ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP PRSYM
    • 2016-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 230

Hydroxy-3-Methylglutaryl-Coenzyme A Reductase (HMGCoR) Antibody in Necrotizing Myopathy and the Role of Statins

Ashima Malik1, Rohit Aggarwal2, Zengbiao Qi3, Noreen Fertig4, Diane Koontz5, Rufus W. Burlingame6, David Lacomis7 and Chester V. Oddis8, 1Rheumatology, University of Pittsburgh, Pittsburgh, PA, 2Medicine / Rheumatology, University of Pittsburgh, Pittsburgh, PA, 3Division of Rheumatology, University of Pittsburgh, Pittsburgh, PA, 4University of Pittsburgh, Pittsburgh, PA, 5Department of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh, PA, 6Rheumatology Research, INOVA Diagnostics, Inc., San Diego, CA, 7Neurology, University of Pittsburgh Medical Ctr, Pittsburgh, PA, 8Rheum/Clinical Immunology, University of Pittsburgh, Pittsburgh, PA

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords: Myositis and statins

  • Tweet
  • Email
  • Print
Session Information

Session Title: Muscle Biology, Myositis and Myopathies: Clinical and Therapuetic Aspects of Idiopathic Inflammatory Myopathies

Session Type: Abstract Submissions (ACR)

Background/Purpose:

Statin use is associated with myalgias, muscle weakness and elevated muscle enzymes, but recent reports of a statin-induced immune-mediated necrotizing myopathy (IMNM) have been intriguing. Of particular interest is the recently reported hydroxy-3-methylglutaryl-coenzyme A reductase antibody (anti-HMGCoR). Our Aim is to evaluate anti-HMGCoR antibody positivity and statin exposure in antibody negative necrotizing myopathy patients.

Methods: Using a large prospective computerized database we identified 48 patients with antibody negative Necrotizing Myopathy from 1980-2011, confirmed by a pathologist- review of all biopsies. As a comparison cohort we had SRP positive myositis patients (32), a subset known to have necrotizing myopathy with poor prognosis. Other controls were Non-SRP non-necrotizing myositis patients (73), non-myositis controls (21), antibody positive necrotizing myopathy controls (13). A validated anti-HMGCoR ELISA assay was done on all cases and controls with values (units/ml) as negative < 20, low positive 20-39, medium positive 40-59, high positive at ≥ 60. Computerized database and clinical chart review was done for history of statin use and other clinical parameters. Chi square test was used to compare between cases and various controls for statin use and anti-HMGCoR positivity. All myositis specific autoantibody testing was done in a research lab using ELISA and immunoprecipitation.

Results: 256 biopsies were reviewed and 48 identified as antibody negative necrotizing myositis. Anti-HMGCoR positivity was significantly (p<0.001) associated with antibody negative necrotizing myopathy 47.9% (23/48) as compared to a) all myositis and non-myositis controls 7.2% (10/139), b) SRP control alone 0% (0/32), c) Non-SRP non-necrotizing myositis controls 5.5% (4/73), but not when compared alone to antibody positive necrotizing myopathy (4/13) (with 2 on statin), P =0.54).

Higher titer anti-HMGCoR levels were seen in antibody negative (17/48) and antibody positive necrotizing myopathy (4/13) but not in other controls (2/126). Statin use was more common (p<0.001) in antibody negative necrotizing myopathy (23/ 48) as compared to all myositis and non-myositis control (17/127), b) SRP control alone (2/26), c) Non-SRP non-necrotizing myositis control (11/70) but only trend compared alone to antibody positive necrotizing myopathy (3/13 (with 2 anti-HMGCoR +) P =0.06).

Within patients with necrotizing myopathy: anti-HMGCoR was associated with patients on statin (19/24) as compared to patients without statin (7/27), p <0.01). Anti-HMGCoR antibodies were more common in any patients on statin (20/34) as compared to patients without statin (20/138), p < 0.001).

Conclusion: Anti-HMGCoR is strongly associated with antibody (-) necrotizing myopathy vs. anti-SRP (+) myositis. Moreover, anti-HMGCoR is more common in necrotizing myopathy pts with history of statin use vs. no statin use.


Disclosure:

A. Malik,
None;

R. Aggarwal,
None;

Z. Qi,
None;

N. Fertig,
None;

D. Koontz,
None;

R. W. Burlingame,
None;

D. Lacomis,
None;

C. V. Oddis,

Genentech and Biogen IDEC Inc.,

.

  • Tweet
  • Email
  • Print

« Back to 2012 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/hydroxy-3-methylglutaryl-coenzyme-a-reductase-hmgcor-antibody-in-necrotizing-myopathy-and-the-role-of-statins/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2022 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies