Premium
Rarity of anti–3‐hydroxy‐3‐methylglutaryl‐coenzyme A reductase antibodies in statin users, including those with self‐limited musculoskeletal side effects
Author(s) -
Mammen Andrew L.,
Pak Katherine,
Williams Emma K.,
Brisson Diane,
Coresh Joe,
Selvin Elizabeth,
Gaudet Daniel
Publication year - 2012
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.20662
Subject(s) - statin , medicine , antibody , myopathy , familial hypercholesterolemia , immunosuppression , hmg coa reductase , reductase , cholesterol , immunology , enzyme , biochemistry , biology
Objective Statins, among the most commonly prescribed medications, are associated with a wide range of musculoskeletal side effects. These include a progressive autoimmune myopathy with anti–3‐hydroxy‐3‐methylglutaryl‐coenzyme A reductase (anti‐HMGCR) antibodies that requires immunosuppression. However, it remains unknown whether these antibodies are found in statin users with and without self‐limited musculoskeletal side effects; this limits their diagnostic utility. The current work assessed the prevalence of anti‐HMGCR antibodies in these groups of statin users. Methods We determined the prevalence of anti‐HMGCR antibodies in 1,966 participants (including 763 current statin users) in a substudy of the community‐based Atherosclerosis Risk in Communities (ARIC) Study and 98 French Canadian subjects with familial hypercholesterolemia, including 51 with documented statin intolerance. Results No participant in the ARIC substudy, including those with past or current statin exposure at the time of sample collection, had anti‐HMGCR antibodies. Similarly, none of 51 patients with self‐limited statin intolerance or 47 statin‐tolerant patients receiving maximal statin therapy were anti‐HMGCR positive. Conclusion The majority of patients with and without statin exposure, including those with self‐limited statin intolerance, do not develop anti‐HMGCR antibodies. Therefore, anti‐HMGCR antibodies are highly specific for those with an autoimmune myopathy.