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The article published by Landewe et al1 offers novel insights to assess the benefits of new therapeutic strategies in rheumatoid arthritis (RA), which focus more on (the visualisation of) structural integrity rather than the inhibition of radiographic progression.1 The authors clearly outline the three major problems of the common superiority study designs: (1) differences in progression are too small, (2) effective disease-modifying antirheumatic drugs used in the control group result in levels of radiographic progression, which are too low and (3) the length of placebo treatment is limited to 3 months preventing an exploration of radiological …
Competing interests None.
Provenance and peer review Not commissioned; internally peer reviewed.
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