Treatment optimization studies have paved the way for success of new therapies in paediatric oncology. The majority of children with cancer are treated within treatment optimization study protocols (TOSPs), but this is not the case for children with common rheumatic diseases such as juvenile idiopathic arthritis. In this Opinion article, Niehues suggests the recruitment of children with rheumatic diseases into TOSPs, making use of rheumatology research networks already established, would secure standardized treatments and outcome measures and could improve patient care considerably.