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Statin-induced necrotizing autoimmune myopathy: a systematic review
Authors:Manoj Kumar Reddy Somagutta  Nishat Shama  Maria Kezia Lourdes Pormento  Ravi Pankajbhai Jagani  Ngaba Neguemadji Ngardig  Klodin Ghazarian  Greta Mahmutaj  Khaled El-Faramawy  Ashwini Mahadevaiah  Molly Sanjay Jain
Abstract:Statins are a class of lipid-lowering medications used worldwide by millions of people and are safe for frequent use in most patients. However, they cause necrotizing autoimmune myopathy in some patients. We reviewed case reports of 80 patients from 2010 to present diagnosed with statin-induced necrotizing autoimmune myopathy (SINAM), aiming to analyze the clinical, physiological, serologic characteristics and outcomes of SINAM. The mean age of these patients was 66 ±9.4, the majority being male (61.3%). All patients reported proximal muscle weakness, and a few had myalgias, extra muscular symptoms such as dysphagia, and pulmonary complications. Most of the patients were on atorvastatin, simvastatin, or rosuvastatin. The mean creatine kinase was 10,094.2 ±7,351.7 U/l, and anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase enzyme was positive for 93.8% of patients. The majority of patients were started on steroids; other treatments were also used. Prompt cessation of statins and initiation of immunosuppressants reduced morbidity and mortality.
Keywords:atorvastatin   statins   statin-induced necrotizing autoimmune myopathy   muscle necrosis
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