Nintedanib and pirfenidone in rheumatoid arthritis-associated interstitial lung disease: aligning visual algorithms with the GRADE evidence hierarchy

I read with great interest the European Respiratory Society/European Alliance of Associations for Rheumatology clinical practice guidelines for connective tissue disease (CTD)-associated interstitial lung disease (ILD) by Antoniou et al. [1]. This comprehensive document represents an important step towards harmonising care in CTD-ILD across rheumatology and respiratory medicine. The clear distinction between moderate and low/very low certainty evidence and the explicit use of GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology is particularly welcome.