Rheumatoid Arthritis‐Associated Interstitial Pneumonia Refractory to Initial Therapy: Successful Control Through Combined Anti‐Inflammatory, Antifibrotic and JAK ‐ STAT ‐Targeted Treatment

Connective tissue disease (CTD)–associated interstitial lung disease (ILD) accounts for a significant proportion of ILD cases, with rheumatoid arthritis (RA) being one of the most common underlying disorders. Although immunosuppressive therapy plays a central role in CTD‐ILD, its efficacy is limited in fibrotic ILDs, particularly those with a usual interstitial pneumonia (UIP) pattern. We report a case of RA‐associated ILD in an elderly woman who experienced acute disease progression despite ongoing treatment. A multimodal approach combining corticosteroids, tacrolimus, antifibrotic therapy (nintedanib) and the Janus kinase (JAK) inhibitor baricitinib led to marked clinical, radiological and biomarker improvement. This case underscores the potential benefit of a multi‐target strategy addressing both inflammation and fibrosis and suggests a possible role for JAK inhibition in refractory RA‐ILD.