104 weeks. Participants who flare after 104 weeks will receive open-label upadacitinib once daily from the time of flare for 24 weeks (re-treatment).
Study 2: PlaceboPLACEBO_COMPARATORParticipants receive matching placebo for 52 weeks and then switch to receive 15 mg upadacitinib orally once a day for 52 weeks. Participants who flare after 104 weeks will receive open-label upadacitinib once daily from the time of flare for 24 weeks (re-treatment).
Upadacitinib 30 mg QDEXPERIMENTALParticipants will receive 30 mg upadacitinib orally once a day (QD) up to Week 24 and placebo to dupilumab by subcutaneous injection every other week from Baseline to Week 22.
Dupilumab 300 mg EOWEXPERIMENTALParticipants will receive a loading dose of 600 mg dupilumab by subcutaneous (SC) injection on Day 1 followed by 300 mg dupilumab SC every other week (EOW) until Week 22 and placebo to upadacitinib orally QD up to Week 24.
Placebo + 52-week CS taperPLACEBO_COMPARATORParticipants received placebo tablets for upadacitinib administered orally once daily (QD) for 52 weeks and a 52-week corticosteroid (CS) taper regimen during Period 1.
7.5 mg Upadacitinib + 26-week CS taperEXPERIMENTALParticipants received 7.5 mg upadacitinib tablets administered orally once daily (QD) for 52 weeks and a 26-week corticosteroid (CS) taper regimen during Period 1.
15 mg Upadacitinib + 26-week CS taperEXPERIMENTALParticipants received 15 mg upadacitinib tablets administered orally once daily (QD) for 52 weeks and a 26-week corticosteroid (CS) taper regimen during Period 1.
Placebo + 52-week CS taper -> PlaceboPLACEBO_COMPARATORParticipants who achieved sustained remission for at least 24 weeks prior to the Week 52 visit (at the end of Period 1) OR at remission at the Week 52 visit only who were assigned to placebo tablets for upadacitinib administered orally once daily (QD) in Period 1 continued to receive placebo tablets for upadacitinib administered orally once daily (QD) in Period 2.
7.5 mg Upadacitinib + 26-week CS taper -> 7.5 mg UpadacitinibEXPERIMENTALParticipants received 7.5 mg upadacitinib tablets administered orally once daily (QD) in Period 2.
7.5 mg Upadacitinib + 26-week CS taper -> PlaceboEXPERIMENTALParticipants received placebo tablets for upadacitinib administered orally once daily (QD) in Period 2.
15 mg Upadacitinib + 26-week CS taper -> 15 mg UpadacitinibEXPERIMENTALParticipants received 15 mg upadacitinib tablets administered orally once daily (QD) in Period 2.
15 mg Upadacitinib + 26-week CS taper -> PlaceboEXPERIMENTALParticipants received placebo tablets for upadacitinib administered orally once daily (QD) in Period 2.
Upadacitinib 45 mgEXPERIMENTALParticipants received 45 mg upadacitinib once daily (QD) for 8 weeks. Participants who did not achieve clinical response per Adapted Mayo score at Week 8 received upadacitinib 45 mg once daily for 8 additional weeks in the open-label extension period.
PlaceboPLACEBO_COMPARATORParticipants received placebo matching to upadacitinib once daily for 8 weeks. Participants who did not achieve clinical response per Adapted Mayo score at Week 8 received upadacitinib 45 mg once daily for 8 weeks in the open-label extension period.
Arm AEXPERIMENTALUpadacitinib Dose A is administered once daily along with Topical Corticosteroids (TCS).
Arm BEXPERIMENTALUpadacitinib Dose B is administered once daily along with Topical Corticosteroids (TCS).
Arm CEXPERIMENTALPlacebo administered once daily and TCS followed by Upadacitinib Dose A once daily along with TCS.
Arm DEXPERIMENTALPlacebo administered once daily and TCS followed by Upadacitinib Dose B once daily along with TCS.
Placebo / UpadacitinibPLACEBO_COMPARATORParticipants will receive placebo orally once a day (QD) for 16 weeks in the double-blind treatment period. At Week 16 participants will be re-randomized to receive either upadacitinib 15 mg or upadacitinib 30 mg QD up to Week 260.
Upadacitinib 15 mg QDEXPERIMENTALParticipants will receive upadacitinib 15 mg orally once a day for up to 260 weeks.
Placebo / Upadacitinib + Topical CorticosteroidsPLACEBO_COMPARATORParticipants will receive placebo orally once a day (QD) for 16 weeks in the double-blind treatment period. At Week 16 participants will be re-randomized to receive either upadacitinib 15 mg or upadacitinib 30 mg QD up to Week 260. Participants will also receive concomitant topical corticosteroids following a step-down regimen through Week 52.
Upadacitinib 15 mg QD + Topical CorticosteroidsEXPERIMENTALParticipants will receive upadacitinib 15 mg orally once a day for up to 260 weeks. Participants will also receive concomitant topical corticosteroids following a step-down regimen through Week 52.
Upadacitinib 30 mg QD + Topical CorticosteroidsEXPERIMENTALParticipants will receive upadacitinib 30 mg orally once a day for up to 260 weeks. Participants will also receive concomitant topical corticosteroids following a step-down regimen through Week 52.
Long-Term ExtensionEXPERIMENTALParticipants who reach Week 260 in Studies M16-045, M18-891, and M16-047 will have the opportunity to roll over into the blinded LTE period of M16-047 to continue receiving the same daily dose of upadacitinib for up to Week 524.
Substudy 1: Cohort 1 Upadacitinib Dose AEXPERIMENTALThis is a maintenance group which includes participants who achieved clinical response to upadacitinib in studies M14-431 and M14-433 and will receive upadacitinib dose A for 52 weeks.
Substudy 1: Cohort 1 Upadacitinib Dose BEXPERIMENTALThis is a maintenance group which includes participants who achieved clinical response to upadacitinib in studies M14-431 and M14-433 and will receive upadacitinib dose B for 52 weeks.
Substudy 1: Cohort 1 PlaceboEXPERIMENTALThis is a maintenance group which includes participants who achieved clinical response to upadacitinib in studies M14-431 and M14-433 and will receive placebo for 52 weeks.
Substudy 1: Cohort 2 PlaceboEXPERIMENTALThis is a maintenance group which includes participants who received double-blind placebo in studies M14-431 and M14-433 and achieved clinical response will continue to receive blinded placebo for 52 Weeks.
Substudy 1: Cohort 3 Upadacitinib Dose BEXPERIMENTALThis is a maintenance group which includes participants who achieved clinical response to upadacitinib from the extended treatment period of studies M14-431 and M14-433 and will receive upadacitinib Dose B for 52 Weeks.
Substudy 2: Cohort 4 Upadacitinib Dose BEXPERIMENTALThis is a long-term extension group which includes participants who achieved clinical response in the open-label extended treatment period of study M14-431 and will receive upadacitinib dose B for 240 weeks.
Substudy 2: Cohort 5 Upadacitinib Dose AEXPERIMENTALThis is a long-term extension group which includes participants who complete Substudy 1 and will receive upadacitinib dose A for 240 weeks.
Substudy 2: Cohort 5 Upadacitinib Dose BEXPERIMENTALThis is a long-term extension group which includes participants who complete Substudy 1 and will receive upadacitinib dose B for 240 weeks.
Substudy 2: Cohort 5 PlaceboEXPERIMENTALThis is a long-term extension group which includes participants who complete Substudy 1 and will receive placebo for 240 weeks.
Placebo / Upadacitinib 15 mgPLACEBO_COMPARATORParticipants randomized to receive placebo once daily for 12 weeks in Period 1 followed by upadacitinib 15 mg once daily for up to 52 weeks in Period 2.
Upadacitinib 15 mgEXPERIMENTALParticipants randomized to receive upadacitinib 15 mg once daily for 12 weeks in Period 1 and up to an additional 52 weeks in Period 2.
Part 1 (Double-blind): PlaceboPLACEBO_COMPARATORParticipants received upadacitinib matching placebo tablets, orally, once daily (QD) for 12 weeks during the Double-blind (DB) Induction Period.
Part 1 (Double-blind): Upadacitinib 45 mgEXPERIMENTALParticipants received upadacitinib 45 mg tablets, orally, QD for 12 weeks during the DB Induction Period.
Part 2 (Open-label): Upadacitinib 45 mgEXPERIMENTALParticipants received upadacitinib 45 mg tablets, orally, QD for 12 weeks during the Open-label (OL) Induction Period.
Part 3 (Extended Treatment DB): Upadacitinib 45 mg From Part 1 DB PlaceboEXPERIMENTALParticipants received upadacitinib 45 mg tablets, orally, QD for 12 weeks (until Week 24) during the Extended Treatment (ET) Period. Participants who received placebo in Part 1 and did not achieve clinical response at Week 12 were included in this group.
Part 3 (Extended Treatment DB): Upadacitinib 30 mg From Part 1 DB Upadacitinib 45 mgEXPERIMENTALParticipants received upadacitinib 30 mg tablets, orally, QD for 12 weeks (until Week 24) during the ET Period. Participants who received DB upadacitinib 45 mg in Part 1 and did not achieve clinical response at Week 12 were included in this group.
Part 3 (Extended Treatment OL): Upadacitinib 30 mg From Part 2 OL Upadacitinib 45 mgEXPERIMENTALParticipants received upadacitinib 30 mg tablets, orally, QD for 12 weeks (until Week 24) during the ET Period. Participants who received OL upadacitinib 45 mg during Part 2 and did not achieve clinical response at Week 12 were included in this group.
Placebo / Upadacitinib 30 mgPLACEBO_COMPARATORAdministered once daily.
Upadacitinib 30 mgEXPERIMENTALAdministered once daily.
AdalimumabACTIVE_COMPARATORPeriod 1: Participants receive adalimumab 40 mg by subcutaneous injection every other week and matching placebo to upadacitinib orally QD for 56 weeks. Period 2: Participants continue to receive adalimumab 40 mg every other week.
Participants receiving Upadacitinib (ABT-494) Dose AEXPERIMENTALThe participants in this arm will receive Upadacitinib (ABT-494) dose A.
Participants receiving Upadacitinib (ABT-494) Dose BEXPERIMENTALThe participants in this arm will receive Upadacitinib (ABT-494) dose B.
Participants receiving Upadacitinib (ABT-494) Dose A or Dose BEXPERIMENTALThe participants in this arm will receive Upadacitinib (ABT-494) dose A or dose B.
Participants receiving PlaceboEXPERIMENTALThe participants in this arm will receive placebo until study is unblinded.
Participants receiving Upadacitinib (ABT-494) Dose CEXPERIMENTALThe participants in this arm will receive Upadacitinib (ABT-494) dose C.
Methotrexate / Upadacitinib 30 mgEXPERIMENTALPeriod 1: Participants receive methotrexate once weekly and placebo to upadacitinib once daily for 14 weeks. Period 2: Participants receive upadacitinib 30 mg once daily until implementation of Protocol Amendment 5 when participants begin to receive upadacitinib 15 mg once daily up to Week 260.
Methotrexate / Upadacitinib 15 mgEXPERIMENTALPeriod 1: Participants receive methotrexate once weekly and placebo to upadacitinib for 14 weeks. Period 2: Participants receive upadacitinib 15 mg once daily up to Week 260.
Placebo / Upadacitnib 15 mgPLACEBO_COMPARATORPeriod 1: Participants receive placebo once daily for 12 weeks followed by upadacitinib 15 mg once daily for 12 weeks. Period 2: Participants will continue on upadacitinib 15 mg once daily from Week 24 to Week 260.
Placebo / Upadacitnib 30 mgPLACEBO_COMPARATORPeriod 1: Participants receive placebo once daily for 12 weeks followed by upadacitinib 30 mg once daily for 12 weeks. Period 2: Participants continue on upadacitinib 30 mg once daily until implementation of Protocol Amendment 4, then participants begin to receive upadacitinib 15 mg once daily up to Week 260.
MethotrexateACTIVE_COMPARATORPeriod 1: Participants will receive placebo to upadacitinib once daily and methotrexate once weekly for 48 weeks. Period 2: Participants will continue on placebo to upadacitinib once daily and methotrexate once weekly until the study is unblinded, after which participants will receive open-label methotrexate up to Week 260.
Upadacitinib 7.5 mg (Japan-only)EXPERIMENTALPeriod 1: Participants will receive upadacitinib 7.5 mg once daily and placebo to methotrexate once weekly for 48 weeks. Period 2: Participants will continue on upadacitinib 7.5 mg once daily and placebo to methotrexate once weekly until the study is unblinded, after which participants will receive open-label upadacitinib 7.5 mg up to Week 260.
Placebo followed by ABT-494PLACEBO_COMPARATORParticipants were to receive placebo to upadacitinib orally once daily (QD) and placebo to adalimumab by subcutaneous injection once every two weeks (eow) for up to 26 weeks. Participants who did not achieve a ≥ 20% improvement in tender joint count (TJC) and swollen joint count (SJC) at Weeks 14, 18, or 22 compared to Baseline were to be switched to 15 mg upadacitinib orally QD. At Week 26, all remaining participants were to be switched to 15 mg upadacitinib QD until Week 48 (end of Period 1). Participants who complete Period 1 will continue to receive 15 mg upadacitinib orally QD for up to 5 years in Period 2.
Upa 22 mg Period 1, then Upa 22 mg Period 2EXPERIMENTALParticipants received upadacitinib 22 mg administered orally once a day (QD) as tablets for 24 weeks during Period 1. Participants then received upadacitinib 22 mg administered orally once a day (QD) as tablets for 28 weeks during Period 2.
Upa 11 mg Period 1, then Upa 11 mg Period 2EXPERIMENTALParticipants received upadacitinib 11 mg administered orally once a day (QD) as tablets for 24 weeks during Period 1. Participants then received upadacitinib 11 mg administered orally once a day (QD) as tablets for 28 weeks during Period 2.
Upa 6 mg Period 1, then Upa 6 mg Period 2EXPERIMENTALParticipants received upadacitinib 6 mg administered orally once a day (QD) as tablets for 24 weeks during Period 1. Participants then received upadacitinib 6 mg administered orally once a day (QD) as tablets for 28 weeks during Period 2.
Placebo Period 1, then Upa 22 mg Period 2EXPERIMENTALParticipants received Placebo for upadacitinib administered orally once a day (QD) as tablets for 24 weeks during Period 1. Participants then received upadacitinib 22 mg administered orally once a day (QD) as tablets for 28 weeks during Period 2.
Placebo Period 1, then Upa 11 mg Period 2EXPERIMENTALParticipants received Placebo for upadacitinib administered orally once a day (QD) as tablets for 24 weeks during Period 1. Participants then received upadacitinib 11 mg administered orally once a day (QD) as tablets for 28 weeks during Period 2.
Placebo followed by Upadacitinib 15 mgEXPERIMENTALParticipants will receive matching placebo orally once a day for 12 weeks (Period 1) followed by 15 mg upadacitinib orally once a day for 36 weeks (Period 2).
Upadacitinib 7.5 mgEXPERIMENTALParticipants randomized to receive upadacitinib 7.5 mg QD for 16 weeks in Period 1. At Week 16 participants were re-randomized to receive 7.5 mg upadacitinib or placebo QD for 72 weeks in Period 2.
SS1: PlaceboPLACEBO_COMPARATORDuring the 8-week induction phase in Substudy 1, participants received placebo for upadacitinib film-coated tablets once daily by mouth (QD) for 8 weeks.
SS1: Upadacitinib 7.5 mgEXPERIMENTALDuring the 8-week induction phase in Substudy 1, participants received 7.5 mg upadacitinib film-coated tablets once daily by mouth (QD) for 8 weeks.
SS1: Upadacitinib 15 mgEXPERIMENTALDuring the 8-week induction phase in Substudy 1, participants received 15 mg upadacitinib film-coated tablets once daily by mouth (QD) for 8 weeks.
SS1: Upadacitinib 30 mgEXPERIMENTALDuring the 8-week induction phase in Substudy 1, participants received 30 mg upadacitinib film-coated tablets once daily by mouth (QD) for 8 weeks. Additional participants were enrolled during the Substudy 1 analysis period and received 30 mg upadacitinib film-coated tablets once daily by mouth (QD) for 4 weeks.
SS1: Upadacitinib 45 mgEXPERIMENTALDuring the 8-week induction phase in Substudy 1, participants received 45 mg upadacitinib film-coated tablets once daily by mouth (QD) for 8 weeks. Additional participants were enrolled during the Substudy 1 analysis period and received 45 mg upadacitinib film-coated tablets once daily by mouth (QD) for 4 weeks.
SS2: Placebo/Upadacitinib 45 mgEXPERIMENTALDuring the Substudy 2 Part 1 induction period, participants received placebo for upadacitinib film-coated tablets once daily by mouth (QD) for 8 weeks. Participants who did not achieve clinical response at Week 8 of Part 1 were enrolled in an open-label extended treatment period and received 45 mg upadacitinib film-coated tablets once daily by mouth (QD) for an additional 8 weeks.
SS2: Upadacitinib 45 mg/Upadacitinib 45 mgEXPERIMENTALDuring the Substudy 2 Part 1 induction period, participants received 45 mg upadacitinib film-coated tablets once daily by mouth (QD) for 8 weeks. Participants who did not achieve clinical response at Week 8 of Part 1 were enrolled in an open-label expended treatment period and received 45 mg upadacitinib film-coated tablets once daily by mouth (QD) for an additional 8 weeks.
SS3: M14-675 clinical respondersEXPERIMENTALParticipants in Study M14-675 (NCT03653026) who achieved clinical response defined by Adapted Mayo Score at Week 8 or Week 16 in that study and did not meet any study discontinuation criteria were eligible to enroll into Substudy 3. Participants were re-randomized and treated with a blinded treatment assignment (15 mg upadacitinib film-coated tablets once daily by mouth \[QD\], or 30 mg upadacitinib film-coated tablets QD, or placebo for upadacitinib film-coated tablets QD) for up to 52 weeks.
Placebo / Upadacitinib 7.5 mgEXPERIMENTALPeriod 1: Participants will receive placebo once daily for 12 weeks. Period 2: Participants will receive Upadacitinib 7.5 mg once daily for 248 weeks.
Upadacitinib 7.5 mg / Upadacitinib 7.5 mgEXPERIMENTALPeriod 1: Participants will receive upadacitinib 7.5 mg once daily for 12 weeks. Period 2: Participants will receive upadacitinib 7.5 mg once daily for 248 weeks.
Upadacitinib 15 mg / Upadacitinib 15 mgEXPERIMENTALPeriod 1: Participants will receive upadacitinib 15 mg once daily for 12 weeks. Period 2: Participants will receive upadacitinib 15 mg once daily for 248 weeks.
Upadacitinib 30 mg / Upadacitinib 30 mgEXPERIMENTALPeriod 1: Participants will receive upadacitinib 30 mg once daily for 12 weeks. Period 2: Participants will receive upadacitinib 30 mg once daily until regulatory approval of RA indication in Japan at which point they will switch to receive upadacitinib 15 mg once daily. Participants will receive upadacitinib for 248 weeks.
Upadacitinib 3 mg BIDEXPERIMENTALParticipants received 3 mg upadacitinib twice daily (BID) for 12 weeks.
Upadacitinib 6 mg BIDEXPERIMENTALParticipants received 6 mg upadacitinib twice daily (BID) for 12 weeks.
Upadacitinib 12 mg BIDEXPERIMENTALParticipants received 12 mg upadacitinib twice daily (BID) for 12 weeks.
Upadacitinib 18 mg BIDEXPERIMENTALParticipants received 18 mg upadacitinib twice daily (BID) for 12 weeks.
Upadacitinib 24 mg QDEXPERIMENTALParticipants received 24 mg upadacitinib once daily (QD) for 12 weeks.
Upadacitinib (Drug)ACTIVE_COMPARATORDuring the 8-week randomized withdrawal (RW) phase, participants in this arm will receive upadacitinib at the dose that was determined to work best for them (optimal treatment dose, OTD) during the earlier open-label phase of the study (15 mg, 30 mg, or 45 mg OTD). This study is not designed to compare the different dose levels. Therefore, participants receiving any of the three dose levels will be considered as one arm because each participant is receiving their own OTD.
Matching PlaceboPLACEBO_COMPARATORDuring the 8-week RW phase, participants assigned to receive placebo will receive placebo tablets that match their OTD selected during the earlier phase of the study.
Participants of age group 12 to <18 years receiving dose AEXPERIMENTALParticipants of age group 12 to \<18 years administered with upadacitinib dose A (weight dependent) as described in the protocol.
Participants of age group 12 to <18 years receiving dose BEXPERIMENTALParticipants of age group 12 to \<18 years administered with upadacitinib dose B (weight dependent) as described in the protocol.
Participants of age group 6 to <12 years receiving dose AEXPERIMENTALParticipants of age group 6 to \<12 years administered with upadacitinib dose A (weight dependent) as described in the protocol.
Participants of age group 2 to <6 years receiving dose AEXPERIMENTALParticipants of age group 2 to \<6 years administered with upadacitinib dose A (weight dependent) as described in the protocol.
Participants of age group 2 to <18 years receiving dose AEXPERIMENTALParticipants of age group 2 to \<18 years administered with upadacitinib dose A as described in the protocol.
Part 1; Cohort 1EXPERIMENTALParticipants, 6 to \<12 years of age, will receive low dose of upadacitinib.
Part 1; Cohort 2EXPERIMENTALParticipants, 6 to \<12 years of age, will receive high dose of upadacitinib.
Part 1; Cohort 3EXPERIMENTALParticipants, 2 to \<6 years of age, will receive low dose of upadacitinib.
Part 1; Cohort 4EXPERIMENTALParticipants, 2 to \<6 years of age, will receive high dose of upadacitinib.
Part 2EXPERIMENTALEligible participants who completed Part 1 will receive weight-dependant low dose of upadacitinib.
Interventions
NameTypeDescription
UpadacitinibDRUGOral Tablets
Upadacitinib PlaceboDRUGOral Tablets
PlaceboDRUGTablets taken orally once a day (Or equivalent oral solution taken two times a day)
DupilumabDRUGSubcutaneous Injection
Upadacitinib 15mg DoseDRUGOral tablet
Dupilumab 300mg DoseDRUGSubcutaneous (SC) injection
Upadacitinib 30mg DoseDRUGOral tablet
NB-UVB (narrow-band ultraviolet B) PhototherapyOTHERNB-UVB phototherapy is a commonly used treatment modality in participants with vitiligo and can be administered in an office setting or at home 2 times per week
TocilizumabDRUGSubcutaneous injection or Intravenous infusion
AdalimumabDRUGSubcutaneous Injection
Upadacitinib Matching PlaceboDRUGOral Tablets
Adalimumab Matching PlaceboDRUGSubcutaneous Injection
Placebo for UpadacitinibDRUGPlacebo for upadacitinib will be administered as oral tablet
PrednisoloneDRUGPrednisolone will be administered as oral tablet
Placebo to dupilumabDRUGPlacebo administered as a subcutaneous injection
Placebo to upadacitinibDRUGTablet
Corticosteroid (CS)DRUGAt Baseline, all participants switched to corticosteroids (CS) provided by the sponsor with the oral prednisone or prednisolone dose at 20, 30, 40, 50, or 60 mg QD. The initial dose of prednisone or prednisolone was at the discretion of the investigator, based on disease severity and comorbid medical conditions, at a minimum of 20 mg QD at Baseline. At Baseline, if a participant was on a dose other than 20, 30, 40, 50, or 60 mg QD, the dose was rounded up or down, as clinically indicated per investigator discretion, to the nearest of these doses. Prednisone or prednisolone was tapered according to a predefined schedule over a 26- or 52-week period. Open-label prednisone or prednisolone was provided until the dose was tapered to 20 mg/day. Subsequently, blinded prednisone or prednisolone was provided for the remaining blinded taper regimen through Week 52.
Topical Corticosteroids (TCS)DRUGIt is administered concomitantly with upadacitinib or placebo.
Matching Placebo for UpadacitinibDRUGMatching placebo tablets
Placebo to AdalimumabDRUGAdministered by subcutaneous injection
Upadacitinib (ABT-494)DRUGUpadacitinib (ABT-494) will be administered orally.
MethotrexateDRUGCapsule; Oral
Placebo UpadacitinibDRUGTablet; Oral
Placebo MethotrexateDRUGCapsule; Oral
Placebo to MethotrexateDRUGCapsule or Tablet; Oral
Placebo for AdalimumabDRUGAdministered by subcutaneous injection once every other week
Pneumococcal 13-valent conjugate vaccine (PCV-13)BIOLOGICALAdministered by intramuscular injection
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Eligibility Criteria
Age Range12 Years to 63 Years
SexALL
Healthy VolunteersNo
Study Sites15

Inclusion Criteria: * Participant is judged to be in good health as determined by the Principal Investigator, based upon the results of the Screening assessments and medical history. * Diagnosis of severe alopecia areata (AA) with Severity of Alopecia Tool (SALT) score \>= 25 (\>= 25% scalp hair lo...

Countries:JapanUnited StatesArgentinaAustraliaAustriaBrazilBulgariaCanadaChileChinaCroatiaFranceGermanyHungaryIsraelItalyMexicoNetherlandsPolandPortugalPuerto RicoSingaporeSlovakiaSouth KoreaSpainTaiwanUnited KingdomBelgiumGreeceNew ZealandColombiaRomaniaCzechiaSwedenTurkey (Türkiye)Bosnia and HerzegovinaEstoniaGuatemalaLatviaLithuaniaSerbiaSouth AfricaSwitzerlandFinlandIrelandSaudi ArabiaMalaysiaNorwayUkraineRussiaDenmarkHong KongEgyptSloveniaBelarusKazakhstanTunisia
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LOWJul 6, 2026NCT06012240lastUpdatePostDate: changed
LOWJul 6, 2026NCT06389136lastUpdatePostDate: changed
LOWJul 6, 2026NCT06012240lastUpdatePostDate: changed
MEDIUMJul 3, 2026NCT03607422TRIAL_REMOVED: changed
MEDIUMJul 3, 2026NCT03607422TRIAL_REMOVED: changed
MEDIUMJul 3, 2026NCT03607422TRIAL_REMOVED: changed