skip to main content

Rheumatoid arthritis-associated ILD — SCE Respiratory MCQ

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

HardILDRheumatoid arthritis-associated ILDSCE Respiratory

A 62-year-old man with rheumatoid arthritis develops progressive dyspnoea. HRCT shows a UIP pattern and FVC has fallen from 82% to 67% predicted over 12 months despite optimised joint control. He is not a current smoker and infection has been excluded. What is the most appropriate management?

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

Reveal the answer and explanation

Correct answer: E — Discuss antifibrotic therapy for progressive fibrosing ILD in an ILD MDT

A substantial FVC decline with progressive fibrosis in rheumatoid arthritis-associated UIP indicates a progressive pulmonary-fibrosis phenotype. The ILD multidisciplinary team should reassess inflammatory treatment and consider antifibrotic therapy under NICE guidance. Long-term high-dose corticosteroid is not the default for established fibrotic UIP.

Reference: https://www.nice.org.uk/guidance/ta747