The recent ACR/American College of Chest Physicians guideline conditionally recommends mycophenolate, azathioprine, and rituximab as the first-line treatment for RA-ILD; in contrast, leflunomide, methotrexate, TNF inhibitors, and abatacept are not conditionally recommended as first-line treatment options for ILD [24]. This evidence concerns the gene TNF and rheumatoid arthritis.