Do you recommend maintaining the same monitoring interval of PFTs every 3–6 months with HRCT as indicated for patients with anti-MDA5 dermatomyositis, or do you recommend closer surveillance in this group?  

In this group of patients, closer surveillance than what is standard for SARD-ILD in general is warranted. They have a uniquely high risk of rapidly progressive-ILD, and rapid deterioration with high mortality. More so, physiologic decline can lag behind symptoms or radiographic change. At baseli...

I think every 3 months in the early course of MDA5, I just get spiro + DLCO to make it easier on the patient. After some degree of stability, I probably would back down to every six months, but would be closely following them early in the course of their illness.

Closer surveillance may be needed at diagnosis of ILD in anti-MDA5 DM at every 3 months for 1st year. But typically, in my experience, patients' symptoms progress faster than every 3 months, so rapidly progressive ILD is diagnosed clinically.