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Statin-associated autoimmune myopathy and anti-HMGCR autoantibodies.
Muscle Nerve. 2013 Oct; 48(4):477-83.MN

Abstract

Statins are among the most commonly prescribed medications that significantly reduce cardiovascular risk in selected individuals. However, these drugs can also be associated with muscle symptoms ranging from mild myalgias to severe rhabdomyolysis. Although statin myotoxicity is usually self-limited, in some instances statin-exposed subjects can develop an autoimmune myopathy typically characterized by progressive weakness, muscle enzyme elevations, a necrotizing myopathy on muscle biopsy, and autoantibodies that recognize 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR), the pharmacologic target of statins. These antibodies are also found in some autoimmune myopathy patients without statin exposure. Importantly, anti-HMGCR antibodies are not found in the vast majority of statin-exposed subjects without autoimmune myopathy, including those with self-limited statin intolerance. Thus, testing for these antibodies may help differentiate those with self-limited statin myopathy who recover after statin discontinuation from those with a progressive statin-associated autoimmune myopathy who typically require immunosuppressive therapy.

Authors+Show Affiliations

Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.No affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Review

Language

eng

PubMed ID

23519993

Citation

Mohassel, Payam, and Andrew L. Mammen. "Statin-associated Autoimmune Myopathy and anti-HMGCR Autoantibodies." Muscle & Nerve, vol. 48, no. 4, 2013, pp. 477-83.
Mohassel P, Mammen AL. Statin-associated autoimmune myopathy and anti-HMGCR autoantibodies. Muscle Nerve. 2013;48(4):477-83.
Mohassel, P., & Mammen, A. L. (2013). Statin-associated autoimmune myopathy and anti-HMGCR autoantibodies. Muscle & Nerve, 48(4), 477-83. https://doi.org/10.1002/mus.23854
Mohassel P, Mammen AL. Statin-associated Autoimmune Myopathy and anti-HMGCR Autoantibodies. Muscle Nerve. 2013;48(4):477-83. PubMed PMID: 23519993.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Statin-associated autoimmune myopathy and anti-HMGCR autoantibodies. AU - Mohassel,Payam, AU - Mammen,Andrew L, Y1 - 2013/08/30/ PY - 2013/03/15/accepted PY - 2013/3/23/entrez PY - 2013/3/23/pubmed PY - 2013/12/16/medline KW - HMG-CoA reductase KW - autoantibodies KW - myopathy KW - myositis KW - necrotizing KW - statins SP - 477 EP - 83 JF - Muscle & nerve JO - Muscle Nerve VL - 48 IS - 4 N2 - Statins are among the most commonly prescribed medications that significantly reduce cardiovascular risk in selected individuals. However, these drugs can also be associated with muscle symptoms ranging from mild myalgias to severe rhabdomyolysis. Although statin myotoxicity is usually self-limited, in some instances statin-exposed subjects can develop an autoimmune myopathy typically characterized by progressive weakness, muscle enzyme elevations, a necrotizing myopathy on muscle biopsy, and autoantibodies that recognize 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR), the pharmacologic target of statins. These antibodies are also found in some autoimmune myopathy patients without statin exposure. Importantly, anti-HMGCR antibodies are not found in the vast majority of statin-exposed subjects without autoimmune myopathy, including those with self-limited statin intolerance. Thus, testing for these antibodies may help differentiate those with self-limited statin myopathy who recover after statin discontinuation from those with a progressive statin-associated autoimmune myopathy who typically require immunosuppressive therapy. SN - 1097-4598 UR - https://www.unboundmedicine.com/medline/citation/23519993/Statin_associated_autoimmune_myopathy_and_anti_HMGCR_autoantibodies_ L2 - https://doi.org/10.1002/mus.23854 DB - PRIME DP - Unbound Medicine ER -