Statin-associated muscle disorders

Statins are one of the most widely used and reputable medications worldwide, with strong evidence of mitigating cardiovascular complications and with a generally favorable safety profile. Nevertheless, statins have commonly come under scrutiny, owing to their associations with muscle disorders. Stat...

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Main Authors: Alan Xu, Vidya Limaye
Format: Article
Language:English
Published: SAGE Publishing 2020-01-01
Series:Indian Journal of Rheumatology
Subjects:
Online Access:http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2020;volume=15;issue=6;spage=137;epage=144;aulast=Xu
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author Alan Xu
Vidya Limaye
author_facet Alan Xu
Vidya Limaye
author_sort Alan Xu
collection DOAJ
description Statins are one of the most widely used and reputable medications worldwide, with strong evidence of mitigating cardiovascular complications and with a generally favorable safety profile. Nevertheless, statins have commonly come under scrutiny, owing to their associations with muscle disorders. Statins are known to cause a range of effects on muscles, varying from mild self-limiting symptoms to detrimental muscular necrosis. In particular, there has been emerging evidence of statin-associated necrotizing autoimmune myositis related to the presence of anti-3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR) autoantibodies. Patients often demonstrate proximal muscle weakness and hyperCKemia, and treatment guidelines are not robust owing to the rarity of the disease. Nevertheless, literature provides evidence for use of corticosteroids, and there are emerging data supporting the incorporation of immunomodulatory agents such as methotrexate, intravenous immunoglobulin, and rituximab. In performing this review, we searched databases in PubMed and EMBASE written in English and limited to the last two decades. Keywords used included “statin,” “myositis,” “autoimmune myopathy,” “anti-HMGCR,” and “necrotising.” Articles were selected by relevance to the topic, and articles pertaining to antisignal recognition particle myopathy and other forms of myositis were excluded.
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spelling doaj-art-e137991620004ddba8a36a976bdc4ee12025-08-20T01:47:49ZengSAGE PublishingIndian Journal of Rheumatology0973-36980973-37012020-01-0115613714410.4103/injr.injr_81_20Statin-associated muscle disordersAlan XuVidya LimayeStatins are one of the most widely used and reputable medications worldwide, with strong evidence of mitigating cardiovascular complications and with a generally favorable safety profile. Nevertheless, statins have commonly come under scrutiny, owing to their associations with muscle disorders. Statins are known to cause a range of effects on muscles, varying from mild self-limiting symptoms to detrimental muscular necrosis. In particular, there has been emerging evidence of statin-associated necrotizing autoimmune myositis related to the presence of anti-3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR) autoantibodies. Patients often demonstrate proximal muscle weakness and hyperCKemia, and treatment guidelines are not robust owing to the rarity of the disease. Nevertheless, literature provides evidence for use of corticosteroids, and there are emerging data supporting the incorporation of immunomodulatory agents such as methotrexate, intravenous immunoglobulin, and rituximab. In performing this review, we searched databases in PubMed and EMBASE written in English and limited to the last two decades. Keywords used included “statin,” “myositis,” “autoimmune myopathy,” “anti-HMGCR,” and “necrotising.” Articles were selected by relevance to the topic, and articles pertaining to antisignal recognition particle myopathy and other forms of myositis were excluded.http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2020;volume=15;issue=6;spage=137;epage=144;aulast=Xuanti-3-hydroxy-3-methylglutaryl coenzyme a reductasemyopathystatins
spellingShingle Alan Xu
Vidya Limaye
Statin-associated muscle disorders
Indian Journal of Rheumatology
anti-3-hydroxy-3-methylglutaryl coenzyme a reductase
myopathy
statins
title Statin-associated muscle disorders
title_full Statin-associated muscle disorders
title_fullStr Statin-associated muscle disorders
title_full_unstemmed Statin-associated muscle disorders
title_short Statin-associated muscle disorders
title_sort statin associated muscle disorders
topic anti-3-hydroxy-3-methylglutaryl coenzyme a reductase
myopathy
statins
url http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2020;volume=15;issue=6;spage=137;epage=144;aulast=Xu
work_keys_str_mv AT alanxu statinassociatedmuscledisorders
AT vidyalimaye statinassociatedmuscledisorders