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MMC / MCR No. (optional for CME points, Malaysia/Singapore HCPs only)

Institution

When do you usually screen for PPF (eg, PFTs, HRCT)?

When I recognize signs of an ILD from the clinical assessment

When the patient reports symptoms of an ILD

When I recognize that the patient is at high risk of developing ILD through assessment of risk factors (eg, demographics, disease manifestations, and antibody profiles)

I do not screen for ILD/PPF

When do you initiate antifibrotic treatment in PPF patients?

Immediately upon detection of first signs of progression regardless of the underlying disease and existing treatment

When pulmonary symptoms worsen

When immunosuppressants/disease-modifying antirheumatic drugs (DMARDs)/corticosteroids fail

I do not consider nor initiate antifibrotic treatment

I refer patients to a pulmonologist when I believe antifibrotic treatment is necessary

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RA-ILD screening algorithm

Footnote

†
Consult risk factors and their score; if the screening tests are negative, screening will be repeated once a year by performing spirometry plus DLCO.¹

References

1.
Narvaez J, et al. Reumatol Clin. 2023;19:74-81.
2.
Geerts S et al. Sarcoidosis Vasc Diffuse Lung Dis. 2017;34:326-35.
3.
Esposito AJ et al. Clin Chest Med 2020;40:545-60.