Do you use MTX along with Rituximab in patients with early NSIP on HRCT in patient with active RA and polymyositis (PL7+)?  

The reluctance of using methotrexate in ILD is mainly due to the risk of pneumonitis. So, I would use MTX in a patient with ILD if their pulmonary reserve is adequate to withstand a case of pneumonitis, which is a rare event. Otherwise, I would azathioprine or tacrolimus in combination with rituxima...