Our study suggests that the flare design used in clinical trials evaluating NSAIDs results in a treatment effect of higher magnitude. These results should be considered when designing a trial and/or interpreting the results of a trial.

This study suggests that the treatment effect of NSAIDs and anti-TNF are both of relevant magnitude considering the main patient-reported outcomes but with a trend in favour of anti-TNF despite the fact that such drugs are given on top of NSAIDs in refractory patients. Moreover, a statistically significant difference was observed for the domain 'acute-phase reactants' confirming the specificity of such drug category.

Early arthritis patients whose treatment adhered to the 2007 EULAR recommendations seemed to benefit from such treatment in terms of risk of clinical and radiographic progression. Using a propensity score of being treated according to recommendations in observational studies may be useful in assessing the potential impact of these recommendations on outcome.