ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 2316

Successful Treatment of Statin-Induced Autoimmune Myopathy without Corticosteroids

Geneviève Oligny Longpré1, Yves Troyanov1, Marvin J. Fritzler2, José Ferreira1, Ira N. Targoff3, Hélène Couture4, Océane Landon-Cardinal1, Eric Rich1, Josiane Bourré-Tessier5, Anne-Marie Mansour1, Julie Drouin1, Sandra Chartrand1, Edith Villeneuve1, Jean-Richard Goulet1, Benjamin Ellezam6, Ana Maria Tsanaclis1, Vincent Morin1, Marie-Pierre Fournier-Gosselin1 and Jean-Luc Senécal1, 1Université de Montréal, Montréal, QC, Canada, 2Medicine, University of Calgary, Calgary, AB, Canada, 3University of Oklahoma, Oklahoma City, OK, 4Université Laval, Québec, QC, Canada, 5Université de Montréal, Montreal, QC, Canada, 6Centre hospitalier universitaire Ste-Justine, Montréal, QC, Canada

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: corticosteroids, Intravenous immunoglobulin (IVIG), myopathy, myositis and statin-induced myopathies

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Date: Tuesday, November 15, 2016

Title: Muscle Biology, Myositis and Myopathies - Poster II: Clinical

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose:  Statin-induced autoimmune myopathy (SI-AIM) is often difficult to treat. While corticosteroids (CSs) are the mainstay induction therapy used by most clinicians for autoimmune myopathies, SI-AIM seems corticosteroid resistant. Intravenous immune globulin (IVIG) on the other hand has been used with success as part of an induction regimen or even as monotherapy (Mammen AL, NEJM, 2015). Our objective was to describe the clinical phenotype and successful treatment regimens of patients with SI-AIM but not treated with CSs.

Methods:  Our study included all patients from the Université de Montréal AIM cohort (comprising four academic hospitals) with a documented anti-3-hydroxy-3-methylglutaryl-CoA reductase (anti-HMGCR) autoantibody. We selected statin-exposed patients who did not receive any CSs during the course of their treatment and performed a retrospective review of medical records. Remission was defined as a serum creatine kinase (CK) level <500 U/L whereas maintenance of remission corresponded to a CK level <500 U/L sustained for at least 6 months.

Results:  From a cohort of 45 anti-HMGCR positive AIM patients, 42 were previously exposed to statins, of whom 8 patients (4 men, 4 women, mean age 59 years) were not treated with CSs and therefore selected for study. Three clinical stages of myopathy were recognized: stage 1 (serum CK elevation, normal muscle strength, normal EMG), stage 2 (CK elevation, normal strength, myopathic EMG) and stage 3 myopathy (CK elevation, proximal muscle weakness, myopathic EMG). Three out of 8 patients presented and were treated in stage 1 myopathy after a mean statin discontinuation time of 23 months (range 5-74 months). The remaining 5/8 patients presented in stage 3 myopathy. The mean time between statin cessation and treatment initiation was 5 months (range 0-10 months), with one patient improving to stage 2 myopathy upon statin discontinuation. MTX monotherapy induced remission in all 3 patients presenting in stage 1 myopathy and in 1 patient in stage 2 myopathy. The mean time to remission was 7 months (range 4-13 months). In the remaining 4 patients with stage 3 myopathy, IVIG was successfully used in 3 patients to induce remission with either MTX or MTX+AZA, whereas 1 patient responded to a MTX+AZA combination alone. The mean time to remission for stage 3 myopathy was 10 months (range 1-21 months). MTX monotherapy (n=5/6) or a MTX+AZA combination (n=1) were able to maintain remission in the 6 patients available for analysis. Thus, all 8 patients did not require CSs to achieve remission.

Conclusion:  Eight patients with SI-AIM were successfully treated with immunosuppressive and/or immunomodulating agents but not with CSs. Four patients with normal strength (i.e. in stage 1 or 2) responded to MTX monotherapy. In patients with proximal muscle weakness, combination therapies with MTX+IVIG, MTX+AZA or MTX+AZA+IVIG were successfully used and thus, these approaches appear reasonable induction strategies in stage 3. Early recognition of stage 1 SI-AIM and timely treatment initiation could minimize the use of IVIG and CS therapies and consequently lead to better outcomes in these patients.


Disclosure: G. Oligny Longpré, None; Y. Troyanov, None; M. J. Fritzler, None; J. Ferreira, None; I. N. Targoff, None; H. Couture, None; O. Landon-Cardinal, None; E. Rich, None; J. Bourré-Tessier, None; A. M. Mansour, None; J. Drouin, None; S. Chartrand, None; E. Villeneuve, None; J. R. Goulet, None; B. Ellezam, None; A. M. Tsanaclis, None; V. Morin, None; M. P. Fournier-Gosselin, None; J. L. Senécal, None.

To cite this abstract in AMA style:

Oligny Longpré G, Troyanov Y, Fritzler MJ, Ferreira J, N. Targoff I, Couture H, Landon-Cardinal O, Rich E, Bourré-Tessier J, Mansour AM, Drouin J, Chartrand S, Villeneuve E, Goulet JR, Ellezam B, Tsanaclis AM, Morin V, Fournier-Gosselin MP, Senécal JL. Successful Treatment of Statin-Induced Autoimmune Myopathy without Corticosteroids [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/successful-treatment-of-statin-induced-autoimmune-myopathy-without-corticosteroids/. Accessed .
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to 2016 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/successful-treatment-of-statin-induced-autoimmune-myopathy-without-corticosteroids/

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 »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology