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Rheumatoid Arthritis (RA)UPWARDSNCT04267536

An Observational Study to Evaluate Impact of CRP-Level on Real World Effectiveness of Upadacitinib as Monotherapy or in Combination With MTX in Adult Participants With Rheumatoid Arthritis

An observational study of Rheumatoid Arthritis (RA), run by AbbVie at 52 sites in Germany.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

Rheumatoid Arthritis (RA) is a chronic inflammatory disease causing pain, stiffness, swelling and loss of joint function. RA can reduce the ability to perform everyday tasks. This study assesses whether C-reactive protein (CRP)-level has an impact on achieving remission with upadacitinib when used alone or in… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Rheumatoid Arthritis (RA)
How many people
534 participants
Where
52 sitesGermany
Study dates
6 Feb 2020to 1 Feb 2022
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Adult Participants with moderate to severe rheumatoid arthritis (RA)

Who may be able to join

  • Diagnosis of moderate to severe active rheumatoid arthritis (RA) upon judgment of the treating physician.
  • Swollen Joint Count (SJC) >= 3 of 28 joints of the Disease Activity Score (DAS)28.
  • Measurement of C-Reactive Protein (CRP)-level at Baseline (BL) or <= 4 weeks prior to BL at a timepoint when the Prednisolone equivalent dose of Glucocorticoid treatment was <= 10 mg/day for at least 7 days.
  • Upadacitinib treatment is indicated as per local Summary of Product characteristics (SmPC).
  • Decision on the treatment with Upadacitinib was made prior to any decision to approach the patient to participate in this study.

Who cannot join

  • Participants who cannot be treated with Upadacitinib according to the local Upadacitinib SmPC.
  • Prior treatment with Upadacitinib.
  • Treatment with Sarilumab or Tocilizumab within the last 8 weeks before the CRP level for inclusion was measured.
  • Participants currently participating in interventional research.
  • Participants who are unwilling or unable to complete the patient reported questionnaires.

Trial locations and contacts

52 sites in 1 country.

52 sites in 1 country

Germany52 sites
  • Kupka & Kupka, Altenburg, DE /ID# 218413

    Altenburg, 04600

  • Marycz, Amberg, DE /ID# 220808

    Amberg, 92224

  • Rheumapraxis am Webereck /ID# 218712

    Augsburg, 86157

  • MVZ Weserbergland /ID# 220809

    Bad Pyrmont, 31812

  • Internistische-rheumatologische Praxisgemeinschaft /ID# 218540

    Bayreuth, 95444

  • Bozorg-Doagoo, Berlin, DE /ID# 218431

    Berlin, 10713

  • Praxis Dr. Silke Zinke /ID# 218433

    Berlin, 13055

  • Eisterhues, Braunschweig, DE /ID# 218532

    Braunschweig, 38100

  • Medizinische Versorgungszentren Burghausen Altoetting /ID# 221385

    Burghausen, 84489

  • Med Versorgungszentrum AGILOMED /ID# 218538

    Chemnitz, 09130

  • Dres. Schuh /ID# 218541

    Coburg, 96450

  • Praxis Dr. Lüthke /ID# 218900

    Dresden, Saxony, 01097

  • Rheumatologisches MVZ Dresden /ID# 218411

    Dresden, 01109

  • Rheumapraxis Düren /ID# 224950

    Düren, 52355

  • Strothmeyer & Scheulen /ID# 218426

    Düsseldorf, 40211

  • Praxis Dilltal /ID# 218427

    Ehringshausen, 35630

  • Praxisgemeinschaft Rheumatologie Nephrologie Erlangen /ID# 222579

    Erlangen, 91056

  • Dres. Waehrisch/Flaxenberg /ID# 218711

    Essen, 45326

  • Michael Mueller, Freiberg, DE /ID# 218414

    Freiberg, 09599

  • Praxis Dr. Kuehne /ID# 221389

    Haldensleben I, 39340

  • Praxis Dr. Liebhaber /ID# 218899

    Halle, 06128

  • Aries, Hamburg, DE /ID# 220804

    Hamburg, 22767

  • Stille, Hanover, DE /ID# 218429

    Hanover, 30161

  • Medizinische Hochschule Hannover /ID# 222068

    Hanover, 30625

  • Heilig, Heidelberg, DE /ID# 221391

    Heidelberg, 69120

  • Rheumazentrum Ruhrgebiet /ID# 221388

    Herne, North Rhine-Westphalia, 44649

  • Praxis K. Pagel /ID# 218714

    Hoppegarten, 15366

  • Hamann & Teich & Boche,Leipzig /ID# 218531

    Leipzig, 04109

  • Schwarze/Haeder, Leipzig, DE /ID# 218412

    Leipzig, 04129

  • Dres. Teipel/Toussaint/Saech /ID# 223969

    Leverkusen, 51373

  • Aurich & Sieburg, Magdeburg /ID# 220811

    Magdeburg, 39104

  • Harmuth, Marktredwitz, DE /ID# 218715

    Marktredwitz, 95615

  • Praxis Dres. Kellerer/Kellerer/Krüger /ID# 218428

    Munich, Bavaria, 81541

  • Prof-med-stud.de /ID# 218534

    Munich, 80935

  • Praxis Dr. med Thilo Klopsch /ID# 218535

    Neubrandenburg, 17033

  • Praxis Hein & Gess /ID# 218716

    Nienburg, 31582

  • Praxis Hein & Gess /ID# 218896

    Nienburg, 31582

  • Elisabeth-Klinik Bigge /ID# 218425

    Olsberg, 59939

  • MVZ für Rheumatologie Dr. M. Welcker GmbH /ID# 218543

    Planegg, 82152

  • Rheumahaus Studien GbR, Potsdam, DE /ID# 218430

    Potsdam, Brandenburg, 14467

  • Knappschaftsklinikum Saar /ID# 218901

    Püttlingen, 66346

  • Rheumazentrum Ratingen /ID# 218897

    Ratingen, 40882

  • Rheumatologische Gemeinschaftspraxis Schwerin /ID# 218432

    Schwerin, 19053

  • Melzer, Seesen, DE /ID# 220803

    Seesen, 38723

  • Rheumatologische Schwerpunktpraxis /ID# 218415

    Stuttgart, 70372

  • Bruederkrankenhaus Trier /ID# 221393

    Trier, 54292

  • Praxis Dr. Haas /ID# 218423

    Tübingen, 72072

  • Praxis Dr. Rinaldi /ID# 218424

    Ulm, Baden-Wurttemberg, 89073

  • Rheumathologie Ulm /ID# 218539

    Ulm, 89073

  • Krankenhaus St. Josef /ID# 221392

    Wuppertal, 42105

  • Praxis Barmen /ID# 218895

    Wuppertal, 42285

  • Fricke-Wagner, Zwickau, DE /ID# 218533

    Zwickau, 08060

Other trials in Germany

About this study

Official title: UPwArds - Post Marketing Observational Study to Evaluate the Impact of CRP-Level on the Real World Effectiveness of UPadacitinib When Used in MonotherApy or in Combination With MTX in Patients With RheumatoiD ArthritiS

Rheumatoid Arthritis (RA) is a chronic inflammatory disease causing pain, stiffness, swelling and loss of joint function. RA can reduce the ability to perform everyday tasks. This study assesses whether C-reactive protein (CRP)-level has an impact on achieving remission with upadacitinib when used alone or in combination with methotrexate (MTX). This study will also assess the reduction in pain, morning stiffness, fatigue, functionality, health status and impact of RA.

CRP is an indicator of inflammation and often used for disease activity monitoring during RA treatment. Upadacitinib is a Janus kinase (JAK) inhibitor indicated for the treatment of adults with moderately to severely active RA who have had an inadequate response or intolerance to methotrexate. This study has two groups - upadacitinib monotherapy and combination. Adult participants with moderate to severe RA will be enrolled. Around 500 participants will be enrolled in the study in multiple sites within Germany.

Read more

Participants will receive upadacitinib alone or in combination with MTX per their physicians' usual prescription. Individual data will be collected for 12 months.

No additional study-related tests will be conducted during the routine physician visits. Only data which are routinely collected during a regular visit will be utilized for this study.

Keywords
Rheumatoid Arthritis (RA), Upadacitinib, RINVOQ, Methotrexate (MTX), ABT-494, C-reactive protein (CRP)
Medical subject headings
Arthritis, Rheumatoid

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT04267536
Study groupRoleWhat they receive
Participants treated with upadacitinib monotherapyParticipants will receive upadacitinib for 12 months as prescribed by the physician
Participants treated with upadacitinib in combination with MTXParticipants will receive upadacitinib in combination with MTX as prescribed by the physician for 12 months

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percentage of Participants Achieving Remission

    Remission is defined as clinical disease activity index (CDAI) <=2.8

    Measured: 6 Months

Secondary outcomes (26)
  1. Percentage of Participants Achieving Remission

    Remission is defined as the disease activity score at 28 joints (DAS28)-C-Reactive protein (CRP)<2.6, DAS28- erythrocyte sedimentation rate (ESR)<2.6, simplified disease activity index (SDAI)<=3.3, CDAI<=2.8, Boolean.

    Measured: Up to 12 Months

  2. Percentage of Participants Achieving Low Disease Activity (LDA)

    LDA is defined as DAS28-CRP<3.2, DAS28-ESR<3.2, SDAI <=11, CDAI<=10

    Measured: Up to 12 Months

  3. Mean Change From Baseline in CDAI

    The CDAI is a validated measure of RA disease activity. Twenty-eight tender joint counts, 28 swollen joint counts, global health assessed by the participant on a visual analogue scale (VAS) from 0 to 10 (cm), and global health assessed by an investigator on a visual analogue scale from 0 to 10 (cm) were included in the CDAI score. Scores on the CDAI range from 0 (lowest disease activity) to 76 (highest disease activity).

    Measured: Up to 12 Months

  4. Mean Change From Baseline in SDAI

    The SDAI is a validated measure of RA disease activity. Twenty-eight tender joint counts, 28 swollen joint counts, global disease activity assessed by the participant on a visual analogue scale from 0 to 10 (cm) , global disease activity assessed by an investigator on a visual analogue scale from 0 to 10 (cm), and serum levels of C-reactive protein (mg/dL) were included in the SDAI score. Scores on the SDAI range from 0 (lowest disease activity) to 86 (highest disease activity).

    Measured: Up to 12 Months

  5. Mean Change From Baseline in DAS28-CRP

    The Disease Activity Score (DAS) 28 is a validated index of rheumatoid arthritis disease activity. Scores on the DAS28 range from 0 (lowest disease activity) to 10 (highest disease activity).

    Measured: Up to 12 Months

  6. Mean Change From Baseline in DAS28-ESR

    The Disease Activity Score (DAS) 28 is a validated index of rheumatoid arthritis disease activity. Scores on the DAS28 range from 0 (lowest disease activity) to 10 (highest disease activity).

    Measured: Up to 12 Months

  7. Percentage of Participants Achieving Pain Reduction (Improvement by 30 %)

    Improvement in pain reduction is assessed by numeric rating scale (NRS). The NRS of Pain sheet will be filled out in the office by participants at the designated visits.

    Measured: Up to 12 Months

  8. Percentage of Participants Achieving Pain Reduction (Improvement by 50 %)

    Improvement in pain reduction is assessed by numeric rating scale (NRS). The NRS of Pain sheet will be filled out in the office by participants at the designated visits.

    Measured: Up to 12 Months

  9. Percentage of Participants Achieving Pain Reduction (Improvement by 70 %)

    Improvement in pain reduction is assessed by numeric rating scale (NRS). The NRS of Pain sheet will be filled out in the office by participants at the designated visits.

    Measured: Up to 12 Months

  10. Mean Change From Baseline in Pain

    The NRS of Pain sheet will be filled out in the office by participants at the designated visits.

    Measured: Up to 12 Months

  11. Percentage of Participants Achieving Fatigue Reduction (Improvement by 30 %)

    Improvement in fatigue reduction is assessed by numeric rating scale (NRS). The NRS of fatigue sheet will be filled out in the office by participants at the designated visits.

    Measured: Up to 12 Months

  12. Percentage of Participants Achieving Fatigue Reduction (Improvement by 50 %)

    Improvement in fatigue reduction is assessed by numeric rating scale (NRS). The NRS of fatigue sheet will be filled out in the office by participants at the designated visits.

    Measured: Up to 12 Months

  13. Percentage of Participants Achieving Fatigue Reduction (Improvement by 70 %)

    Improvement in fatigue reduction is assessed by numeric rating scale (NRS). The NRS of fatigue sheet will be filled out in the office by participants at the designated visits.

    Measured: Up to 12 Months

  14. Mean Change From Baseline in Fatigue

    Change in Fatigue is assessed by numeric rating scale (NRS). The NRS of fatigue sheet will be filled out in the office by participants at the designated visits.

    Measured: Up to 12 Months

  15. Change From Baseline in Rheumatoid Arthritis Impact of Disease (RAID)

    RAID is a tool for assessment of disease activity purely based on a patient questionnaire.

    Measured: Up to 12 Months

  16. Percentage of Participants Achieving RAID <= 3

    RAID is a tool for assessment of disease activity purely based on a patient questionnaire.

    Measured: Up to 12 Months

  17. Percentage of Participants Achieving RAID > 3 and <=4

    RAID is a tool for assessment of disease activity purely based on a patient questionnaire.

    Measured: Up to 12 Months

  18. Percentage of Participants Achieving RAID > 4 and <=6

    RAID is a tool for assessment of disease activity purely based on a patient questionnaire.

    Measured: Up to 12 Months

  19. Percentage of Participants Achieving RAID > 6

    RAID is a tool for assessment of disease activity purely based on a patient questionnaire.

    Measured: Up to 12 Months

  20. Change From Baseline in Morning Stiffness Severity

    Morning stiffness severity was assessed by a numeric rating-scale (NRS). Participants rated the severity of morning stiffness during the past week from 0 to 10 with 0 representing "not severe" and 10 "very severe".

    Measured: Up to 12 Months

  21. Change From Baseline in Morning Stiffness Duration

    The duration of morning stiffness was reported by participants as the average daily length during the past week in minutes (from time of awaking to time of maximal improvement).

    Measured: Up to 12 Months

  22. Change From Baseline in Functionality (FFbH)

    A self-administered patient questionnaire used to assess patient function based on 18 questions. The numerically coded responses to the questions are added to provide a total patient score.

    Measured: Up to 12 Months

  23. Change From Baseline in Patient Health Questionnaire (PHQ-9)

    The PHQ-9 is a 9-item questionnaire for assessing the severity of depression. Each question is answered on a scale from 0 (not at all) to 3 (nearly every day). The total score ranges from 0 to 27, where higher scores indicate more severe depression.

    Measured: Up to 12 Months

  24. Percentage of Participants With Minimal Clinically Important Difference (MCID) in PHQ-9

    MCID is defined as the at least 5 points difference from baseline in PHQ-9. The PHQ-9 is a 9-item questionnaire for assessing the severity of depression.

    Measured: Up to 12 Months

  25. Percentage of Participants With Low Disease Activity (LDA) or Remission Without Actual Concomitant MTX

    LDA is defined as DAS28 < 3.2, CDAI<=10, SDAI <11. Remission is defined as DAS28<2.6, CDAI<=2.8; Boolean Remission.

    Measured: Up to 12 Months

  26. Percentage of Participants With LDA or Remission With Actual Concomitant MTX

    LDA is defined as DAS28 < 3.2, CDAI<=10, SDAI <11. Remission is defined as DAS28<2.6, CDAI<=2.8; Boolean Remission.

    Measured: Up to 12 Months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Feb 2020
  2. Study start6 Feb 2020
  3. Primary completion1 Feb 2022
  4. Study completion1 Feb 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
534 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04267536
Sponsor's protocol ID
P20-078
Acronym
UPWARDS
Status last verified
Jan 2023
First submitted
11 Feb 2020
Last updated
26 Jan 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

An observational study of Rheumatoid Arthritis (RA), run by AbbVie at 52 sites in Germany.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 26 Jan 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 52 sites in Germany. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage of Participants Achieving Remission (time frame: 6 Months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Jan 2023.

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