Systemic autoimmune diseases   

Do you taper one DMARD as you uptitrate another versus do you stop the first DMARD and quickly uptitrate another one?

I have a patient with recently diagnosed primary biliary cholangitis/cirrhosis (PBC) with SSc. Her laboratory values are within normal limits, but end...

When do you switch to steroid-sparing medications? What steroid-sparing therapies do you prefer?

The patient is a young African American female of reproductive age with positive Fibrillarin antibody and nucleolar antibody. No ILD.

Do you frequently order liver biopsies for these patients?This question is part of a collaboration with RheumMadness and is specifically in reference ...

Will you still favor starting with steroids and traditional immunosuppressive agents, move IVIG earlier in your treatment strategy, or start with IVIG...

Do you do blood work? Or do you rely on review of systems?

Do you typically start the patient on hydroxychloroquine?  What work-up do you perform?

In what cases do you discontinue the medication?

Have you tried hyaluronidase? 

What recommendations do you provide if there is concern that the patient is beginning to flare? Have you prescribed any of the new JAK inhibitors?