Brief Answer:
Glutathione , vitamin E, check ESR/CRP

Detailed Answer:
Hello and Welcome

I appreciate your concern

Mixed connective tissue disease can present itself in a variety of ways, e.g where some patients have predominantly renal or pulmonary disease while others have muscular connective tissue manifestations. Treatment is directed according to the organ system involved and tailored accordingly. Specific supplements haven't been tested for MCD in well known studies/trials but based upon selected patients outcome recommendations can be made.

Glutathione and vitamin E supplements are potent antioxidants that can aid in overall well being and are used in a number of inflammatory and degenerative diseases to slow progression and improve overall outcome.

If there is evidence of marked inflammation like elevated ESR or CRP , then NSAIDS, corticosteroids or monoclonal antibodies can be considered in consult with your doctor.


Let me know if you have any query

wishing you best of health

thanks

Dr. M.S. Khalil

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Brief Answer:
Gabapentin, pregabalin, opioids , capsaicin

Detailed Answer:
hello again,

In MCTD, especially if joint involvement is the main factor affecting the quality of life, requires anti inflammatory medication. Unfortunately apixaban ( eliquis) interacts with almost all the NSAIDs resulting in a greater risk of hemorrhage.

There is an alternative though. Warfarin is also used in the prophylaxis against recurrent thromboembolic disease after initial combination with enoxaparin. Warfarin interacts with antibiotics and a bunch of other drugs but not so much with NSAIDs. The only cumbersome aspect of warfarin therapy is INR monitoring which isn't associated with eliquis. The efficacy and risk of bleeding is pretty much the same for both.

If you want to stay with apixaban then gabapentin, pregabalin and opioids are the other options in addition to intra articular steroid shots and topical substance P depleters ( capsaicin ).

Please consult your doctor before altering any medication.

Let me know if there is any query.

Thanks.
Dr. M.S. Khalil

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