What would be your approach to a patient with Scleroderma/Myositis overlap syndrome (+anti-Ku) and active inflammatory eye disease despite high dose mycophenolate?  

This is a challenging question but impossible to answer without more information. Inflammatory eye disease includes uveitis, scleritis, corneal melt, and orbital inflammation. Just as scleroderma itself has a range of manifestations that drive the treatment, the various eye inflammations would requi...

I would add Adalimumab as well. I think Methotrexate may be better than Mycohenolate.