Cargando…
Challenges in Treating Statin-Associated Necrotizing Myopathy
Myalgia and mild elevation in muscle enzymes are common side effects of statin therapy. While these symptoms are generally self-limited, in rare cases, statin use is associated with an immune-mediated necrotizing myopathy caused by development of autoantibodies against HMG-CoA reductase. The primary...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7929690/ https://www.ncbi.nlm.nih.gov/pubmed/33708450 http://dx.doi.org/10.1155/2021/8810754 |
_version_ | 1783659963549220864 |
---|---|
author | Webster, Patrick Wiemer, Nicholas Al Harash, Abdalhamid Marshall, Cody Khatoon, Nazia Lucke, Michael |
author_facet | Webster, Patrick Wiemer, Nicholas Al Harash, Abdalhamid Marshall, Cody Khatoon, Nazia Lucke, Michael |
author_sort | Webster, Patrick |
collection | PubMed |
description | Myalgia and mild elevation in muscle enzymes are common side effects of statin therapy. While these symptoms are generally self-limited, in rare cases, statin use is associated with an immune-mediated necrotizing myopathy caused by development of autoantibodies against HMG-CoA reductase. The primary presenting symptom of this condition is progressive symmetric proximal weakness that does not abate or worsens even after cessation of statin therapy and is associated with markedly elevated creatine kinase (CK) levels. To date, no randomized controlled trials have been conducted to identify the most effective treatment for statin-associated autoimmune myopathy. Treatment recommendations involve a combination of steroids and immunosuppressive drugs. This single-center case series highlights the clinicopathologic features diagnostic for statin-associated autoimmune myopathy as well as treatment challenges for the patient population. The series highlights a range of potential presentations, from mildly symptomatic despite highly elevated CK, to severe muscle weakness including dysphagia. Multiple patients required several immunosuppressant medications as well as intravenous immunoglobulin (IVIG) to achieve disease control. In this case series, marked improvement was noted in several diabetic patients with IVIG. |
format | Online Article Text |
id | pubmed-7929690 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-79296902021-03-10 Challenges in Treating Statin-Associated Necrotizing Myopathy Webster, Patrick Wiemer, Nicholas Al Harash, Abdalhamid Marshall, Cody Khatoon, Nazia Lucke, Michael Case Rep Rheumatol Case Report Myalgia and mild elevation in muscle enzymes are common side effects of statin therapy. While these symptoms are generally self-limited, in rare cases, statin use is associated with an immune-mediated necrotizing myopathy caused by development of autoantibodies against HMG-CoA reductase. The primary presenting symptom of this condition is progressive symmetric proximal weakness that does not abate or worsens even after cessation of statin therapy and is associated with markedly elevated creatine kinase (CK) levels. To date, no randomized controlled trials have been conducted to identify the most effective treatment for statin-associated autoimmune myopathy. Treatment recommendations involve a combination of steroids and immunosuppressive drugs. This single-center case series highlights the clinicopathologic features diagnostic for statin-associated autoimmune myopathy as well as treatment challenges for the patient population. The series highlights a range of potential presentations, from mildly symptomatic despite highly elevated CK, to severe muscle weakness including dysphagia. Multiple patients required several immunosuppressant medications as well as intravenous immunoglobulin (IVIG) to achieve disease control. In this case series, marked improvement was noted in several diabetic patients with IVIG. Hindawi 2021-02-24 /pmc/articles/PMC7929690/ /pubmed/33708450 http://dx.doi.org/10.1155/2021/8810754 Text en Copyright © 2021 Patrick Webster et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Webster, Patrick Wiemer, Nicholas Al Harash, Abdalhamid Marshall, Cody Khatoon, Nazia Lucke, Michael Challenges in Treating Statin-Associated Necrotizing Myopathy |
title | Challenges in Treating Statin-Associated Necrotizing Myopathy |
title_full | Challenges in Treating Statin-Associated Necrotizing Myopathy |
title_fullStr | Challenges in Treating Statin-Associated Necrotizing Myopathy |
title_full_unstemmed | Challenges in Treating Statin-Associated Necrotizing Myopathy |
title_short | Challenges in Treating Statin-Associated Necrotizing Myopathy |
title_sort | challenges in treating statin-associated necrotizing myopathy |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7929690/ https://www.ncbi.nlm.nih.gov/pubmed/33708450 http://dx.doi.org/10.1155/2021/8810754 |
work_keys_str_mv | AT websterpatrick challengesintreatingstatinassociatednecrotizingmyopathy AT wiemernicholas challengesintreatingstatinassociatednecrotizingmyopathy AT alharashabdalhamid challengesintreatingstatinassociatednecrotizingmyopathy AT marshallcody challengesintreatingstatinassociatednecrotizingmyopathy AT khatoonnazia challengesintreatingstatinassociatednecrotizingmyopathy AT luckemichael challengesintreatingstatinassociatednecrotizingmyopathy |