A Study to Assess Adverse Events, Change in Disease Activity, and How the Drug Moves Through the Body in Children With Juvenile Psoriatic Arthritis (jPsA) Receiving Subcutaneously Injected Risankizumab or Adalimumab (KnaPsAck)

May 11, 2026 updated by: AbbVie

Open-label, Randomized, Assessor-blinded, Efficacy, Safety, Tolerability, and Pharmacokinetics Study of Subcutaneous Risankizumab With an Adalimumab Reference Arm in Children With Active Juvenile Psoriatic Arthritis

Psoriatic arthritis (PsA) is a type of arthritis that happens when the body's immune system attacks healthy cells and tissues causing joint pain, stiffness, and swelling. Symptoms can get worse and go away for periods of time. PsA that begins before a patient's 16th birthday is called juvenile PsA (jPsA).This study will evaluate how safe risankizumab is for the treatment of psoriatic arthritis and to assess change in disease symptoms.

Risankizumab is being studied for the treatment of jPsA and adalimumab is approved for the treatment of jPsA. Participants are placed in 1 of 2 groups, called treatment arms. Each group receives a different treatment. There is a 1 in 4 chance that participants will be assigned to receive adalimumab. Approximately 40 juvenile participants with jPsA will be enrolled at approximately 30 sites worldwide.

Participants will receive risankizumab and adalimumab as subcutaneous (SC) injections based on body weight. At the start of Period 1, participants are randomized to receive risankizumab or adalimumab for 24 weeks. Participants who respond to the study treatment received in Period 1, will continue to receive the same treatment in Period 2 for another 100 weeks. Those with worsening jPsA symptoms in Period 2 will be withdrawn from the study. Participants who receive adalimumab are followed for safety for 70 days after the last study treatment. Participants who receive risankizumab are followed for 140 days after the last study treatment.

There may be higher treatment burden for participants in this trial compared to their standard of care (due to study procedures). Participants will attend regular visits during the study at a hospital or clinic. The effect of the treatment will be checked by medical assessments, blood tests, checking for side effects and completing questionnaires.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

40

Phase

  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

    • Victoria
      • Clayton, Victoria, Australia, 3168
        • Recruiting
        • Monash Health - Monash Medical Centre /ID# 260255
    • Alberta
      • Calgary, Alberta, Canada, T3B 6A8
        • Recruiting
        • Alberta Children's Hospital /ID# 257880
    • British Columbia
      • Vancouver, British Columbia, Canada, V6H 3N1
        • Recruiting
        • British Columbia Children and Women's Hospital and Health Centre /ID# 257884
    • Ontario
      • Toronto, Ontario, Canada, M5G 1X8
        • Recruiting
        • Hospital for Sick Children /ID# 257879
    • New Aquitaine
      • Bordeaux, New Aquitaine, France, 33076
        • Recruiting
        • CHU Bordeaux - Hopital Pellegrin /ID# 258729
    • Paris
      • Le Kremlin-Bicêtre, Paris, France, 94270
        • Recruiting
        • AP-HP - Hopital Bicetre /ID# 258728
      • Berlin, Germany, 13125
        • Recruiting
        • Helios Klinikum Berlin - Buch /ID# 268803
      • Hamburg, Germany, 22081
        • Recruiting
        • Hamburger Zentrum fuer Kinder- und Jugendrheumatologie /ID# 259104
    • North Rhine-Westphalia
      • Sankt Augustin, North Rhine-Westphalia, Germany, 53757
        • Recruiting
        • Asklepios Klinik Sankt Augustin /ID# 259106
        • Contact:
          • Site Coordinator
          • Phone Number: +49-2241-249-240
    • Firenze
      • Florence, Firenze, Italy, 50139
        • Recruiting
        • Azienda Ospedaliero Universitaria Meyer /ID# 258587
    • Milano
      • Milan, Milano, Italy, 20122
        • Recruiting
        • ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO /ID# 276753
    • Roma
      • Rome, Roma, Italy, 00165
        • Recruiting
        • Ospedale Pediatrico Bambino Gesù /ID# 258869
    • Lesser Poland Voivodeship
      • Cracow, Lesser Poland Voivodeship, Poland, 30-002
        • Recruiting
        • Malopolskie Badania Kliniczne /ID# 258777
    • Lublin Voivodeship
      • Lublin, Lublin Voivodeship, Poland, 20-093
        • Recruiting
        • Uniwersytecki Szpital Dzieciecy w Lublinie /ID# 258781
    • Masovian Voivodeship
      • Warsaw, Masovian Voivodeship, Poland, 02-637
        • Recruiting
        • Narodowy Instytut Geriatrii, Reumatologii I Rehabilitacji /ID# 277050
    • Silesian Voivodeship
      • Sosnowiec, Silesian Voivodeship, Poland, 41-200
        • Recruiting
        • Centrum Zdrowia Dziecka i Rodziny im Jana Pawla II w Sosnowcu /ID# 277058
    • Łódź Voivodeship
      • Lodz, Łódź Voivodeship, Poland, 91-738
        • Recruiting
        • SPZOZ Centralny Szpital Kliniczny Uniwersytetu Medycznego w Lodzi /ID# 258785
      • Valencia, Spain, 46026
        • Recruiting
        • Hospital Universitario y Politecnico La Fe /ID# 257567
    • Barcelona
      • Esplugues de Llobregat, Barcelona, Spain, 08950
        • Recruiting
        • Hospital Sant Joan de Deu /ID# 257568
        • Contact:
          • Site Coordinator
          • Phone Number: +34610550263
      • Bristol, United Kingdom, BS2 8BJ
        • Recruiting
        • University Hospitals Bristol and Weston NHS Foundation Trust /ID# 258847
      • Liverpool, United Kingdom, L12 2AP
        • Recruiting
        • Alder Hey Children's NHS Foundation Trust /ID# 262770
    • England
      • Sheffield, England, United Kingdom, S10 2TH
        • Recruiting
        • Sheffield Children's Hospital NHS Foundation Trust /ID# 258848
    • Arkansas
      • Little Rock, Arkansas, United States, 72202
        • Recruiting
        • Arkansas Children's Hospital /ID# 258776
        • Contact:
          • Site Coordinator
          • Phone Number: 501-364-3686
    • District of Columbia
      • Washington D.C., District of Columbia, United States, 20010-2916
    • Florida
      • Hollywood, Florida, United States, 33021
        • Recruiting
        • Joe Dimaggio Children's Hospital Hollywood /ID# 260634
        • Contact:
          • Site Coordinator
          • Phone Number: 954-265-4466
    • Indiana
      • Indianapolis, Indiana, United States, 46202
        • Recruiting
        • Indiana University Health Riley Hospital for Children /ID# 259067
    • Minnesota
      • Minneapolis, Minnesota, United States, 55454
        • Recruiting
        • M Health Fairview University of Minnesota Medical Center - West Bank /ID# 260111
        • Contact:
    • New York
      • New York, New York, United States, 10032-3729
        • Recruiting
        • Columbia University Medical Center /ID# 262587
        • Contact:
          • Site Coordinator
          • Phone Number: 212-305-4308
      • Valhalla, New York, United States, 10595
        • Recruiting
        • Boston Childrens Health Physicians /ID# 258061
        • Contact:
          • Site Coordinator
          • Phone Number: 914-504-0152
    • North Carolina
      • Chapel Hill, North Carolina, United States, 27514
        • Recruiting
        • University of North Carolina - Children's Hospital /ID# 259286
        • Contact:
          • Site Coordinator
          • Phone Number: 919-504-6650
    • Ohio
      • Cleveland, Ohio, United States, 44109
        • Recruiting
        • MetroHealth Medical Center /ID# 262377
    • Texas
      • Austin, Texas, United States, 78757-7571
        • Recruiting
        • Child Neurology Consultants of Austin /ID# 260562
        • Contact:
          • Site Coordinator
          • Phone Number: 512-494-4000

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Diagnosis of juvenile psoriatic arthritis (jPsA) according to International League of Associations for Rheumatology criteria for at least 3 months prior to screening.
  • Active Disease in >= 3 joints at screening and at Baseline (swelling not due to deformity, or limitation of motion with pain, tenderness, or both) are eligible for inclusion in the study.
  • Have had an inadequate response (lack of efficacy after minimum 2-month duration of therapy at maximally tolerated dose), or intolerance to previous or current treatment with at least 1 of the following conventional synthetic disease-modifying antirheumatic drug (csDMARDs): methotrexate (MTX), sulfasalazine, leflunomide, or hydroxychloroquine.

Exclusion Criteria:

  • Have any other autoimmune disease, rheumatic disease (including systemic Juvenile idiopathic arthritis [JIA], rheumatoid factor-positive or rheumatoid factor-negative polyarticular JIA, extended oligoarticular JIA, persistent oligoarticular JIA, enthesitis-related arthritis, and undifferentiated JIA), or overlap syndrome.
  • Prior inadequate response to treatments in the anti-TNF or IL-23 inhibitor classes.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Risankizumab
Participants will receive risankizumab for 24 weeks, in Period 1. Participants who respond to the study treatment received in Period 1, will continue to receive the same treatment in Period 2 for another 100 weeks. There will be a 140 day safety follow up after the treatment period.
Subcutaneous (SC) Injection
Other Names:
  • ABBV-066
  • Skyrizi
Experimental: Adalimumab
Participants will receive adalimumab for 24 weeks, in Period 1. Participants who respond to the study treatment received in Period 1, will continue to receive the same treatment in Period 2 for another 100 weeks. There will be a 70 day safety follow up after the treatment period.
SC Injection

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Percentage of Participants who Achieve >= 30% Improvement in Juvenile Idiopathic Arthritis American College of Rheumatology Response Criteria (JIA-ACR 30)
Time Frame: Up to 24 Weeks
The JIA-ACR 30 response is defined as a >= 30% improvement of at least 3 or more of the 6 juvenile idiopathic arthritis core response variables (JIA-CRVs) without >30% worsening in more than 1 of the remaining JIA-CRVs compared with Baseline. The 6 JIA-CRVs are: physician global assessment of disease activity (PhGA), global assessment of overall well being, no of joints with active arthritis, no of joints with limitation of motion high sensitivity C-reactive protein (hsCRP), and functional ability assessed by Childhood Health Assessment Questionnaire Disability Index (CHAQ-DI).
Up to 24 Weeks
Number of Participants with Adverse Events (AEs)
Time Frame: Up to Week 144
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.
Up to Week 144

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Percentage of Participants who Achieve >= 50% Improvement in Juvenile Idiopathic Arthritis American College of Rheumatology Response Criteria (JIA-ACR 50)
Time Frame: Up to 24 Weeks
The JIA-ACR 50 response is defined as a >= 50% improvement of at least 3 or more of the 6 JIA-CRVs without >50% worsening in more than 1 of the remaining JIA-CRVs compared with Baseline. The 6 JIA-CRVs are: PhGA, parent/patient global assessment of overall well being, no of joints with active arthritis, no of joints with limitation of motion hsCRP, and functional ability assessed using the disability index of the CHAQ-DI.
Up to 24 Weeks
Percentage of Participants who Achieve >= 70% Improvement in Juvenile Idiopathic Arthritis American College of Rheumatology Response Criteria (JIA-ACR 70)
Time Frame: Up to 24 Weeks
The JIA-ACR 70 response is defined as a >= 70% improvement of at least 3 or more of the 6 JIA-CRVs without >70% worsening in more than 1 of the remaining JIA-CRVs compared with Baseline. The 6 JIA-CRVs are: PhGA, parent/patient global assessment of overall well being, no of joints with active arthritis, no of joints with limitation of motion hsCRP, and functional ability assessed using the disability index of the CHAQ-DI.
Up to 24 Weeks
Percentage of Participants who Achieve >= 90% Improvement in Juvenile Idiopathic Arthritis American College of Rheumatology Response Criteria (JIA-ACR 90)
Time Frame: Up to 24 Weeks
The JIA-ACR 90 response is defined as a >= 90% improvement of at least 3 or more of the 6 JIA-CRVs without >90% worsening in more than 1 of the remaining JIA-CRVs compared with Baseline. The 6 JIA-CRVs are: PhGA, parent/patient global assessment of overall well being, no of joints with active arthritis, no of joints with limitation of motion hsCRP, and functional ability assessed using the disability index of the CHAQ-DI.
Up to 24 Weeks
Change from Baseline in Juvenile Arthritis Disease Activity Score (JADAS)-10
Time Frame: Up to Week 24
JADAS is a composite score of physician global assessment of disease activity, parent/patient global assessment of overall well-being, number of joints with active arthritis (swelling not due to deformity, or limitation of motion with pain, tenderness or both), and high sensitivity C-reactive protein (hsCRP). JADAS-10 is based on the count of any involved joint, up to a maximum of ten joints.
Up to Week 24
Change from Baseline in JADAS-27
Time Frame: Up to Week 24
JADAS is a composite score of physician global assessment of disease activity, parent/patient global assessment of overall well-being, number of joints with active arthritis (swelling not due to deformity, or limitation of motion with pain, tenderness or both), and hsCRP. JADAS-27 includes a count of the following joints: cervical spine, elbows, wrists, metacarpophalangeal joints (from first to third), and proximal interphalangeal joints, hips, knees, and ankles.
Up to Week 24
Percentage of Participants with Achievement of Minimal Disease Activity (MDA)
Time Frame: Week 24
MDA is defined as JADAS-10 of <= 6. JADAS-10 is based on the count of any involved joint, up to a maximum of ten joints.
Week 24
Percentage of Participants with Inactive Disease
Time Frame: Week 24
Inactive disease is defined as JADAS-10 of <= 2.7. JADAS-10 is based on the count of any involved joint, up to a maximum of ten joints.
Week 24
Change from Baseline in Clinical Juvenile Arthritis Disease Activity Score (cJADAS)-10
Time Frame: Up to Week 24
cJADAS is a composite score of physician global assessment of disease activity, parent/patient global assessment of overall well-being, and number of joints with active arthritis (swelling not due to deformity, or limitation of motion with pain, tenderness or both). JADAS-10 is based on the count of any involved joint, up to a maximum of ten joints.
Up to Week 24
Change from Baseline in cJADAS-27
Time Frame: Up to Week 24
cJADAS is a composite score of physician global assessment of disease activity, parent/patient global assessment of overall well-being, and number of joints with active arthritis (swelling not due to deformity, or limitation of motion with pain, tenderness or both). JADAS-27 includes a count of the following joints: cervical spine, elbows, wrists, metacarpophalangeal joints (from first to third), and proximal interphalangeal joints, hips, knees, and ankles.
Up to Week 24
Change from Baseline in the Pain-Visual Analogue Scale (VAS)
Time Frame: Week 24
Participants assessed their pain using a Patient's Global Assessment Pain visual analogue scale (VAS). The range is 0 to 100 with no pain being indicated by 0 and severe pain by 100.
Week 24
Percentage of Participants with Psoriasis (PsO) who Achieve Psoriasis Area Severity Index (PASI) 75 in Participants with at least 3% Body Surface Area (BSA) at Baseline
Time Frame: Up to Week 24
The PASI is a measure of psoriasis severity. Four anatomic sites - head, upper extremities, trunk, and lower extremities - are assessed for erythema, induration and desquamation using a 5-point scale, with a lower score indicating more mild disease.
Up to Week 24
Percentage of Participants with PsO who Achieve PASI 90 in Participants with at least 3% BSA at Baseline
Time Frame: Up to Week 24
The PASI is a measure of psoriasis severity. Four anatomic sites - head, upper extremities, trunk, and lower extremities - are assessed for erythema, induration and desquamation using a 5-point scale, with a lower score indicating more mild disease.
Up to Week 24
Percentage of Participants with PsO who Achieve Static Physician Global Assessment of Disease Activity (sPGA) of PsO of 'Clear' (0) or Almost Clear (1) in Participants with at least 3% BSA at Baseline
Time Frame: Up to Week 24
The sPGA is a 5-point score ranging from 0 to 4, based on the physician's assessment of the average thickness, erythema, and scaling of all psoriatic lesions, with a lower score indicating less body coverage.
Up to Week 24
Percentage of Participants with PsO who Achieve change from Baseline in Children's Dermatology Life Quality Index (CDLQI) in Participants with at least 3% BSA at Baseline
Time Frame: Up to Week 24
The CDLQI is a 10-item questionnaire used to assess the impact of dermatologic disease symptoms and treatment on quality-of-life (QOL), with a higher score indicating greater impairment of QOL. The CDLQI has been validated for use in participants 4 to 16 years old.
Up to Week 24

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Study Director: ABBVIE INC., AbbVie

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

July 8, 2024

Primary Completion (Estimated)

September 1, 2026

Study Completion (Estimated)

October 1, 2028

Study Registration Dates

First Submitted

October 20, 2023

First Submitted That Met QC Criteria

October 20, 2023

First Posted (Actual)

October 25, 2023

Study Record Updates

Last Update Posted (Actual)

May 13, 2026

Last Update Submitted That Met QC Criteria

May 11, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • M23-732
  • 2023-506026-36-00 (Other Identifier: EU CT)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

AbbVie is committed to responsible clinical trial data sharing. This includes access to anonymized, individual and trial-level data (analysis data sets), as well as other information.

IPD Sharing Time Frame

For details on when studies are available for sharing visit https://vivli.org/ourmember/abbvie/

IPD Sharing Access Criteria

To learn more about the process, or to submit a request, visit the following link https://www.abbvieclinicaltrials.com/hcp/data-sharing/

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

Yes

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

Yes

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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