Statin-induced necrotizing myositis - a discrete autoimmune entity within the "statin-induced myopathy spectrum"

Autoimmun Rev. 2013 Oct;12(12):1177-81. doi: 10.1016/j.autrev.2013.07.001. Epub 2013 Jul 11.


Statin-induced necrotizing myositis is increasingly being recognised as part of the "statin-induced myopathy spectrum". As in other immune-mediated necrotizing myopathies, statin-induced myositis is characterised by proximal muscle weakness with marked serum creatinine kinase elevations and histological evidence of myonecrosis, with little or no inflammatory cell infiltration. Unlike other necrotizing myopathies, statin-induced myopathy is associated with the presence of autoantibodies directed against 3-hydroxy-3-methylglutaryl- coenzyme A reductase (the enzyme target of statin therapies), and with Human Leukocyte Antigen-DRB1*11. This article summarises the clinical presentation, investigations and management of this rare, but serious complication of statin therapy.

Keywords: 200/100kDa; Antibody; HMGCR; Myositis; Necrotizing; Statin.

Publication types

  • Review

MeSH terms

  • Autoantibodies / blood
  • Autoantibodies / immunology
  • Humans
  • Hydroxymethylglutaryl CoA Reductases / immunology
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects*
  • Myositis / chemically induced*
  • Myositis / diagnosis
  • Myositis / pathology
  • Myositis / therapy


  • Autoantibodies
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Hydroxymethylglutaryl CoA Reductases