What immunosuppression regimens do you use in patients with progressive RB-ILD despite smoking cessation and prednisone?

In patients with progressive RB-ILD who continue to worsen despite quitting tobacco use and prednisone, treatment options are very limited. Since there are no RCTs specifically studying immunosuppressive treatment in RB-ILD, most available evidence comes from observational studies, and most recommen...

I have definitely used immune suppressants (azathioprine, mycophenolate, and tacrolimus) in progressive RB-ILD despite smoking cessation and prednisone. As with other forms of ILD, I try to limit exposure to prednisone if at all possible.

If there is fibrosis, I would not hesitate to use an anti-fib...