Figure 1.

A stepwise algorithm for the management of RA-associated ILD (RA-ILD).

ACPA, anti-citrullinated protein antibody; AZA, azathioprine; CsA, cyclosporin A; CYC, cyclophosphamide; DMARDs, disease-modifying anti-rheumatic drugs; FVC, forced vital capacity; HRCT, high-resolution computed tomography; ILD, interstitial lung disease; MMF, mycophenolate mofetil; RA, rheumatoid arthritis; RF, rheumatoid factor; TAC, tacrolimus, UIP, usual interstitial pneumonia.

*Supportive interventions such as smoking cessation, pulmonary rehabilitation, oxygen therapy, preventive vaccination.

^§DMARDs with potential pulmonary toxicity should be tightly monitored. ^&There is no clear evidence-based recommendations on the choice of immunomodulatory agent for the treatment of RA-ILD.

^#Optimal therapy for RA-ILD with a UIP pattern is under debate.