Mixed Connective Tissue Disease (MCTD)

View All Arthritis Types Mixed connective tissue disease (MCTD) is an autoimmune disease first described in 1972 and is considered an "overlap" of three diseases, systemic lupus erythematosus (lupus), scleroderma and polymyositis. People with MCTD experience symptoms of each of these three diseases.  In many cases, this mixed set of symptoms is eventually dominated by symptoms characteristic of one of the three illnesses, especially scleroderma or lupus.View All Arthritis Types
How common is MCTD?
What are the warning signs of MCTD?
What causes MCTD?
Treatment of MCTD is directed at suppressing immune-related inflammation of tissues and is similar to treatment for lupus. Corticosteroids (for example, prednisone) are usually effective, especially when the disease is diagnosed early. Mild cases can be treated with nonsteroidal anti-inflammatory drugs (NSAIDs), hydroxychloroquine or similar drugs, and low doses of corticosteroids.

The more severe the disease, the higher the dose of corticosteroid needed. Prednisone is the most common corticosteroid used and is taken in pill form. Prednisone is usually considered when the symptoms of MCTD are not being controlled by other treatments.

Prednisone use needs to be carefully monitored because of its many side effects, and the drug must never be stopped abruptly. Some of the side effects from long-term use include cataracts, high blood pressure, sleep problems, muscle loss, bruising, thinning of the bones (osteoporosis), weight gain and increased risk of infections. The goal with this and most drugs is to find the lowest effective dose to avoid as many of the side effects as possible.

In severe cases of MCTD, immunosuppressive drugs (e.g. cytotoxic drugs) may also be needed. These drugs are powerful medications that suppress inflammation and the immune system. You may be prescribed these if your MCTD symptoms are difficult to control with prednisone alone or if you are experiencing side effects from prednisone.

In general, the more advanced the disease and the greater the organ damage, the less effective the treatment will be. Scleroderma-like damage to the skin and esophagus (pronounced e-sof-a-gus) is least likely to respond to treatment. Symptom-free periods can sometimes last for many years through minimal or no ongoing treatment. However, MCTD will progress in spite of treatment in about 13 percent of cases. In large part, the prognosis for MCTD is usually quite good.
Arthritis medications are designed to control a disease, slow its progression, and to help manage pain. There is a wide range of options – with new ones coming on the horizon – so understanding all possible treatments is not easy. 

These medications can be very complex, so you are encouraged to ask for in-depth explanations from your health care team – including pharmacists, who are an excellent source of information. 

To explore this area of treatment, The Arthritis Society has developed a comprehensive expert guide that delivers detailed information on medications used to treat arthritis.

Explore the Arthritis Medications A Reference Guide

The optimal treatment is what is best in each individual case – so speak with your doctor and/or pharmacist about what kind of medications are most appropriate for you.

Educational Programs 

The Arthritis Society provides a range of in-person workshops and online programs, all with a specific focus in mind. They include chronic pain management, overcoming fatigue, understanding your health-care team, symptom checkers, and more. Participants learn new information and skills, and for in-person workshops, can share ideas and experiences with others.

Explore arthritis workshops and courses


Discover information you can trust, because it’s based on evidence and vetted by experts, in The Society’s resource area. Learn about each disease, possible treatments, self-management, lifestyle issues, and so much more.

Browse publications

Discover More Discover More

online education module
Online Arthritis Self Management Courses

Online education programs that are informative, convenient and FREE.

Arthritis Community
Arthritis Community

Connect with others, share your arthritis experience and get answers in a safe online space.

Printed publications
Arthritis Publications

Evidence-based content to help you learn about the disease, treatments and self-management.