Juvenile Idiopathic Arthritis Clinical Trial
Official title:
EFFICACY, SAFETY AND TOLERABILITY OF TOFACITINIB FOR TREATMENT OF POLYARTICULAR COURSE JUVENILE IDIOPATHIC ARTHRITIS (JIA) IN CHILDREN AND ADOLESCENT SUBJECTS
Evaluate efficacy, safety and tolerability of tofacitinib in pediatric JIA patients.
This is a randomized withdrawal, double blind, placebo controlled study of pediatric subjects
(2 to <18 years of age) with JIA. The primary objective is to compare the efficacy of
tofacitinib versus placebo for the treatment of signs and symptoms of JIA at Week 26 of the
double blind phase as measured by the percentage of subjects with disease flare (according to
PRCSG/PRINTO Disease Flare criteria) after Week 18 of the open label run in phase.All
eligible subjects enrolled in the study will initially receive open label tofacitinib for 18
weeks (run in phase). At the end of the 18 week run in phase, only subjects who achieve at
least a JIA ACR 30 response will be randomized to the 26 week double blind, placebo
controlled phase. Subjects who do not achieve a JIA ACR 30 response at this time point will
be discontinued from the study. In addition, subjects who experience a single episode of
disease flare at any time during the study (including the open label run in and double blind
phase) will also be discontinued from the study. All subjects participating in this study,
including those discontinued from the study, will have the option, if eligible (based on
inclusion and exclusion criteria), of enrolling in the tofacitinib JIA long term extension
study (A3921145).
Subjects who are eligible for the 26 week double blind phase will be randomized (1:1 ratio)
to either active tofacitinib or placebo. For subjects with polyarticular course JIA (ie,
extended oligoarthritis, polyarthritis RF+, polyarthritis RF , systemic JIA with active
arthritis but without active systemic features), randomization will be stratified by JIA
category and baseline CRP (normal, above normal). For subjects with psoriatic and enthesitis
related arthritis, randomization will be stratified by JIA category.
Approximately 210 subjects will be enrolled in the open label run in phase. Among subjects
with polyarticular course JIA, stratification will target at least 50% with a baseline CRP
above the upper limit of normal. The first cohort (ie, polyarticular course JIA) will have at
least 170 subjects enrolled in the run in phase with the minimum number of JIA categories as
follows: 24 with extended oligoarthritis, 20 with polyarthritis RF+, 62 with polyarthritis
RF-, and no minimum for subjects with systemic JIA with active arthritis but without active
systemic features. Additional cohorts (ie, psoriatic and enthesitis related arthritis) will
include a minimum of 20 subjects with psoriatic arthritis, and 20 subjects with enthesitis
related arthritis. The overall target minimum number of subjects to be enrolled in the study
by age is as follows: 20 subjects 2 to <6 years, 20 subjects 6 to <12 years, and 20 subjects
12 to <18 years. The duration of subject participation among those who complete the study
(without discontinuation) is expected to be approximately 44 weeks.
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