Clinical and genetic associations of autoantibodies to 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase in patients with immune-mediated myositis and necrotizing myopathy
Date
2015
Authors
Limaye, V.
Bundell, C.
Hollingsworth, P.
Rojana-Udomsart, A.
Mastaglia, F.
Blumbergs, P.
Lester, S.
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Journal article
Citation
Muscle and Nerve, 2015; 52(2):196-203
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Vidya Limaye, Chris Bundell, Peter Hollingsworth, Arada Rojana-Udomsart, Frank Mastaglia, Peter Blumbergs and Sue Lester
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Abstract
Introduction: Inhibition of 3-hydroxy-3-methylglutaryl- 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. Methods: Anti-HMGCR antibodies were detected by ELISA in sera from patients with IIM/IMNM. Results: Anti-HMGCR antibodies were detected in 19 of 207 patients with IIM/IMNM, and there was a trend toward an association with male gender (P50.079). Anti- HMGCR antibodies were associated strongly with statin exposure (OR539, P50.0001) and HLA-DRB1*11 (OR550, P<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 (P50.008), which was not confirmed by multiple regression. Among anti- HMGCR⁺ patients there was a trend toward increased malignancy (P50.15). Conclusions: Anti-HMGCR antibodies are seen in all subtypes of IIM and IMNM and are associated strongly with statin use and HLA-DR11.
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© 2014 Wiley Periodicals, Inc.