Statin-Induced Anti-3-Hydroxy-3-Methylglutaryl-Coenzyme A Reductase (Anti-HMGCR) Myopathy

Statins are known to pharmacologically target 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR). Several subtypes of anti-HMGCR autoimmune myopathies have been reported as a result of statin use. Although these types vary widely, a severe and rare form of statin-induced myopathy is immune-medi...

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Published inCurēus (Palo Alto, CA) Vol. 15; no. 1; p. e34121
Main Authors Ghazal, Fatima, Zur, Michelle, Silver, Aaron
Format Journal Article
LanguageEnglish
Published United States Cureus 23.01.2023
Subjects
Cardiology
Internal Medicine
Rheumatology
immune-mediated necrotizing myopathy
anti hmgcr antibody
statin safety
statin-induced necrotizing autoimmune myopathy
statin-associated muscle symptoms
anti-hmgcr myopathy
drug-induced myopathy
statin-induced myopathy
critical illness myopathy
transthyretin amyloidosis
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Summary:Statins are known to pharmacologically target 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR). Several subtypes of anti-HMGCR autoimmune myopathies have been reported as a result of statin use. Although these types vary widely, a severe and rare form of statin-induced myopathy is immune-mediated necrotizing myopathy (IMNM), resulting in severe muscle injury that does not respond to statin cessation and is associated with poor outcomes. Diagnosis is confirmed through biopsy confirming the necrosis of biopsy fibers, in addition to elevated anti-HMGCR serum levels. Management lacks proper guidelines, however, immunosuppressive therapy has been proposed as a possible intervention. The aim of this report is to increase providers' knowledge of the presentation and possible treatment of statin-induced immune-mediated necrotizing myopathy.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.34121