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Adalimumab Dose Adjustment for Pediatric Uveitis Treatment Trial (ADAPT)

7 juli 2026 uppdaterad av: Nisha Acharya

The goal of this clinical trial is to learn whether children and young adults with well-controlled juvenile idiopathic arthritis (JIA)-associated uveitis or chronic anterior uveitis can safely take adalimumab (or biosimilar) injections less often while maintaining control of their disease.

The main question it aims to answer is: can adalimumab/biosimilar injections be given less frequently without uveitis (eye inflammation) or arthritis (joint inflammation) returning?

Researchers will compare adalimumab/biosimilar injection schedules of every 2 weeks, 4 weeks, 8 weeks, and 12 weeks to determine how injection frequency affects disease control.

Participants will:

  • Take adalimumab/biosimilar injections every 2, 4, 8, or 12 weeks.
  • Attend study visits every 6 weeks over 24 weeks, with an additional follow-up visit at 48 weeks for checkups, tests, and questionnaires.
  • Keep a diary of how often they take adalimumab/biosimilar and other drugs they take for their uveitis/arthritis.

Studieöversikt

Status

Har inte rekryterat ännu

Betingelser

Intervention / Behandling

Studietyp

Interventionell

Inskrivning (Beräknad)

160

Fas

  • Fas 4

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

Studieorter

  • Förenta staterna
    • California
      • Los Angeles, California, Förenta staterna, 90095
        • University of California, Los Angeles
        • Huvudutredare:
          • Edmund Tsui, MD
        • Kontakt:
      • Sacramento, California, Förenta staterna, 95817
        • University of California, Davis
        • Kontakt:
        • Huvudutredare:
          • Parisa Emami-Naeini, MD MPH
        • Huvudutredare:
          • Angel Herrera-Guerra, MD PhD
      • San Francisco, California, Förenta staterna, 94143
        • University of California, San Francisco
        • Huvudutredare:
          • Nisha Acharya, MD
        • Kontakt:
        • Underutredare:
          • John Gonzales, MD
        • Underutredare:
          • Thuy Doan, MD PhD
    • Florida
      • Miami, Florida, Förenta staterna, 33136
        • University of Miami
        • Kontakt:
        • Huvudutredare:
          • Stephanie Llop, MD
        • Underutredare:
          • Janet Davis, MD
    • Missouri
      • Kansas City, Missouri, Förenta staterna, 64108
        • Children's Mercy Hospital
        • Kontakt:
        • Huvudutredare:
          • Ashley Cooper, MD
        • Huvudutredare:
          • Erin Stahl, MD
    • Ohio
      • Cincinnati, Ohio, Förenta staterna, 45229
        • Cincinnati Children's Hospital
        • Huvudutredare:
          • Virginia Miraldi Utz, MD
        • Huvudutredare:
          • Sheila Angeles-Han, MD
        • Kontakt:
    • Tennessee
      • Nashville, Tennessee, Förenta staterna, 37212
        • Vanderbilt University Medical Center
        • Kontakt:
        • Huvudutredare:
          • Sapna Gangaputra, MD MPH
        • Huvudutredare:
          • Thomas (Brent) Graham, MD MS
    • Texas
      • Austin, Texas, Förenta staterna, 78712
        • University of Texas, Austin
        • Kontakt:
        • Huvudutredare:
          • Eric Crowell, MD MPH
    • Utah
      • Salt Lake City, Utah, Förenta staterna, 84132
        • University of Utah Health
        • Kontakt:
        • Huvudutredare:
          • Marissa Larochelle, MD
  • Italien
      • Florence, Italien, 50139
        • Meyer Children's Hospital
        • Huvudutredare:
          • Gabriele Simonini
        • Kontakt:
        • Huvudutredare:
          • Ilaria Maccora
  • Storbritannien
      • Bristol, Storbritannien, BS1 3NU
        • University Hospitals Bristol and Weston
        • Huvudutredare:
          • A V Ramanan
        • Kontakt:
        • Huvudutredare:
          • Catherine Guly
      • Leicester, Storbritannien, LE1 5WW
        • University Hospitals of Leicester
        • Kontakt:
        • Huvudutredare:
          • Arani Sridhar
        • Huvudutredare:
          • Bharat Kapoor
      • Liverpool, Storbritannien, L14 5AB
        • Alder Hey Children's Hospital
        • Huvudutredare:
          • Gavin Cleary
        • Huvudutredare:
          • Jose Gonzalez-Martin
        • Kontakt:
      • London, Storbritannien, WC1N 3JH
        • Great Ormond Street Hospital
        • Huvudutredare:
          • Elena Moraitis
        • Huvudutredare:
          • Harry Petrushkin
        • Kontakt:
        • Underutredare:
          • Lola Solebo
      • Manchester, Storbritannien, M13 9WL
        • Manchester University NHS Foundation Trust
        • Kontakt:
        • Huvudutredare:
          • Jane Ashworth
      • Newcastle upon Tyne, Storbritannien, NE1 4LP
        • Great North Children's Hospital
        • Huvudutredare:
          • Sharmila Jandial
        • Kontakt:
      • Norwich, Storbritannien, NR4 6TZ
        • Norfolk and Norwich University Hospital
        • Huvudutredare:
          • Kate Armon
        • Huvudutredare:
          • Narman Puvanachandra
        • Kontakt:
      • Sheffield, Storbritannien, S10 2TQ
        • Sheffield Children's Hospital

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Barn
  • Vuxen
  • Äldre vuxen

Tar emot friska volontärer

Nej

Beskrivning

Inclusion Criteria:

  • Stated willingness to comply with all study procedures and availability for the duration of the study period
  • History of juvenile idiopathic arthritis (JIA) or chronic anterior uveitis (CAU), diagnosed prior to 16 years of age (patient may be older than 16 at time of enrollment)
  • ≥2 years of age (per FDA approval for use in children with polyarticular JIA)
  • Weight must be ≥15kg
  • Formal diagnosis of JIA-associated uveitis or CAU with no other suspected etiology
  • ≥24 consecutive months of controlled ocular inflammation (≤0.5+ anterior chamber cell, ≤0.5+ vitreous haze, and no active retinal/choroidal lesions in either eye)
  • ≥24 consecutive months of controlled arthritis verified by a pediatric rheumatologist if defined as JIA-associated uveitis
  • ≥24 consecutive months of treatment with adalimumab or biosimilar of adalimumab
  • ≥180 days on a stable dose of adalimumab or biosimilar of adalimumab; dose must be no greater than 20mg (if weight <30kg), or 40mg (if weight ≥30kg), injected every two weeks
  • If on biosimilar of adalimumab, ≥90 days on the biosimilar
  • Ability to continue to obtain commercial supply of adalimumab or biosimilar
  • If on a conventional disease-modifying anti-rheumatic drug (cDMARD) (injectable or oral methotrexate, mycophenolate mofetil, azathioprine, or leflunomide), dose must be ≤25 mg weekly for methotrexate, ≤3 g daily for mycophenolate mofetil, ≤250 mg daily for azathioprine, or ≤20 mg daily for leflunomide; dose and route of administration must be stable for ≥90 days
  • Willingness to limit consumption of alcohol during the study period
  • Agreement to avoid live attenuated vaccinations
  • Agreement to use highly effective contraception or abstinence for ≥28 days prior to screening and throughout the study period (for males and females of reproductive age)
  • Suitable, in the opinion of the Investigator, to continue treatment with adalimumab/biosimilar per regional labeling

Exclusion Criteria:

  • History of acute anterior uveitis characterized by redness and symptoms, including but not limited to floaters, pain, and light sensitivity
  • Intraocular surgery in the past 90 days or planned surgery in the next 24 weeks
  • Severe cataract or opacity preventing view to the posterior pole in both eyes
  • Chronic hypotony (<5mmHg for ≥90 days) in either eye
  • Treatment with oral corticosteroids or intraocular corticosteroid injection within the last 24 weeks
  • Use of topical corticosteroid eye drops within the last 90 days
  • Use of nonsteroidal anti-inflammatory drug (NSAID) eye drops within the last 90 days
  • Pregnancy or lactation (a pregnancy test will be conducted at baseline and follow-up visits for females post-menarche)
  • Presence of intraretinal or subretinal fluid in either eye
  • Prior safety or tolerability issues with adalimumab
  • History of cancer, active tuberculosis, or hepatitis B
  • Other medical condition expected to dictate treatment course during the study
  • Any of the following laboratory test results on their most recent tests within the past 90 days prior to screening/enrollment: leukocyte count <2500, platelet count ≤75000, hemoglobin<9.0, aspartate transaminase (AST) or alanine transaminase (ALT) ≥ 2 times the upper limit of normal range, creatinine ≥1.5

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Dubbel

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Aktiv komparator: 2-Week Dose
Participants receive adalimumab/biosimilar at their current weight-based dose every 2 weeks for 24 weeks, continuing in accordance with current standard of care practice.
Biologisk: Adalimumab/Biosimilar
Adalimumab is a fully human monoclonal anti-tumor necrosis factor alpha antibody - a biologic, immunomodulatory drug. Adalimumab (20mg or 40mg) is a clear, colorless solution available as an injectable auto-pen or pre-filled syringe for subcutaneous injection. All FDA-approved adalimumab biosimilars are allowed for this trial and include: Abrilada (adalimumab-afzb), Amjevita (adalimumab-atto), Cyltezo (adalimumab-adbm), Hadlima (adalimumab-bwwd), Hulio (adalimumab-fkjp), Hyrimoz (adalimumab-adaz), Idacio (adalimumab-aacf), Simlandi (adalimumab-ryvk), Yuflyma (adalimumab-aaty), and Yusimry (adalimumab-aqvh).
Andra namn:
  • Humira
  • Hyrimoz
  • Idacio
  • Hulio
  • Simlandi
  • Abrilada
  • Amjevita
  • Cyltezo
  • Hadlima
  • Yuflyma
  • Yusimry
Experimentell: 4-Week Dose
Participants receive adalimumab/biosimilar at their current weight-based dose every 4 weeks for 24 weeks.
Biologisk: Adalimumab/Biosimilar
Adalimumab is a fully human monoclonal anti-tumor necrosis factor alpha antibody - a biologic, immunomodulatory drug. Adalimumab (20mg or 40mg) is a clear, colorless solution available as an injectable auto-pen or pre-filled syringe for subcutaneous injection. All FDA-approved adalimumab biosimilars are allowed for this trial and include: Abrilada (adalimumab-afzb), Amjevita (adalimumab-atto), Cyltezo (adalimumab-adbm), Hadlima (adalimumab-bwwd), Hulio (adalimumab-fkjp), Hyrimoz (adalimumab-adaz), Idacio (adalimumab-aacf), Simlandi (adalimumab-ryvk), Yuflyma (adalimumab-aaty), and Yusimry (adalimumab-aqvh).
Andra namn:
  • Humira
  • Hyrimoz
  • Idacio
  • Hulio
  • Simlandi
  • Abrilada
  • Amjevita
  • Cyltezo
  • Hadlima
  • Yuflyma
  • Yusimry
Experimentell: 8-Week Dose
Participants receive adalimumab/biosimilar at their current weight-based dose every 8 weeks for 24 weeks.
Biologisk: Adalimumab/Biosimilar
Adalimumab is a fully human monoclonal anti-tumor necrosis factor alpha antibody - a biologic, immunomodulatory drug. Adalimumab (20mg or 40mg) is a clear, colorless solution available as an injectable auto-pen or pre-filled syringe for subcutaneous injection. All FDA-approved adalimumab biosimilars are allowed for this trial and include: Abrilada (adalimumab-afzb), Amjevita (adalimumab-atto), Cyltezo (adalimumab-adbm), Hadlima (adalimumab-bwwd), Hulio (adalimumab-fkjp), Hyrimoz (adalimumab-adaz), Idacio (adalimumab-aacf), Simlandi (adalimumab-ryvk), Yuflyma (adalimumab-aaty), and Yusimry (adalimumab-aqvh).
Andra namn:
  • Humira
  • Hyrimoz
  • Idacio
  • Hulio
  • Simlandi
  • Abrilada
  • Amjevita
  • Cyltezo
  • Hadlima
  • Yuflyma
  • Yusimry
Experimentell: 12-Week Dose
Participants receive adalimumab/biosimilar at their current weight-based dose every 12 weeks for 24 weeks.
Biologisk: Adalimumab/Biosimilar
Adalimumab is a fully human monoclonal anti-tumor necrosis factor alpha antibody - a biologic, immunomodulatory drug. Adalimumab (20mg or 40mg) is a clear, colorless solution available as an injectable auto-pen or pre-filled syringe for subcutaneous injection. All FDA-approved adalimumab biosimilars are allowed for this trial and include: Abrilada (adalimumab-afzb), Amjevita (adalimumab-atto), Cyltezo (adalimumab-adbm), Hadlima (adalimumab-bwwd), Hulio (adalimumab-fkjp), Hyrimoz (adalimumab-adaz), Idacio (adalimumab-aacf), Simlandi (adalimumab-ryvk), Yuflyma (adalimumab-aaty), and Yusimry (adalimumab-aqvh).
Andra namn:
  • Humira
  • Hyrimoz
  • Idacio
  • Hulio
  • Simlandi
  • Abrilada
  • Amjevita
  • Cyltezo
  • Hadlima
  • Yuflyma
  • Yusimry

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Cumulative Incidence of Treatment Failure
Tidsram: From baseline to 24 weeks post-randomization

Proportion of participants in each treatment arm experiencing treatment failure by Week 24.

Treatment failure is defined by recurrence of ocular inflammation (at least one of the following in at least one eye):

  • >0.5+ anterior chamber (AC) cell at a single visit as defined by the Standardization of Uveitis Nomenclature (SUN) criteria
  • >0.5+ vitreous haze at a single visit
  • Active retinal/choroidal inflammation and/or macular edema in either eye at a single visit. Macular edema is defined as central subfield thickness on optical coherence tomography (OCT) >2 standard deviations above normal thickness (>320µm on Spectralis or >300µm on Zeiss or Topcon) and having a greater than 20% increase from baseline and/or presence of intraretinal or subretinal fluid.

Treatment failure may also be defined as recurrence of joint disease persistent and severe enough to necessitate unmasking to manage the arthritis recurrence.
From baseline to 24 weeks post-randomization

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Nisha Acharya

Samarbetspartners

University of California, Los Angeles
University of Miami
National Eye Institute (NEI)
National Institutes of Health (NIH)
University of California, Davis
University of California, San Francisco
Norfolk and Norwich University Hospitals NHS Foundation Trust
Vanderbilt University Medical Center
Children's Hospital Medical Center, Cincinnati
University of Utah
Moorfields Eye Hospital NHS Foundation Trust
University Hospitals, Leicester
Manchester University NHS Foundation Trust
Children's Mercy Hospital Kansas City
Newcastle-upon-Tyne Hospitals NHS Trust
University Hospitals Bristol and Weston NHS Foundation Trust
University of Texas at Austin
Great Ormond Street Hospital for Children NHS Foundation Trust
Alder Hey Children's NHS Foundation Trust
Sheffield Children's NHS Foundation Trust
Meyer Children's Hospital IRCCS

Utredare

  • Huvudutredare: Nisha Acharya, MD MS, University of California, San Francisco

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Allmänna publikationer

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Beräknad)

1 september 2026

Primärt slutförande (Beräknad)

1 maj 2030

Avslutad studie (Beräknad)

1 november 2030

Studieregistreringsdatum

Först inskickad

7 juli 2026

Först inskickad som uppfyllde QC-kriterierna

7 juli 2026

Första postat (Faktisk)

13 juli 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

13 juli 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

7 juli 2026

Senast verifierad

1 juli 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • 25-45347
  • UG1EY038172 (U.S.S. NIH-anslag/kontrakt)

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

NEJ

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Ja

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

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