Statin use in patients with non-HMGCR idiopathic inflammatory myopathies: A retrospective study.
idiopathic inflammatory myopathy
muscle adverse events
retrospective study
statin use
Journal
Clinical cardiology
ISSN: 1932-8737
Titre abrégé: Clin Cardiol
Pays: United States
ID NLM: 7903272
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
02
02
2020
revised:
31
03
2020
accepted:
03
04
2020
pubmed:
21
5
2020
medline:
3
6
2021
entrez:
21
5
2020
Statut:
ppublish
Résumé
Statins are the most widely used lipid lowering therapies which reduce cardiovascular risk, but are associated with muscular adverse events (AEs). Idiopathic inflammatory myopathies (IIM) are autoimmune diseases of the muscle with higher risk of cardiovascular disease. More data is needed regarding statin safety in patients with intrinsic muscle disease such as IIM. Statins are tolerated in patients with IIM without leading to significant increase in muscular AEs. Statin use was retrospectively examined in a longitudinal IIM cohort. Safety analysis included assessment of muscular and nonmuscular AEs by chart review. IIM patients receiving a statin during the cohort follow-up period were matched to IIM patients not receiving a statin for comparative analysis of longitudinal outcomes. 33/214 patients had a history of statin use. 63% started for primary prevention, while others were started for clinical ASCVD events, vascular surgery, IIM related heart failure, and cardiac transplantation. A high intensity statin was used in nine patients with non-HMGCR myositis, and tolerated in 8/9 patients. Statin related muscular AE was noted in three patients. There were no cases of rhabdomyolysis, or statin related nonmuscular AEs in a median observation period of 5 years. In patients newly started on statins during cohort follow-up (n = 7) there was no change in disease activity after statin initiation. Long term outcomes were not different between statin and nonstatin IIM control groups. Statins were well tolerated in patients with non-HMGCR positive IIM. Given the accelerated atherosclerotic risk in IIM patients, further prospective studies of statin safety in IIM patients are warranted.
Sections du résumé
BACKGROUND
BACKGROUND
Statins are the most widely used lipid lowering therapies which reduce cardiovascular risk, but are associated with muscular adverse events (AEs). Idiopathic inflammatory myopathies (IIM) are autoimmune diseases of the muscle with higher risk of cardiovascular disease. More data is needed regarding statin safety in patients with intrinsic muscle disease such as IIM.
HYPOTHESIS
OBJECTIVE
Statins are tolerated in patients with IIM without leading to significant increase in muscular AEs.
METHODS
METHODS
Statin use was retrospectively examined in a longitudinal IIM cohort. Safety analysis included assessment of muscular and nonmuscular AEs by chart review. IIM patients receiving a statin during the cohort follow-up period were matched to IIM patients not receiving a statin for comparative analysis of longitudinal outcomes.
RESULTS
RESULTS
33/214 patients had a history of statin use. 63% started for primary prevention, while others were started for clinical ASCVD events, vascular surgery, IIM related heart failure, and cardiac transplantation. A high intensity statin was used in nine patients with non-HMGCR myositis, and tolerated in 8/9 patients. Statin related muscular AE was noted in three patients. There were no cases of rhabdomyolysis, or statin related nonmuscular AEs in a median observation period of 5 years. In patients newly started on statins during cohort follow-up (n = 7) there was no change in disease activity after statin initiation. Long term outcomes were not different between statin and nonstatin IIM control groups.
CONCLUSION
CONCLUSIONS
Statins were well tolerated in patients with non-HMGCR positive IIM. Given the accelerated atherosclerotic risk in IIM patients, further prospective studies of statin safety in IIM patients are warranted.
Identifiants
pubmed: 32432360
doi: 10.1002/clc.23375
pmc: PMC7368310
doi:
Substances chimiques
Autoantibodies
0
Hydroxymethylglutaryl-CoA Reductase Inhibitors
0
HMGCR protein, human
EC 1.1.1.-
Hydroxymethylglutaryl CoA Reductases
EC 1.1.1.-
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
732-742Subventions
Organisme : NHLBI NIH HHS
ID : R01HL123064
Pays : United States
Organisme : NHLBI NIH HHS
ID : 5K23HL094834
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01HL123064
Pays : United States
Organisme : NHLBI NIH HHS
ID : 5K23HL094834
Pays : United States
Informations de copyright
© 2020 The Authors. Clinical Cardiology published by Wiley Periodicals, Inc.
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