We thank Rivano-Fischer and Stålnacke (2021) for the time they invested in our study. We believe that most of their criticism was already addressed in our original publication (LoMartire et al., 2021). In this response, we first reply to their comments, then discuss problems with their promoted uncontrolled before-and-after (UBA) design, and finally present target trial emulation as an alternative for observational data. This reply represents the perspective of LoMartire, Constan, and Frumento only.