Statins and myositis: the role of anti-HMGCR antibodies

Expert Rev Clin Immunol. 2015;11(12):1277-9. doi: 10.1586/1744666X.2015.1102632. Epub 2015 Oct 22.


Muscle toxicity is a recognized adverse effect of statin use. Recently, a new myositis syndrome was described in association with antibodies directed against the pharmacologic target of statins, anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (anti-HMGCR antibody). The patient's genetic background, characteristic histologic patterns (immune-mediated necrotizing myopathy), and presence of anti-HMGCR antibodies define the syndrome. In most patients, statin discontinuation is insufficient to reverse the myositis symptoms, and immunosuppressive therapy is needed. The mechanisms by which these antibodies may lead to disease are not fully elucidated. Several important questions remain unsolved and warrant further research.

Keywords: anti-HMGCR; immune mediated necrotizing myopathy; myalgia; myositis; statins.

Publication types

  • Editorial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Autoantibodies / immunology*
  • Autoantibodies / metabolism
  • Autoimmune Diseases / enzymology
  • Autoimmune Diseases / immunology*
  • Autoimmune Diseases / pathology
  • Humans
  • Hydroxymethylglutaryl CoA Reductases / immunology*
  • Hydroxymethylglutaryl CoA Reductases / metabolism
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors*
  • Myositis / enzymology
  • Myositis / immunology*
  • Myositis / pathology


  • Autoantibodies
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • HMGCR protein, human
  • Hydroxymethylglutaryl CoA Reductases