Medication Treatment Options for Mixed Connective Tissue Disease (MCTD)

What is mixed connective tissue disease (MCTD)?

Mixed connective tissue disease (MCTD) is a rare autoimmune condition; it is often referred to as an overlap disease because the symptoms of MCTD overlap with symptoms of other connective tissue conditions, including polymyositis, scleroderma and systemic lupus erythematosus (SLE). In some cases, MCTD also mimics symptoms of rheumatoid arthritis.

Autoimmune diseases develop when the immune system mistakenly attacks healthy cells; mixed connective tissue disease occurs when the immune system attacks the fibers that support the framework of the body. An estimated 25% of individuals with a connective tissue disease develop another connective tissue condition over the course of several years.

Medication treatment options

Although there is no cure for mixed connective tissue disease, certain medications can help manage the symptoms. Medications may be prescribed for continuous use or for use only during flare-ups. The severity of MCTD and the specific organs affected determine the appropriate medication(s) for treatment. Medication options include the following:

• Corticosteroids, such as prednisone, help to halt the immune system from attacking healthy cells, resulting in reduced inflammation. Side effects may include weight gain, high blood sugar levels, increased blood pressure, mood swings, cataracts and bone loss. Due to these side effects, corticosteroids are typically used for a short time.
• Antimalarial drugs, such as hydroxychloroquine, are antirheumatic medications prescribed to treat MCTD and assist with the prevention of flare-ups.
• Calcium channel blockers, such as nifedipine and amlodipine, work by relaxing the muscles in the blood vessel walls and are often used to treat symptoms of Raynaud’s disease.
• Pulmonary hypertension medications, such as bosentan or sildenafil, are often prescribed to treat high blood pressure in the arteries to the lungs caused by MCTD. Pulmonary hypertension is the leading cause of death related to MCTD. Individuals with MCTD should be closely monitored for signs of pulmonary hypertension.
• Other immunosuppressants, such as azathioprine and mycophenolate mofetil, may be prescribed to treat specific symptoms, such as lupus-related symptoms. People requiring long-term treatment are often prescribed these medications. Immunosuppressant use should be limited during pregnancy due to an increased risk for fetal malformations or toxicity.
• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, may relieve MCTD-related pain and inflammation and are often recommended for mild cases of MCTD. These medications are available over-the-counter or by prescription, depending on the strength required.