ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2080

HLA-DRB1*11:01 Association Differenciates Anti-hmgcr Immune-mediated Necrotizing Myopathy from Non-immune Mediated Statin Myotoxicity

Cristina Corrales Selaya1, Diana Prieto-Peña2, gonzalo Ocejo-Viñals3, Carmen Secada Gómez4, alfonso Corrales-Martínez5, Carmen Ibarbia6, Zaida Salmón-gonzalez6, Marta Martín-millan6, Virginia Portilla-González6, Nerea mota-perez6, M. sebastian-mora gil6, J.C Batista-liz6, Veronica Pulito-Cueto7, Raquel Lopez-mejias7, Ricardo Blanco-Alonso8 and Jose Luis Hernandez6, 1Rheumatology, Marques de Valdecilla University Hospital. IDIVAL, Santander, Cantabria, Spain, 2Division of Rheumatology, Hospital Universitario Marqués de Valdecilla. IDIVAL, Immunopathology group, Santander, Cantabria, Spain, 3Department of Immunology, Marqués de Valdecilla University Hospital (HUMV), Santander, Spain, 4Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain, 5Hospital Universitario Marques de Valdecilla, Santander, Spain, 6Hospital Universitario Marques de Valdecilla, Santander, Cantabria, Spain, 7IDIVAL, Santander, Spain, 8Division of Rheumatology, Hospital Universitario Marqués de Valdecilla. IDIVAL, Immunopathology group, Santander, Spain

Meeting: ACR Convergence 2024

Keywords: , ,

Session Information

Date: Monday, November 18, 2024

Title: Muscle Biology, Myositis & Myopathies – Basic & Clinical Science Poster III

Session Type: Poster Session C

Session Time: 10:30AM-12:30PM

Background/Purpose: Genetic risk factors may explain why only a small proportion of patients taking statins develop severe cases of anti-3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) immune-mediated necrotizing myopathy (IMNM). A high prevalence of HLA-DRB1*11:01 carriers has been described in patients with anti-HMGCR IMNM. However, it is unknown whether this allele is specifically associated with anti-HMGCR IMNM or if it is also associated with non-immune-mediated statin myotoxicity.

The main objective is to elucidate whether Anti-HMGCR IMNM and non-immune-mediated statin myotoxicity exhibit a different HLA-DRB11 association.

Methods: HLA-DRB1 typing was performed using the Luminex 100 system in 11 patients with anti-HMGCR IMNM diagnosis, 20 patients with non-immune- mediated statin myotoxicity and 29 ethnically matched controls receiving statins without myotoxicity. Comparisons were performed between the three groups.

Results: Demographic, clinical features and laboratory abnormalities were different between anti-HMGCR IMNM patients and non-immune-statin myotoxicity (Table 1). HLA-DRB1*11 phenotype frequency was significantly increased in patients with anti-HMGCR IMNM compared to controls (81.8% versus 17.2%, respectively; p < 0.001; odds ratio-OR [95% confidence interval-CI] =21.6 [2.87-237.4]). Remarkably, a higher proportion of HLA-DRB1*11 carriers was observed in anti-HMGCR IMNM patients when compared to non-immune-mediated statin myotoxicity (81.8% vs 25%; p < 0.001; OR [95% CI] =13.5 [1.73-153.21]). This association was mainly due to the HLA-DRB1*11:01 allele. Patients with non-immune-mediated statin myotoxicity and controls did not exhibit HLA-DRB1*11 allele differences (Table 2).

Conclusion: We found that HLA-DRB1*11, particularly the HLA-DRB1*11:01 allele, is strongly associated with anti-HMGCR IMNM while this association was not observed in patients with non-immune-mediated statin myotoxicity. HLA-DRB1*11:01 might be useful as a specific genetic marker to identify those patients at high risk of anti-HMGCR IMNM.

Supporting image 1

Demographic, clinical features and laboratory parameters in patients with anti-HMGCR IMNM, non-immune-mediated statin myotoxicity and patients taking statins without myotoxicity (controls).

Supporting image 2

Table 2. Genetic differences of HLA-DRB1*11 allele frequencies between patients with anti-HMGCR IMNM, non-immune-mediated statin myotoxicity patients and controls.

Disclosures: C. Corrales Selaya: None; D. Prieto-Peña: None; g. Ocejo-Viñals: None; C. Secada Gómez: None; a. Corrales-Martínez: None; C. Ibarbia: None; Z. Salmón-gonzalez: None; M. Martín-millan: None; V. Portilla-González: None; N. mota-perez: None; M. sebastian-mora gil: None; J. Batista-liz: None; V. Pulito-Cueto: None; R. Lopez-mejias: None; R. Blanco-Alonso: AbbVie, 2, 5, 6, Bristol-Myers Squibb, 2, 6, Galapagos, 6, Janssen, 2, 6, Lilly, 2, 6, MSD, 2, 5, 6, Pfizer, 2, 6, Roche, 2, 5, 6; J. Hernandez: None.

To cite this abstract in AMA style:

Corrales Selaya C, Prieto-Peña D, Ocejo-Viñals g, Secada Gómez C, Corrales-Martínez a, Ibarbia C, Salmón-gonzalez Z, Martín-millan M, Portilla-González V, mota-perez N, sebastian-mora gil M, Batista-liz J, Pulito-Cueto V, Lopez-mejias R, Blanco-Alonso R, Hernandez J. HLA-DRB1*11:01 Association Differenciates Anti-hmgcr Immune-mediated Necrotizing Myopathy from Non-immune Mediated Statin Myotoxicity [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/hla-drb11101-association-differenciates-anti-hmgcr-immune-mediated-necrotizing-myopathy-from-non-immune-mediated-statin-myotoxicity/. Accessed .

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