Think of it another way: if this trial design had already been a requirement, today we wouldn't have any new IBD drugs beyond Remicade. Because it would have been very difficult and ruinously expensive for the drug companies to prove that Humira, Entyvio, Stelara, Skyrizi, etc. and the JAK inhibitors work a lot better than Remicade instead of a lot better than placebo.
So for us that would mean Remicade or nothing. If Remicade didn't work for you or it lost effectiveness over time, you would be left with only the therapeutic weak tea options that we had 25 years ago before the advent of the biologics era.