TY - JOUR T1 - A Decade of Data Discloses the Window Is Still Not Clear JF - The Journal of Rheumatology JO - J Rheumatol SP - 1 LP - 2 DO - 10.3899/jrheum.131116 VL - 41 IS - 1 AU - MARC COHEN Y1 - 2014/01/01 UR - http://www.jrheum.org/content/41/1/1.abstract N2 - In this issue of The Journal, Keystone, et al publish a 10-year prospective trial: a remarkable feat given the myriad difficulties of completing clinical trials these days1. It is the longterm extension (LTE) of the PREMIER trial, and a fairly large number of patients (250, or about 30%) complete the 10-year followup. The authors clearly concede the limitations of all LTE trials, most importantly that they are essentially completers’ analyses. Very little can be learned from those patients not completing the trial, and any and all conclusions must be interpreted in the context that they are only about those patients who presumably did well and therefore continued in the study. This article does successfully address these inherent issues.The PREMIER trial was more interesting than some of the similar trials conducted at about the same time because the double-blinded portion was longer than most at 2 years, and there were 3 arms; methotrexate (MTX), adalimumab (ADA), and the combination of the 2 (MTX + ADA)2. The patients in the study have early, MTX-naive, and very aggressive disease, many with multiple erosions at baseline. This may be a different population than that seen in some very recent trials, and may not be typical of any rheumatologist’s rheumatoid arthritis (RA) practice today, and the authors acknowledge this possibility. Early disease in this article is defined as less than 3 years of disease without details as to whether this is from onset of symptoms, joint swelling, or time … Address correspondence to Dr. Cohen; E-mail: mcohen{at}rheumdoc.net ER -