Management of rheumatoid arthritis-interstitial lung disease (RA-ILD) begins by assessing severity and risk for progression. All patients should receive non-pharmacologic therapies. Those with clinically significant RA-ILD may have their RA disease-modifying therapies adjusted and consideration given to other immunomodulatory therapies and glucocorticoids. If progression occurs despite these therapies, anti-fibrotics and alternative immunomodulatory therapies should be considered.
Abbreviations: AZA = azathioprine, COPD = chronic obstructive pulmonary disease, DLCO = diffusing capacity for carbon monoxide, DMARD = disease-modifying anti-rheumatic drug, FVC = forced vital capacity, GERD = gastroesophageal reflux disease, HRCT = high-resolution computed tomography, MMF = mycophenolate mofetil, OSA = obstructive sleep apnea, PFT = pulmonary function tests, TNFi = tumor necrosis factor inhibitor