mixed connective tissue disease

I think o-one of the hardest things that, that we sometimes do is, let's say you do get an ANA.

Let's say you do get, I don't know, a centromere pattern RNP or something else, but the patient clearly has no other signs or symptoms of systemic sclerosis or MCTD or anything else.

How do you talk to patients about that? How do you counsel patients?

So again, that's where, so positive ANA with an anti-centromere antibody, and that's not an uncommon consult.

Let's talk about medications.

It sounds like for most primary Raynaud's, you tend to advise them sort of environmental measures, as we talked about.

And then let's talk about a patient that does need medications, whether they have MCTD or maybe early systemic sclerosis.

How do you think about medications? Which one do you start first?