Challenges in clinical trial design in inflammatory arthritis

The prognosis for patients with rheumatoid arthritis has improved dramatically, thanks in large part to many new therapies and therapeutic approaches. Paradoxically, this has created problems for rheumatologists since clinically useful information from appropriate clinical trials has not kept pace with all the new therapeutic options. Essentially, rheumatologists now have many more therapeutic options than they know what to do with. This article discusses why we are in this situation and suggests opportunities to move forward.