What is the risk of uveitis flare in patients with JIA and uveitis, who are in remission, when tapering medications?

The ADJUST Trial is in progress and is trying to answer precisely this question for those currently receiving adalimumab. I am not aware currently of a large database to provide a reliable answer to this question. My approach is to require no evidence for active uveitis for at least 12 months, and then reduce the frequency of adalimumab to every 3 weeks for 3 months, followed by every 4 weeks for 3 months if the disease remains inactive. If the drug being tapered is an anti-metabolite, I would usually reduce the dosage rather than the frequency. Any change in dosage requires increased monitoring since patients are usually not able to gauge the activity of JIA-associated uveitis. I prefer to make changes in dosage or frequency gradually, alt...