Adalimumab Dose Adjustment for Pediatric Uveitis Treatment Trial

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