A new innovation spotlight highlighted synthetic control arms as an alternative to traditional placebo-heavy trial designs, using external datasets to estimate counterfactual outcomes. The approach is designed to reduce patient burden in trials while improving statistical power when placebo groups are difficult to recruit or ethically problematic. The coverage describes external control arm generation using iterative sampling from external datasets and discusses the role of external data sources—such as real-world hospital datasets and historical trials—in building the comparison group. The spotlight points to complex disease areas like idiopathic pulmonary fibrosis, where recruitment, withdrawal, and trial timelines can undermine conventional placebo-control designs.