AbbVie announced positive top-line data from the SELECT-PsA 2 Phase 3 study. In this study, both doses of RINVOQ™ (upadacitinib; 15 mg and 30 mg, once daily) met the primary endpoint of ACR20 response at week 12 versus placebo in adult patients with active psoriatic arthritis who have responded inadequately to one or more biologic disease modifying anti-rheumatic drugs (bDMARDs). In addition, patients on both doses of RINVOQ achieved significantly greater responses compared to placebo for all ranked secondary endpoints. SELECT-PsA 2 is the first study evaluating the efficacy and safety of RINVOQ in adult patients with active psoriatic arthritis. RINVOQ, a selective and reversible JAK inhibitor discovered and developed by AbbVie, is being studied as a once-daily therapy in psoriatic arthritis and multiple immune-mediated diseases.
"Too many people living with psoriatic arthritis still fail to achieve their treatment goals, underscoring a clear medical need for additional therapeutic options," said Michael Severino, M.D., vice chairman and president, AbbVie. "We are pleased with these data, which show the potential of RINVOQ to improve outcomes for people with psoriatic arthritis across a variety of symptoms. Data from this Phase 3 study will support regulatory submissions for RINVOQ in psoriatic arthritis."
Results show that at week 12, 57/64 percent of patients receiving 15/30 mg of RINVOQ achieved ACR20, respectively, compared to 24 percent in the placebo group (p<0.0001). Additionally, ACR50 was achieved by 32/38 percent of patients receiving 15/30 mg of RINVOQ, respectively, compared to 5 percent on placebo at week 12 (p<0.0001).1 9/17 percent of patients achieved ACR70 in the 15/30 mg RINVOQ groups, respectively, compared to 0.5 percent in the placebo group at week 12 (p<0.0001). Patients receiving RINVOQ also had greater improvements in physical function at week 12, as measured by the Health Assessment Questionnaire Disability Index (HAQ-DI). RINVOQ showed improvement in skin symptoms at week 16, with 52/57 percent of patients receiving 15/30 mg of RINVOQ achieving a 75 percent improvement in the Psoriasis Area Severity Index (PASI 75), respectively, compared to 16 percent on placebo (p<0.0001). 25/29 percent of 15/30 mg RINVOQ-treated patients achieved minimal disease activity (MDA) at week 24 (p<0.0001), respectively, compared to 3 percent in the placebo group.
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In this study, the safety profile of RINVOQ was consistent with that observed in previously reported studies in patients with rheumatoid arthritis, with no new safety risks detected. Through week 24, serious infections occurred in 0.5/2.8 percent of patients in the 15/30 mg RINVOQ groups, respectively, compared to 0.5 percent in the placebo group. There was one pulmonary embolism reported in the 15 mg RINVOQ group and none in the 30 mg and placebo groups. There was one non-fatal adjudicated major adverse cardiovascular event (MACE) in the 15 mg RINVOQ group (acute myocardial infarction) and no MACE in the 30 mg and placebo groups. One death was reported in a patient receiving placebo (motor vehicle accident).
Psoriatic arthritis is a heterogeneous systemic inflammatory disease with hallmark manifestations in joints and skin, affecting more than 50 million people worldwide. In psoriatic arthritis, the immune system creates inflammation that can lead to pain, fatigue and stiffness in the joints.
SELECT-PsA 2 is a Phase 3, multicenter, randomized, double-blind, parallel-group, placebo-controlled study designed to evaluate the safety and efficacy of RINVOQ in adult patients with active psoriatic arthritis who have a history of inadequate response to at least one bDMARD. Patients were randomized to RINVOQ 15 mg, RINVOQ 30 mg or placebo followed by either RINVOQ 15 mg or RINVOQ 30 mg at week 24.
The primary endpoint was the percentage of subjects achieving an ACR20 response after 12 weeks of treatment. Secondary endpoints included change from baseline in HAQ-DI, proportion of patients achieving ACR50 and ACR70 at week 12, proportion of patients achieving PASI 75 at week 16, as well as proportion of patients achieving MDA at week 24. The trial is ongoing, and the long-term extension remains blinded to evaluate the long-term safety, tolerability and efficacy of the two once-daily doses (15 mg and 30 mg) of RINVOQ in patients who have completed the placebo-controlled period.
Discovered and developed by AbbVie, RINVOQ is a selective and reversible JAK inhibitor studied in several immune-mediated inflammatory diseases. Earlier this year, RINVOQ received U.S. Food and Drug Administration approval for adult patients with moderately to severely active rheumatoid arthritis. RINVOQ also received a positive opinion from the European Union's Committee for Medicinal Products for Human Use and is currently awaiting final approval by the European Commission. Phase 3 trials of RINVOQ in psoriatic arthritis, Crohn's disease, atopic dermatitis, ulcerative colitis and giant cell arteritis are ongoing and it is also being investigated to treat ankylosing spondylitis.