NIH Clinical Trial Cuts Widen Gaps in Autoimmune Research
A new Research Letter published in JAMA Internal Medicine reports that 383 NIH-funded clinical trials lost grant support in the first half of 2025, disrupting studies involving more than 74,000 participants. Although the authors do not specify autoimmune-related trials, several disproportionately affected categories (such as prevention of disease onset trials, behavioral intervention type trials, and infectious disease trials) overlap with areas that help inform autoimmune risk factors, immune triggers, and long-term disease management for people with autoimmune and immune-mediated conditions.
Clinical trials in these categories often include approaches relevant to the lived experience of autoimmunity and chronic illness, such as chronic pain, fatigue, sleep disturbances, exercise intolerance, or post-viral immune dysfunction. These areas of research already have limited pharmaceutical options and rely heavily on NIH funding to move forward.
An accompanying Editor’s Note underscores the ethical concerns raised by these funding disruptions. The authors write that terminating clinical trial grants “for reasons other than safety or efficacy” leads to “the violation of foundational ethical principles of human participant research,” raising serious and important questions about the obligations owed to individuals who volunteer their time, health information, and risk tolerance to advance medical research.
“Clinical trial participation often requires individuals to travel and attend dedicated study visits and undergo additional testing and procedures.”
“First and foremost, it is betrayal of the fundamental principles of informed consent for research. Participants have agreed to give of their time and effort and expose themselves to potential risks for the sake of advancing knowledge.”
“Moreover, participants who have been exposed to an intervention in the context of a trial may be harmed by its premature withdrawal or inadequate follow-up and monitoring for adverse effects.”
Although some terminated grants were eventually restored, the authors stress that these reversals “can be expected to, at best, mitigate the harms,” as the scientific opportunity, participants’ trust, and irreplaceable data collection have already been compromised. For people with autoimmune and chronic illnesses in particular, who depend on consistent research progress to clarify disease mechanisms, improve symptom management, and expand treatment options, these disruptions widen existing gaps between urgent scientific need and actual progress. They also influence which patient communities remain understudied and how confident individuals can feel when participating in clinical research.
Citations
Patel, V. R., Liu, M., & Jena, A. B. (2025). Clinical Trials Affected by Research Grant Terminations at the National Institutes of Health. JAMA internal medicine, e256088. Advance online publication. https://doi.org/10.1001/jamainternmed.2025.6088
Brender, T. D., & Gross, C. P. (2025). Consequences of Grant Termination in Clinical Trials. JAMA internal medicine, 10.1001/jamainternmed.2025.6093. Advance online publication. https://doi.org/10.1001/jamainternmed.2025.6093