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We thank the readers for their interest in our manuscript reporting the comparative impact of an extract of TwHF and methotrexate, or the combination in subjects with rheumatoid arthritis.1 We completely agree with the readers that the study must be interpreted with caution because it was carried out in an open-label manner owing to cost considerations. We discussed this in detail in the section on Limitations in the Discussion of the paper. However, it is difficult to predict how patient expectation might bias the study. On the one hand, extracts of TwHF have been used for hundreds of years in China to treat various symptoms and, over the past 30 years, extracts of TwHF have become a standard therapy …
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