skip to main content

Rheumatoid arthritis-associated ILD — SCE Respiratory MCQ

Instant feedback + full explanation. One question, done properly.

HardInterstitial Lung DiseaseRheumatoid arthritis-associated ILDSCE Respiratory

A woman with RA-UIP declines despite mycophenolate: over 12 months FVC falls from 72% to 64%, symptoms worsen and fibrosis extends on HRCT. What additional NHS treatment is supported for this phenotype?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Nintedanib for progressive fibrosing RA-associated interstitial lung disease

Explanation lettering: C = shown as A · D = shown as B · E = shown as C · B = shown as D · A = shown as E

C is correct. Symptomatic, physiological and radiological progression despite management identifies progressive fibrosing ILD; NICE supports nintedanib in this chronic phenotype. RA-UIP is not automatically IPF, so IPF-labelled pirfenidone cannot be assumed. Inhaled steroid does not treat fibrosis, waiting for severe loss forfeits function, and cyclophosphamide is not a default indefinite strategy. Treatment remains multidisciplinary with adverse-effect and liver monitoring.

Reference: NICE TA747 nintedanib for progressive fibrosing ILD: https://www.nice.org.uk/guidance/ta747/chapter/1-Recommendations