Absence of anti-HMG-CoA reductase autoantibodies in severe self-limited statin-related myopathy

Muscle Nerve. 2016 Jun;54(1):142-4. doi: 10.1002/mus.25127.

Abstract

Introduction: Patients with self-limited statin-related myopathy improve spontaneously when statins are stopped. In contrast, patients with statin-associated autoimmune myopathy have autoantibodies recognizing 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase (HMGCR) and usually require immunosuppressive therapy to control their disease. On initial presentation, it can sometimes be difficult to distinguish between these 2 diseases, as both present with muscle pain, weakness, and elevated serum creatine kinase (CK) levels. The goal of this study was to determine whether patients with severe self-limited statin-related myopathy also make anti-HMGCR autoantibodies.

Methods: We screened 101 subjects with severe self-limited cerivastatin-related myopathy for anti-HMGCR autoantibodies.

Results: No patient with severe self-limited cerivastatin-related myopathy had anti-HMGCR autoantibodies.

Conclusion: Anti-HMGCR autoantibody testing can be used to help differentiate whether a patient has self-limited myopathy due to cerivastatin or autoimmune statin-associated myopathy; these findings may apply to other statins as well. Muscle Nerve 54: 142-144, 2016.

Keywords: adverse drug reaction; autoimmune; myopathy; rhabdomyolysis; statins.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural

MeSH terms

  • Aged
  • Autoantibodies / metabolism*
  • Creatine Kinase / blood
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / immunology*
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / toxicity*
  • Male
  • Middle Aged
  • Muscular Diseases / blood
  • Muscular Diseases / chemically induced*
  • Muscular Diseases / immunology*
  • Pyridines / toxicity*
  • Retrospective Studies

Substances

  • Autoantibodies
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Pyridines
  • cerivastatin
  • Creatine Kinase