How do you approach management of new onset ILD in a patient with RA who is otherwise well controlled on methotrexate or leflunomide?

We do not have any randomized controlled trials for DMARDs in RA-ILD. Most of the data is case series or retrospective analysis. Nonetheless, we can use current data to at least make clinical decisions until we receive more direction from high-quality clinical trials. We now know that in general met...

First and foremost. Is the ILD truly connected to the RA or therapy? I prefer to perform bronchoscopy with BAL stains and cultures, as well as cell differential, if it can be done safely. I want reassurance that this immunocompromised individual does not have an opportunistic infection causing diffu...