# Adalimumab Dose Adjustment for Pediatric uveitis Treatment (ADAPT) Trial

> **NIH EY UG1** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2026 · $7,400

## Abstract

PROJECT SUMMARY
Juvenile idiopathic arthritis (JIA) is the most common rheumatologic condition in children, and 12-38% of patients
with JIA develop chronic asymptomatic anterior uveitis, typically within 4 to 7 years of arthritis onset. JIA-
associated uveitis can cause significant morbidity, with as many as 1/3 of all patients developing substantial
visual impairment and up to 15% becoming legally blind. The anti-tumor necrosis factor (TNF) human monoclonal
antibody adalimumab has shown efficacy in treating JIA-associated uveitis but is associated with a risk of serious
adverse events, including opportunistic infections and malignancy. Furthermore, long-term treatment with
adalimumab is expensive and causes a significant financial burden for the patient and healthcare system. The
Adalimumab in Juvenile Idiopathic Arthritis (JIA)-associated Uveitis Stopping Trial (ADJUST), an NEI-funded,
double-masked, randomized controlled trial recently conducted by our team, revealed 64% cumulative failure
among patients with previously stable JIA-associated uveitis at 24 weeks after stopping adalimumab. The rate
of recurrence of inflammation when stopping adalimumab was high, even when over 70% of the patients had
over two years of controlled uveitis. Encouragingly, all patients who relapsed regained control upon restarting
treatment. Collectively, these reasons contribute to a growing interest in developing evidence-based guidelines
for reduction in adalimumab dose frequency once control of inflammation has been achieved.
We propose to conduct a multicenter, parallel-treatment, observer-masked, randomized trial to generate an
adalimumab regimen-response curve with rates of treatment failure in patients with controlled JIA-associated
uveitis across a range of adalimumab injection frequencies. (Aim 1). 160 patients across eighteen clinical
centers will be randomized to one of four regimens: 1) injections administered every 2 weeks (standard of
care) 2) injections administered eve

## Key facts

- **NIH application ID:** 11523068
- **Project number:** 3UG1EY038172-01S1
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** NISHA  ACHARYA
- **Activity code:** UG1 (R01, R21, SBIR, etc.)
- **Funding institute:** EY
- **Fiscal year:** 2026
- **Award amount:** $7,400
- **Award type:** 3
- **Project period:** 2026-01-01T00:00:00 → 2030-12-31T00:00:00

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11523068

## Citation

> US National Institutes of Health, RePORTER application 11523068, Adalimumab Dose Adjustment for Pediatric uveitis Treatment (ADAPT) Trial (3UG1EY038172-01S1). Retrieved via AI Analytics 2026-05-20 from https://api.ai-analytics.org/grant/nih/11523068. Licensed CC0.

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