Honestly? Yes. The issue I'd have with said minimums is that, at least from my experience in biomedical research is that they're often done with exceedingly poor statistical grounding and pathetic sample sizes. Admittedly, perhaps things are better in the clinical space, though my gut argues otherwise.

So, to re-answer your question

>Would you propose to expose 100 more patients to an inferior treatment just to improve your fragility index

Absolutely, especially if the alternative is exposing a million more patients to a different, more expensive inferior treatment because the statistical analysis was garbage.