Proprotein Convertase Subtilisin/Kexin Type 9 Antibody and Statin-Associated Autoimmune Myopathy
Authors: Juan de Dios García-Díaz, Iraida M. Corral-Bueno, José María Mesa-Latorre, Cristina Lozano-Durán, Concepción Hernández-Ahijado
Journal: Annals of Internal Medicine (2019)

Letters2 July 2019Proprotein Convertase Subtilisin/Kexin Type 9 Antibody and Statin-Associated Autoimmune MyopathyJuan de Dios García-Díaz, MD, PhD, Iraida M. Corral-Bueno, MD, José María Mesa-Latorre, MD, Cristina Lozano-Durán, MD, and Concepción Hernández-Ahijado, MDJuan de Dios García-Díaz, MD, PhDUniversity Hospital Príncipe de Asturias, Madrid, Spain (J.D., I.M.C., J.M.M., C.L., C.H.)Search for more papers by this author, Iraida M. Corral-Bueno, MDUniversity Hospital Príncipe de Asturias, Madrid, Spain (J.D., I.M.C., J.M.M., C.L., C.H.)Search for more papers by this author, José María Mesa-Latorre, MDUniversity Hospital Príncipe de Asturias, Madrid, Spain (J.D., I.M.C., J.M.M., C.L., C.H.)Search for more papers by this author, Cristina Lozano-Durán, MDUniversity Hospital Príncipe de Asturias, Madrid, Spain (J.D., I.M.C., J.M.M., C.L., C.H.)Search for more papers by this author, and Concepción Hernández-Ahijado, MDUniversity Hospital Príncipe de Asturias, Madrid, Spain (J.D., I.M.C., J.M.M., C.L., C.H.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L18-0705 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Muscle symptoms are common adverse effects of statins and are usually attributable to a toxic effect of the drugs. In recent years, a different and rare myopathy known as statin-associated autoimmune myopathy has been recognized. This is a necrotizing myositis that is immune-mediated rather than toxic and usually occurs after treatment with statins. Its distinguishing features are its persistence after withdrawal of statins and its association with antibodies against 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR) (1). Management usually requires steroids and other immunosuppressive therapies. Other cholesterol-lowering medications and dietary supplements can cause or worsen this myopathy, which makes decreasing cholesterol ...References1. Mammen AL. Statin-associated autoimmune myopathy. N Engl J Med. 2016;374:664-9. [PMID: 26886523] doi:10.1056/NEJMra1515161 CrossrefMedlineGoogle Scholar2. Sabatine MS, Giugliano RP, Keech AC, Honarpour N, Wiviott SD, Murphy SA, et al; FOURIER Steering Committee and Investigators.. Evolocumab and clinical outcomes in patients with cardiovascular disease. N Engl J Med. 2017;376:1713-22. [PMID: 28304224] doi:10.1056/NEJMoa1615664 CrossrefMedlineGoogle Scholar3. Thongtang N, Lin J, Schaefer EJ, Lowe RS, Tomassini JE, Shah AK, et al. Effects of ezetimibe added to statin therapy on markers of cholesterol absorption and synthesis and LDL-C lowering in hyperlipidemic patients. Atherosclerosis. 2012;225:388-96. [PMID: 23040830] doi:10.1016/j.atherosclerosis.2012.09.001 CrossrefMedlineGoogle Scholar4. Zhang L, McCabe T, Condra JH, Ni YG, Peterson LB, Wang W, et al. An anti-PCSK9 antibody reduces LDL-cholesterol on top of a statin and suppresses hepatocyte SREBP-regulated genes. Int J Biol Sci. 2012;8:310-27. [PMID: 22355267] doi:10.7150/ijbs.3524 CrossrefMedlineGoogle Scholar5. Peach M, Xu R, Fitzpatrick D, Hamilton L, Somaratne R, Scott R, et al. Effect of evolocumab on cholesterol synthesis and absorption. J Lipid Res. 2016;57:2217-24. [PMID: 27707817] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University Hospital Príncipe de Asturias, Madrid, Spain (J.D., I.M.C., J.M.M., C.L., C.H.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L18-0705.This article was published at Annals.org on 19 February 2019. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byUse of Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors in Statin‐Associated Immune‐Mediated Necrotizing Myopathy: A Case SeriesAtorvastatin/ezetimibe 2 July 2019Volume 171, Issue 1Page: 68-69KeywordsCholesterolCreatine kinaseImmunosuppressivesLow density lipoproteinMonoclonal antibodiesMusclesProtein metabolismStable coronary artery diseaseStatinsSteroids ePublished: 19 February 2019 Issue Published: 2 July 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...