A 58-year-old woman with a 10-year history of rheumatoid arthritis (RA) on methotrexate and prednisolone presents with progressive dyspnea and dry cough for 3 months. High-resolution CT chest shows bilateral lower lobe predominant reticular opacities with traction bronchiectasis. Pulmonary function tests reveal FVC 65% predicted and DLCO 52% predicted. What is the most appropriate next step in management?

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