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Statin-Associated Autoimmune Myopathy: Current Perspectives

Authors Tiniakou E

Received 30 March 2020

Accepted for publication 11 May 2020

Published 27 May 2020 Volume 2020:16 Pages 483—492


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Garry Walsh

Eleni Tiniakou

Johns Hopkins University School of Medicine, Department of Medicine, Division of Rheumatology, Baltimore, MD, USA

Correspondence: Eleni Tiniakou
Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Mason Lord, Center Tower, Baltimore, MD 21224, USA
Tel +1 410 550-6962

Abstract:: 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

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