From the Research
The best treatment for Mixed Connective Tissue Disease (MCTD) involves a combination of medications tailored to the specific symptoms present, with hydroxychloroquine and glucocorticoids being the cornerstones of treatment, as evidenced by the most recent study 1. The treatment approach should be individualized based on organ involvement, disease severity, and patient-specific factors.
- For mild disease, hydroxychloroquine (200-400mg daily) is typically the first-line treatment, particularly for arthritis, skin manifestations, and fatigue.
- For more severe symptoms, corticosteroids like prednisone (starting at 0.5-1mg/kg/day with gradual tapering) are often necessary.
- Immunosuppressive agents such as methotrexate (7.5-25mg weekly), azathioprine (1-2.5mg/kg/day), or mycophenolate mofetil (1-3g daily) may be added for steroid-sparing effects or in cases resistant to initial therapy.
- For pulmonary hypertension, which can be a serious complication, specific treatments include endothelin receptor antagonists (bosentan, ambrisentan), phosphodiesterase-5 inhibitors (sildenafil, tadalafil), or prostacyclin analogs.
- Raynaud's phenomenon, common in MCTD, is managed with calcium channel blockers like nifedipine (30-120mg daily) and lifestyle modifications such as avoiding cold exposure and smoking cessation. The goal of treatment is to control inflammation, prevent organ damage, and improve quality of life while minimizing medication side effects, as supported by the study 1, which found that hydroxychloroquine and glucocorticoids were sufficient to control disease manifestations in nearly half of the patients.