Phase III SELECT-GCA study of upadacitinib (Rinvoq) showed positive results in patients with giant cell arteritis.- AbbVie.

In this study, 46 percent of patients receiving upadacitinib 15 mg in combination with a 26-week steroid taper regimen achieved sustained remission compared to 29 percent of patients receiving placebo in combination with a 52-week steroid taper regimen (p=0.0019).

"Many people living with GCA continue to suffer from the potentially debilitating symptoms of this disease, with limited treatment options available to them," said Kori Wallace, M.D., Ph.D., vice president, global head of immunology clinical development, AbbVie. "These results demonstrate our relentless commitment to improving the lives of people living with immune-mediated diseases by developing new treatments where significant medical needs still exist."

GCA is an autoimmune disease that causes inflammation of the temporal and other cranial arteries, the aorta, and other large and medium arteries. GCA generally impacts elderly patients older than 50 years, most commonly between the ages of 70 and 80 years. Women have the highest risk of developing this disease, which can cause headache, jaw pain and changes in or loss of vision, including sudden and permanent loss of vision.

Key secondary endpoints were also met, including a higher percentage of patients receiving upadacitinib 15 mg in combination with a 26-week steroid taper regimen achieved sustained complete remission from week 12 through week 52 compared to patients receiving placebo in combination with a 52-week steroid taper regimen (37 percent versus 16 percent; p<0.0001). a lower percentage of patients experienced at least one disease flare through week 52 in the upadacitinib 15 mg group versus the placebo group (34 percent versus 56 percent; p="0.0014)." the study results also showed that upadacitinib 7.5 mg did not meet the primary or any of the secondary endpoints.>

"I am encouraged by these results, which add to the body of evidence supporting the efficacy and safety profile of upadacitinib for the treatment of rheumatic diseases," said Daniel Blockmans, M.D., Ph.D., Department of General Internal Medicine, University Hospitals Gasthuisberg, Belgium, professor of medicine, KU Leuven, Belgium, and lead investigator of the SELECT-GCA trial. "Based on these results, upadacitinib has the potential to be the first oral treatment option for patients with GCA, a disease with inflammation of the large arteries that primarily impacts older people and has only one approved treatment to date3 commonly used with steroids."

During the 52-week, placebo-controlled period, the safety profile of upadacitinib 15 mg was generally consistent with that observed in approved indications. Upadacitinib 15 mg was generally well tolerated, with no new safety signals identified in this GCA population. Discontinuations due to adverse events occurred in 15 percent of patients in the upadacitinib 15 mg group and 21 percent of patients in the placebo group. In this study, the proportion of patients who experienced a serious adverse event was similar (23 percent in the upadacitinib 15 mg group and 21 percent in the placebo group). Serious infections occurred in 6 percent of the upadacitinib 15 mg group and 11 percent of the placebo group. Overall, the proportions of patients with incidence of malignancy excluding non-melanoma skin cancer and adjudicated venous thromboembolic events (VTEs) were balanced across both the upadacitinib 15 mg (2 percent and 3 percent, respectively) and placebo (2 percent and 4 percent, respectively) treatment groups. There were no adjudicated major adverse cardiac events (MACE) in the upadacitinib 15 mg group compared to two events in the placebo group. Four treatment-emergent deaths were reported, two in the placebo group and two in the upadacitinib 15 mg group. Of the two treatment-emergent deaths in the upadacitinib 15 mg group, one was attributed to COVID-19, and the other was adjudicated as an unexplained cause.

Full results across all treatment groups from the SELECT-GCA study will be presented at a future medical meeting. Use of upadacitinib in GCA is not approved and its safety and efficacy have not been evaluated by regulatory authorities.

a Sustained remission is defined as having an absence of GCA signs and symptoms from week 12 through week 52 and adherence to the protocol-defined steroid taper over the course of the study term. b Sustained complete remission is defined as having an absence of GCA signs and symptoms from week 12 through week 52, adherence to the protocol-defined steroid taper, and normalization of both erythrocyte sedimentation rate (ESR) and high sensitivity C-reactive protein (hsCRP) from week 12 through week 52.

About SELECT-GCA trial ; SELECT-GCA (M16-852) was a Phase III, multicenter, randomized, double-blind placebo-controlled study designed to evaluate the safety and efficacy of upadacitinib in 428 patients with GCA. The study consists of two periods. The first period, which is reported in this release, evaluated the efficacy of upadacitinib in combination with a 26-week corticosteroid taper regimen compared to placebo in combination with a 52-week corticosteroid taper regimen. In addition, the study assessed the safety and tolerability of upadacitinib in these patients. The second period will evaluate the safety and efficacy of continuing versus withdrawing upadacitinib in maintaining remission in participants who achieved sustained remission in the first period. For more information regarding this study, please visit ClinicalTrials.gov (Identifier NCT03725202).