PMC8084679_01
Clinical course and therapeutic strategy. ILD: interstitial lung disease; MTX: methotrexate; ETA: etanercept; TCZ: tocilizumab; RTX: rituximab; VAS: Visual Analogue Scale; FVC: forced vital capacity; DLCO: diffusing capacity of the lung for carbon monoxide; RA: rheumatoid arthritis; CRP: C-reactive protein; RF: rheumatoid factor; ACPA: anticitrullinated protein antibodies; ANA: antinuclear antibodies; ENA: extractable nuclear antigen; ANCA: antineutrophil cytoplasmic antibodies; DAS-28: disease activity score on 28 joints.
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Fourteen months later, ILD was casually detected (Figure 1), and ETA was replaced with subcutaneous tocilizumab (TCZ) 162 mg weekly. This latter drug was stopped after few months for relapsing infections, mainly involving the urinary and lower respiratory tract (Figure 1).
Chest high-resolution computed tomography: November 2017 compared to last follow-up, September 2020. Reticular abnormalities, honeycombing aspects, and traction bronchiectasis compatible with usual interstitial pneumonia. Despite an initial progression, interstitial lung disease showed a substantial stability at the last follow-up.
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