RA (with pulmonary fibrosis too) treatment options?

Hi!  I am new here & I'm posting a question for my mom, who has rheumatoid arthritis.  She has had it for many years (20+) now & she has also been diagnosed with pulmonary fibrosis, which has complicated her treatment.  Because of the PF, she cannot take some of the newer RA drugs, as they are potentially too damaging to the lungs/too likely to make her get an upper respiratory infection.  The docs say there is no way she can take drugs like Humira, Enbrel, Remicade, Orencia, etc. because of this.  She is already taking Plaquenil, Imuran, Arava, Celebrex, & Prednisone.  Unfortunately, the RA is progressing.  If any of you have any treatment suggestions, I would greatly appreciate it!  (Or if you know of any good websites, articles, etc.) 

My mom has fought this disease for so long, I hate to see her struggling so much at this point.

Thanks for your help!

bears_fan

Hi bears.
What state do you live? I'm suspecting Il. but that's just a hunch.
Is she under the care of a rheummy that is affiliated with a major university hospital?
This is a very bad situation as the TNFs and Dmards all help slow the progression, yet it is contraindicated in her case due to the lung fibrosis.

Wow, what is more important at this time? It's a tough complicated call.
Yes, she shouldn't risk getting pneumonia or TB or any Resp infection in that matter. What is her age? I ask because that could be the main factor of weighing the options.
If your mom is say around 70 or over, starting the TNF meds might be too risky for the lungs & pain management for RA might be smarter, keep the prednisone and Imuran and all.
What are the dosages of Imuran she takes?
Is a rheummy & pulmonologist working together on this?
This is hard....RA progresses and can cause worse heart & lung problems....and God, so can the treatments.

Is she on the highest possible dosages of the meds she is on?
Prayers are with you. Write back soon.
Erin