Somagutta Manoj Kumar Reddy, Shama Nishat, Pormento Maria Kezia Lourdes, Jagani Ravi Pankajbhai, Ngardig Ngaba Neguemadji, Ghazarian Klodin, Mahmutaj Greta, El-Faramawy Khaled, Mahadevaiah Ashwini, Jain Molly Sanjay
Department of Medicine, Avalon University School of Medicine, Willemstad, Curaçao.
Department of Clinical and Translational Research, Larkin Community Hospital, South Miami, USA.
Reumatologia. 2022;60(1):63-69. doi: 10.5114/reum.2022.114108. Epub 2022 Feb 28.
Statins are a class of lipid-lowering medications used worldwide by millions of people and are safe for frequent use in most patients. However, they cause necrotizing autoimmune myopathy in some patients. We reviewed case reports of 80 patients from 2010 to present diagnosed with statin-induced necrotizing autoimmune myopathy (SINAM), aiming to analyze the clinical, physiological, serologic characteristics and outcomes of SINAM. The mean age of these patients was 66 ±9.4, the majority being male (61.3%). All patients reported proximal muscle weakness, and a few had myalgias, extra muscular symptoms such as dysphagia, and pulmonary complications. Most of the patients were on atorvastatin, simvastatin, or rosuvastatin. The mean creatine kinase was 10,094.2 ±7,351.7 U/l, and anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase enzyme was positive for 93.8% of patients. The majority of patients were started on steroids; other treatments were also used. Prompt cessation of statins and initiation of immunosuppressants reduced morbidity and mortality.
他汀类药物是一类在全球被数百万人使用的降脂药物，大多数患者频繁使用是安全的。然而，它们在一些患者中会引起坏死性自身免疫性肌病。我们回顾了2010年至今诊断为他汀类药物诱导的坏死性自身免疫性肌病（SINAM）的80例患者的病例报告，旨在分析SINAM的临床、生理、血清学特征及转归。这些患者的平均年龄为66±9.4岁，大多数为男性（61.3%）。所有患者均报告有近端肌无力，少数患者有肌痛、吞咽困难等肌肉外症状及肺部并发症。大多数患者服用阿托伐他汀、辛伐他汀或瑞舒伐他汀。平均肌酸激酶为10,094.2±7,351.7 U/L，93.8%的患者抗3-羟基-3-甲基戊二酰辅酶A还原酶抗体呈阳性。大多数患者开始使用类固醇治疗；也使用了其他治疗方法。及时停用他汀类药物并开始使用免疫抑制剂可降低发病率和死亡率。
