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632: Statins may initiate a persisting immune-mediated myopathy and myositis: A study of 10 cases
Journal article   Peer reviewed

632: Statins may initiate a persisting immune-mediated myopathy and myositis: A study of 10 cases

M. Needham, V. Fabian, W. Knezevic, P. Lamont, P. Panegyres, P. Zilko and F. Mastaglia
Journal of Clinical Neuroscience, Vol.14(10)
2007
DOI: https://doi.org/10.1016/j.jocn.2007.02.063
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Abstract

Background: Statins may cause a necrotising myopathy and hyperCKaemia which are usually reversible once the drug is discontinued. Aim: To investigate the muscle pathology in a group of 10 patients who developed myopathic symptoms during statin therapy and in whom symptoms persisted or progressed after withdrawal of the drug. Methods: All patients were examined by a neurologist or rheumatologist on more than one occasion and had a muscle biopsy after cessation of statin therapy. Immunohistochemical techniques for MHC Class I and II antigen expression and demonstration of macrophages and lymphocyte subsets were applied in addition to routine biopsy stains. Results: In 4 of the 10 patients the biopsy showed an active necrotizing inflammatory myopathy and in another features of inclusion body myositis. In the remaining cases the biopsy demonstrated a necrotizing myopathy without inflammation but with diffuse upregulation of MHC-I in 5 cases and nonspecific myopathic changes in one. Conclusions: Our findings suggest that statin therapy may initiate an immune-mediated myopathy or myositis with progressive symptoms after withdrawal of the drug, or unmask a pre-existing myopathy. The

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