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Rheumatoid arthritis interstitial lung disease — SCE Rheumatology MCQ

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HardInflammatory ArthritisRheumatoid arthritis interstitial lung diseaseSCE Rheumatology

A patient with rheumatoid arthritis has progressive fibrosing interstitial lung disease despite appropriate immunomodulatory management. FVC has fallen and fibrosis is increasing on HRCT. What additional treatment should the ILD MDT consider?

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Correct answer: D — Nintedanib for the progressive fibrosing lung phenotype

Nintedanib is NICE-recommended for eligible chronic progressive fibrosing ILD, including connective-tissue-disease-associated phenotypes, alongside management of the underlying inflammatory disease. An ILD MDT should confirm progression, exclude alternative causes and coordinate monitoring.

Reference: NICE TA747: nintedanib for progressive fibrosing interstitial lung diseases (Published November 2021): https://www.nice.org.uk/guidance/ta747/chapter/1-Recommendations; ERS/EULAR clinical practice guideline for connective-tissue-disease-associated ILD (Published 2025): https://publications.ersnet.org/lookup/doi/10.1183/13993003.02533-2024