What treatments for rheumatoid arthritis can best be assessed by large, simple, long-term trials?

If the really important questions in the long-term management of rheumatoid arthritis are to be answered reliably, then clinical trials may have to be undertaken that are very much larger and simpler than has previously been the case. For sufficient numbers of busy clinicians to collaborate wholeheartedly with such trials, the extra work per patient should be very slight. In addition, the collaborators should be more than recompensed for even that slight extra trouble by pro-rata secretarial and/or locum assistance, so that it will actually be less work for them to collaborate wholeheartedly in such a trial than not to do so. Two particular trials are discussed to illustrate these general principles.