Disclosure: A.L.M. holds a patent for anti-HMGCR antibody testing.
Statin-associated autoimmune myopathy and anti-HMGCR autoantibodies
Article first published online: 30 AUG 2013
Copyright © 2013 Wiley Periodicals, Inc.
Muscle & Nerve
Volume 48, Issue 4, pages 477–483, October 2013
How to Cite
Mohassel, P. and Mammen, A. L. (2013), Statin-associated autoimmune myopathy and anti-HMGCR autoantibodies. Muscle Nerve, 48: 477–483. doi: 10.1002/mus.23854
This work was supported by the National Institutes of Health (K08-AR-054783 to A.L.M.).
- Issue published online: 23 SEP 2013
- Article first published online: 30 AUG 2013
- Accepted manuscript online: 21 MAR 2013 04:16AM EST
- Manuscript Accepted: 15 MAR 2013
- National Institutes of Health. Grant Number: K08-AR-054783
- HMG-CoA reductase;
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. Muscle Nerve 48: 477–483, 2013