Lupus-Like Syndrome Associated with Statin Therapy

Abstract

Statins are among the most widely prescribed drugs. An increasing number of lupus-like syndrome has recently been reported with these lipid-lowering agents. We describe a new case associated with simvastatin therapy. The presence of anti-dsDNA antibodies in the serum is for the first time reported confirming that statins may also induce a systemic autoimmune reaction. Statin-induced lupus-like syndrome is characterized by the long delay between the beginning of therapy and the skin eruption. Antinuclear antibodies may persist for many months after drug discontinuation. The causal relationship may be therefore difficult to establish, and probably many cases are unrecognized. Early diagnosis may avoid unnecessary immunosuppressive therapy.

Immunomodulation by statins: mechanisms and potential impact on autoimmune diseases

“…Statin therapy has been used to lower the cholesterol level in SLE patients in order to reduce the risk of cardiovascular disease. However, besides reducing the incidence of cardiovascular disease in the patients, statin therapy has been shown to trigger or aggravate autoimmune diseases (Hanson and Bossingham 1998;Noel and Panizzon 2004). This unwanted side effect, which appears to be a lupus-like syndrome, is of considerable concern especially when considering the use of statins in the treatment of inflammatory autoimmune diseases.…”

Statin myopathy

“…There is a growing body of literature that suggests statins may also induce autoimmune illness [37]. In addition to ordinary statin myopathy, statins can induce a musculocutaneous syndrome that closely resembles dermatomyositis (DM) [26•].…”

Simvastatin-induzierte Dermatomyositis

“…Eine Simvastatin-induzierte Dermatomyositis ist bisher nicht beschrieben. Bei der Pravastatin-induzierten Dermatomyositis zeigten 3 von 9 Patienten eine spontane Besserung nach Absetzen der Medikation, die übrigen Patienten erhielten zusätzlich systemisch Glukokortikosteroide [10,12].…”

“…Interessant ist, wie auch in dem hier vorgestellten Fall, die lange Latenzzeit von 6 Jahren seit Beginn der Therapie mit HMG-CoA-Reduktase-Inhibitoren bis zum Auftreten der ersten Hautveränderungen [12]. In den meisten Fäl-len wurde bereits frühzeitig eine Therapie mit hoch dosierten Glukokortikosteroiden und anderen Immunsuppressiva begonnen.…”