How do you determine whether to add abatacept or rituximab to the treatment regimen in patients with mild RA-ILD on methotrexate?

I think of many agents before rituxan for RA ILD: all in various stages of being studied MMF, Orencia/abatacept, Tocli/actemra, and even JAK inhibitors xeljanz/rinvoq. Generally, if I treat and control the joints, the lungs stabilize. 10-20% run independently from joints or extra-articular ILD witho...

No data either way. Both will work for joints. If progressive ILD, I would favor ritux, based on the totality of the data (even though the quality is low). The downside of ritux is the response to vaccination we are seeing.

There are published articles indicating that overall RA-ILD is less progressive than IPF, for example. In addition, I fully agree in looking for overlap autoimmune syndromes, especially ruling out myositis disorders. I have seen more than a few patients with such disorders initially presenting or be...

This question has been answered already, but I thought I would add a few comments. Both rituximab and abatacept are reasonable options based on current data over TNF inhibitors. The point about rituximab and infections/vaccinations is relevant, especially in light of a recent publication by Zhang et...