Evidence map›Paper›PMID 39863370›Full record

Trial reportLancet (London, England)2025

Stopping of adalimumab in juvenile idiopathic arthritis-associated uveitis (ADJUST): a multicentre, double-masked, randomised controlled trial.

Nisha R Acharya, Athimalaipet V Ramanan, Alison B Coyne, Kathryn L Dudum, Elia M Rubio, Sydney M Woods, Catherine M Guly, Elena Moraitis, Harry J D Petrushkin, Kate Armon and 5 more

2 registry-linked trialsAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Lancet (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03816397 phase4completednot on this map

Adalimumab in Juvenile Idiopathic Arthritis-associated Uveitis Stopping Trial

TypeinterventionalSponsorNisha AcharyaRan2020 to 2025Enrolled87ConditionsUveitis, JIAArmsAdalimumab, Placebo
NCT07699107 phase4not yet recruitingnot on this mapstarted 2026, after this paper: background citation

Adalimumab Dose Adjustment for Pediatric Uveitis Treatment Trial

TypeinterventionalSponsorNisha AcharyaRan2026 to 2030Enrolled160ConditionsJuvenile Idiopathic Arthritis Associated Uveitis, Uveitis, AnteriorArmsAdalimumab/Biosimilar
3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
  4. Article
  5. Systemic immunosuppressive therapy in idiopathic non-infectious uveitis and scleritis: disease remission, discontinuation, and relapse patterns.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026
    Article
  6. Article
  7. Review
  8. Article
  9. Review
  10. Memory CD4Frontiers in immunology · 2026
    Review
  11. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors.

Nisha R AcharyaFrancis I Proctor Foundation, University of California San Francisco, San Francisco, CA, USA; Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA; Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, USA. Electronic address: nisha.acharya@ucsf.edu.
Athimalaipet V RamananDepartment of Paediatric Rheumatology, Bristol, UK; Translational Health Sciences, University of Bristol, Bristol, UK.
Alison B CoyneFrancis I Proctor Foundation, University of California San Francisco, San Francisco, CA, USA.
Kathryn L DudumFrancis I Proctor Foundation, University of California San Francisco, San Francisco, CA, USA.
Elia M RubioFrancis I Proctor Foundation, University of California San Francisco, San Francisco, CA, USA.
Sydney M WoodsFrancis I Proctor Foundation, University of California San Francisco, San Francisco, CA, USA.
Catherine M GulyBristol Royal Hospital for Children, Bristol, UK; Bristol Eye Hospital, Bristol, UK; University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
Elena MoraitisRheumatology Department, Great Ormond Street Hospital NHS Foundation Trust, London, UK.
Harry J D PetrushkinRheumatology Department, Great Ormond Street Hospital NHS Foundation Trust, London, UK.
Kate ArmonPaediatric Rheumatology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; School of Medicine, University of Cambridge, Cambridge, UK.
Narman PuvanachandraJenny Lind Children's Hospital within Norfolk and Norwich University Hospital NHS Trust, Norwich, UK.
Jessy T ChoiSheffield Children's Hospital, Sheffield, UK; Sheffield Teaching Hospitals, Sheffield, UK; University of Sheffield, Sheffield, UK.
Daniel P HawleySheffield Children's Hospital, Sheffield, UK.
Benjamin F ArnoldFrancis I Proctor Foundation, University of California San Francisco, San Francisco, CA, USA; Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA; Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, USA.
ADJUST Study Group

Funding

Adalimumab in Juvenile Idiopathic Arthritis-associated Uveitis Trial (ADJUST) - Diversity SupplementUG1EY029658 · NEI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI ACHARYA, NISHA · 2019 to 2023
$6.5M
NEI NIH HHS UG1 EY029658
6 · The paper itself

Abstract

backgroundAdalimumab is an effective treatment for juvenile idiopathic arthritis-associated uveitis. Data are scarce on the effects of discontinuing adalimumab after control of the disease had been reached. We aimed to assess efficacy and safety of discontinuing treatment in patients with juvenile idiopathic arthritis-associated uveitis.

methodsWe conducted a multicentre, double-masked, randomised, placebo-controlled trial at 20 ophthalmology and rheumatology clinics across the USA, the UK, and Australia. Patients aged at least 2 years who had controlled arthritis and uveitis for at least 1 year on adalimumab were randomly assigned in a 1:1 ratio using a web-based system to receive adalimumab or placebo, administered subcutaneously every 2 weeks until the 48-week visit or treatment failure. The primary outcome was the time to treatment failure, defined by recurrence of uveitis or arthritis; all participants were included in the primary and safety analysis. Unmasking occurred at treatment failure, and patients were offered open-label adalimumab through 48 weeks of follow-up. This trial was registered with ClinicalTrials.gov (NCT03816397).

findings87 patients were enrolled from March 3, 2020, to Feb 14, 2024, whereafter the prespecified interim stopping criteria were met and enrolment was stopped. One patient in each group dropped out but data were included in analyses. Six (14%) of 43 patients in the adalimumab group and 30 (68%) of 44 patients in the placebo group had treatment failure (hazard ratio 8·7, 95% CI 3·6-21·2; p<0·0001). The median time to treatment failure in the placebo group was 119 days (IQR 84-243). The median time to re-establishing sustained control of inflammation in the placebo group after restarting adalimumab was 105 days (63-196). 226 non-serious adverse events occurred in the adalimumab group (7·5 events per person-year, 95% CI 6·5-8·5), and 115 non-serious adverse events occurred in the placebo group (6·8 events per person-year, 5·6-8·1). Four serious adverse events were reported, all in the adalimumab group.

interpretationDiscontinuing adalimumab led to higher rates of recurrence of uveitis, arthritis, or both in patients with previously controlled juvenile idiopathic arthritis-associated uveitis. However, all patients who had treatment failure successfully regained control of inflammation by the end of the 48-week study period after restarting adalimumab.

fundingUS National Institutes of Health (National Eye Institute).

Indexed as

AdalimumabAntirheumatic AgentsArthritis, JuvenileUveitisWithholding TreatmentAdolescentChildChild, PreschoolDouble-Blind MethodFemaleHumansMaleTreatment FailureTreatment OutcomeAdalimumabAntirheumatic Agents

Identifiers

PMID39863370
PMCPMC13398007

What OpenQuestion holds

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LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.