Rarity of anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase antibodies in statin users, including those with self-limited musculoskeletal side effects
Rarity of anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase antibodies in statin users, including those with self-limited musculoskeletal side effects
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DOI：
10.1002/acr.20662
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发表时间：
2012-02-01
影响因子：
4.7
通讯作者：
Gaudet, Daniel
中科院分区：
文献类型：
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作者：
Mammen, Andrew L.;Pak, Katherine;Gaudet, Daniel
目的 他汀类药物是最常用的处方药物之一，与多种肌肉骨骼副作用有关。其中包括需要免疫抑制的抗 3-羟基-3-甲基戊二酰辅酶 A 还原酶（抗 HMGCR）抗体导致的进行性自身免疫性肌病。然而，目前尚不清楚这些抗体是否存在于有或没有自限性肌肉骨骼副作用的他汀类药物使用者中。这限制了它们的诊断效用。目前的工作评估了这些他汀类药物使用者群体中抗 HMGCR 抗体的流行情况。方法。我们在社区动脉粥样硬化风险 (ARIC) 研究的一项子研究中确定了 1,966 名参与者（包括 763 名当前他汀类药物使用者）和 98 名患有家族性高胆固醇血症的法裔加拿大受试者（其中 51 名有记录的他汀类药物不耐受者）的抗 HMGCR 抗体的患病率。结果。 ARIC 亚研究的参与者，包括那些在样本收集时过去或当前接触过他汀类药物的参与者，都没有抗 HMGCR 抗体。同样，51 名自限性他汀类药物不耐受患者或 47 名接受最大量他汀类药物治疗的他汀类药物耐受患者均未出现抗 HMGCR 阳性。结论。大多数有或没有接触过他汀类药物的患者，包括具有自限性他汀类药物不耐受的患者，不会产生抗 HMGCR 抗体。因此，抗 HMGCR 抗体对于患有自身免疫性肌病的患者具有高度特异性。
Objective Statins, among the most commonly prescribed medications, are associated with a wide range of musculoskeletal side effects. These include a progressive autoimmune myopathy with anti3-hydroxy-3-methylglutaryl-coenzyme A reductase (anti-HMGCR) antibodies that requires immunosuppression. However, it remains unknown whether these antibodies are found in statin users with and without self-limited musculoskeletal side effects; this limits their diagnostic utility. The current work assessed the prevalence of anti-HMGCR antibodies in these groups of statin users.Methods. We determined the prevalence of anti-HMGCR antibodies in 1,966 participants (including 763 current statin users) in a substudy of the community-based Atherosclerosis Risk in Communities (ARIC) Study and 98 French Canadian subjects with familial hypercholesterolemia, including 51 with documented statin intolerance.Results. No participant in the ARIC substudy, including those with past or current statin exposure at the time of sample collection, had anti-HMGCR antibodies. Similarly, none of 51 patients with self-limited statin intolerance or 47 statin-tolerant patients receiving maximal statin therapy were anti-HMGCR positive.Conclusion. The majority of patients with and without statin exposure, including those with self-limited statin intolerance, do not develop anti-HMGCR antibodies. Therefore, anti-HMGCR antibodies are highly specific for those with an autoimmune myopathy.