Therapeutics and Clinical Risk Management (May 2020)
Statin-Associated Autoimmune Myopathy: Current Perspectives
Abstract
Eleni Tiniakou Johns Hopkins University School of Medicine, Department of Medicine, Division of Rheumatology, Baltimore, MD, USACorrespondence: Eleni TiniakouJohns Hopkins University School of Medicine, 5200 Eastern Avenue, Mason Lord, Center Tower, Baltimore, MD 21224, USATel +1 410 550-6962Email [email protected]:: Although generally well tolerated, statin users frequently report muscle-related side effects, ranging from self-limiting myalgias to rhabdomyolysis or the rare clinical entity of statin-associated immune-mediated necrotizing myopathy (IMNM). Statin-associated IMNM is based on the development of autoantibodies against 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR), the rate-limiting enzyme in cholesterol synthesis and the pharmacologic target of statins, and leads to a necrotizing myopathy requiring immunosuppressive therapy. This review attempts to recapitulate the diverse aspects of anti-HMGCR IMNM, including clinical presentation, diagnostic modalities, genetic risk associations, therapeutic options and potential pathogenetic pathways.Keywords: stains, myopathy, statin toxicity, statin myopathy, anti-HMGCR
