O55. Prevalence of Autoantibodies to Hmgcr in Myositis Patients

Betteridge, Zoë; Chinoy, Hector; Jani, Meghna; Palmer, R.I.; New, Paul; Cooper, Robert G.; McHugh, Neil

doi:10.1093/rheumatology/keu095.001

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“…Anti-HMGCR autoantibodies were specific for statin-related IMNM: the prevalence of statin exposure was between 40% and 92% in patients with these antibodies [20,22,24,27,29,92,[94][95][96][97][98][99], whereas they were found positive only in small proportion in inflammatory myopathies [20,24].…”

Section: Anti-hmgcrmentioning

confidence: 99%

Statins and Immune-Mediated Necrotizing Myopathy

Turrin¹

2019

CMI

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Statins are a well-recognized cause of a variety of skeletal myopathic effects, which generally resolve when discontinuing the treatment. Among autoimmune manifestations associated with statins, there is immune-mediated necrotizing myopathy (IMNM).The present article summarizes the main features of statin-related IMNM, describing diagnosis, classification, epidemiology, treatment, and the main autoantibodies detected.Statins are a well-recognized cause of a variety of skeletal myopathic effects, which generally resolve when discontinuing the treatment. Among autoimmune manifestations associated with statins, there is immune-mediated necrotizing myopathy (IMNM).The present article summarizes the main features of statin-related IMNM, describing diagnosis, classification, epidemiology, treatment, and the main autoantibodies detected.Although it is impossible to define the precise number, it evident that more than 550 statin-related IMNM cases have been described in the literature. Among IMNM, two forms must be distinguished: with anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) and with anti-signal recognition particle (SRP) antibodies. The differential diagnosis should be made between the IMNM and self-limited statin-related myopathy, drug-induced rhabdomyolysis, and nonautoimmune myopathies.Patients who have failed to normalize high creatine phosphokinase (CPK) after statin withdrawal should be tested for anti-HMGCR antibodies and, if these are positive, undergo muscle biopsy to confirm the diagnosis of IMNM. Pharmacological therapy of IMNM, not yet based on evidence, involves the use of high-dose corticosteroids, immunosuppressant drugs used alone or in combination, intravenous immunoglobulins (IVIg) or plasmapheresis.

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Section: Anti-hmgcrmentioning

confidence: 99%

Statins and Immune-Mediated Necrotizing Myopathy

Turrin¹

2019

CMI

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O55. Prevalence of Autoantibodies to Hmgcr in Myositis Patients

Cited by 1 publication

References 0 publications

Statins and Immune-Mediated Necrotizing Myopathy

Statins and Immune-Mediated Necrotizing Myopathy

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