Clinical and genetic associations of autoantibodies to 3‐hydroxy‐3‐methyl‐glutaryl‐coenzyme a reductase in patients with immune‐mediated myositis and necrotizing myopathy. Issue 2 (6th January 2015)

• Record Type: Journal Article
• Authors: Limaye, Vidya; Bundell, Chris; Hollingsworth, Peter; Rojana‐Udomsart, Arada; Mastaglia, Frank; Blumbergs, Peter; Lester, Sue
• Is Part Of: Muscle & nerve. Volume 52:Issue 2(2015:Aug.)
• Page Start: 196
• Page End: 203
• Publication Date: 2015-01-06
• Subjects: Neuromuscular diseases -- Periodicals; Muscles -- Periodicals; Nerves -- Periodicals; 616.74
• DOI: 10.1002/mus.24541
• Languages: English
• ISSNs: 0148-639X

Abstract

<abstract abstract-type="main"> <title>ABSTRACT</title> <p> <italic>Introduction</italic>: Inhibition of 3‐hydroxy‐3‐methyl‐glutaryl‐coenzyme A reductase (HMGCR) with statins may trigger idiopathic inflammatory myositis (IIM) or immune‐mediated necrotizing myopathy (IMNM). Anti‐HMGCR antibodies have been detected in patients with IIM/IMNM. We aimed to determine the associations of anti‐HMGCR in IIM/IMNM. <italic>Methods</italic>: Anti‐HMGCR antibodies were detected by ELISA in sera from patients with IIM/IMNM. <italic>Results</italic>: Anti‐HMGCR antibodies were detected in 19 of 207 patients with IIM/IMNM, and there was a trend toward an association with male gender (<italic>P</italic> = 0.079). Anti‐HMGCR antibodies were associated strongly with statin exposure (OR = 39, <italic>P</italic> = 0.0001) and HLA‐DRB1*11 (OR = 50, <italic>P</italic> &lt; 0.0001). The highest risk for development of anti‐HMGCR antibodies was among HLA‐DR11 carriers exposed to statins. Univariate analysis showed a strong association of anti‐HMGCR antibodies with diabetes mellitus (<italic>P</italic> = 0.008), which was not confirmed by multiple regression. Among anti‐HMGCR⁺ patients there was a trend toward increased malignancy (<italic>P</italic> = 0.15). <italic>Conclusions</italic>: Anti‐HMGCR antibodies are seen in all subtypes of IIM and IMNM and are associated strongly with statin use and HLA‐DR11. <italic>Muscle Nerve</italic><bold>52</bold>: 196–203, 2015</p> </abstract>