Rheumatology International

, Volume 39, Issue 2, pp 311–316 | Cite as

Safety of statin drugs in patients with dyslipidemia and stable systemic autoimmune myopathies

  • Isabela Bruna Pires Borges
  • Samuel Katsuyuki ShinjoEmail author


Recent studies have shown a high prevalence of dyslipidemia in patients with systemic autoimmune myopathies (SAM). However, little is known about the safety of the use of statins in these patients, and this gap in research motivated the accomplishment of the present study. In a retrospective cohort study conducted from 2004 to 2018, 250 patients with SAM were evaluated, and 24 patients had stable forms of SAM (16 dermatomyositis, 1 polymyositis and 7 antisynthetase syndrome) but had dyslipidemia and had received statins. Patients with clinically amyopathic dermatomyositis, immune-mediated necrotizing myopathy, dermatomyositis, or polymyositis induced by statins were excluded. The mean age of the patients was 50.6 years, and they were predominantly women. The median duration of the disease was 5.0 years. Twelve patients received simvastatin (10–60 mg/day), and 11 patients received atorvastatin (20–40 mg/day), and 1 patient received atorvastatin (10 mg/day) which was later replaced by simvastatin (20 mg/day). The median time of exposure to the statin was 22.5 months. The follow-up appointments showed that the patients’ lipid profiles had improved and that there had been no recurrences of disease activity or clinical intercurrences. Despite the small sampling, the data showed that the use of statins in patients with SAM was safe. New studies with a larger sample and patients with different degrees of disease activity are necessary to corroborate the results of the present study.


Dermatomyositis Dyslipidemia Metabolic syndrome Polymyositis Statins 



This work was funded by Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) (#2015/12628-0) to I.B.P.B; Fundação Faculdade de Medicina and FAPESP (#2016/20371-1) to I.B.P.B.

Compliance with ethical standards

Conflict of interest

All authors declare no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The present study was approved by the local ethics committee.


  1. 1.
    Bohan A, Peter JB (1975) Polymyositis and dermatomyositis (first of two parts). N Engl J Med 292:344–347CrossRefGoogle Scholar
  2. 2.
    Dalakas MC (2010) Inflammatory muscle diseases: a critical review on pathogenesis and therapies. Curr Opin Pharmacol 10:346–352CrossRefGoogle Scholar
  3. 3.
    Dalakas MC (2015) Inflammatory muscle diseases. N Engl J Med 372:1734–1747CrossRefGoogle Scholar
  4. 4.
    Lundberg IE, Tjärnlund A, Bottai M et al (2017) 2017 European League Against Rheumatism/American College of Rheumatology classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups. Ann Rheum Dis 76:1955–1964CrossRefGoogle Scholar
  5. 5.
    Moraes MT, Souza FH, Barros TB et al (2013) An analysis of metabolic syndrome in adult dermatomyositis with a focus on cardiovascular disease. Arthritis Care Res 65:793–799CrossRefGoogle Scholar
  6. 6.
    Souza FHC, Shinjo SK (2014) High prevalence of metabolic syndrome in polymyositis. Clin Exp Rheumatol 32:82–87Google Scholar
  7. 7.
    Silva MG, Borba EF, Mello SB et al (2016) Serum adipocytokine profile and metabolic syndrome in young adult female dermatomyositis patients. Clinics 71:709–714CrossRefGoogle Scholar
  8. 8.
    Araujo PAO, Silva MG, Borba EF et al (2018) High prevalence of metabolic syndrome in antisynthetase syndrome. Clin Exp Rheumatol 36:241–247Google Scholar
  9. 9.
    Padala S, Thompson PD (2012) Statins as a possible cause of inflammatory and necrotizing myopathies. Atherosclerosis 222:15–21CrossRefGoogle Scholar
  10. 10.
    Bruckert E, Hayem G, Dejager S et al (2005) Mild to moderate muscular symptoms with high-dose statin therapy in hyperlipidemic patients—the PRIMO study. Cardiovasc Drugs Ther 19:403–414CrossRefGoogle Scholar
  11. 11.
    Needham M, Fabian V, Knezevic W et al (2007) Progressive myopathy with up-regulation of MHC-I associated with statin therapy. Neuromuscul Disord 17:194–200CrossRefGoogle Scholar
  12. 12.
    Mammen AL, Chung T, Christopher-Stine L et al (2011) Autoantibodies against 3-hydroxy-3-methylglutaryl-coenzyme A reductase in patients with statin-associated autoimmune myopathy. Arthritis Rheumatol 63:713–721CrossRefGoogle Scholar
  13. 13.
    Musset L, Allenbach Y, Benveniste O et al (2016) Anti-HMGCR antibodies as a biomarker for immune-mediated necrotizing myopathies: a history of statins and experience from a large international multi-center study. Autoimmun Rev 15:983–993CrossRefGoogle Scholar
  14. 14.
    Pinal-Fernandez I, Mammen AL (2016) Spectrum of immune-mediated necrotizing myopathies and their treatments. Curr Opin Rheumatol 28:619–624CrossRefGoogle Scholar
  15. 15.
    Basharat P, Lahouti AH, Paik JJ et al (2016) Statin-induced anti-HMGCR-associated myopathy. J Am Coll Cardiol 68:234–235CrossRefGoogle Scholar
  16. 16.
    Caughey GE, Gabb GM, Ronson S, Ward M (2018) Association of statin exposure with histologically confirmed idiopathic inflammatory myositis in an Australian population. JAMA Intern Med 178:1224–1229CrossRefGoogle Scholar
  17. 17.
    Borges IBP, Silva MG, Misse RG et al (2018) Lipid-lowering agent-triggered dermatomyositis and polymyositis: a case series and literature review. Rheumatol Int 38:293–301CrossRefGoogle Scholar
  18. 18.
    Connors GR, Christopher-Stine L, Oddis CV et al (2010) Interstitial lung disease associated with the idiopathic inflammatory myopathies: what progress has been made in the past 35 years? Chest 138:1464–1474CrossRefGoogle Scholar
  19. 19.
    Medical Research Council (1981) Aids to the examination of the peripheral nervous system, Memorandum no. 45. Her Majesty’s Stationery Office, LondonGoogle Scholar
  20. 20.
    Cruellas MG, Viana VS, Levy-Neto M et al (2013) Myositis-specific and myositis-associated autoantibody profiles and their clinical associations in a large series of patients with polymyositis and dermatomyositis. Clinics 68:909–914CrossRefGoogle Scholar
  21. 21.
    Lakka HM, Laaksonen DE, Lakka TA et al (2002) The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 288:2709–2716CrossRefGoogle Scholar
  22. 22.
    Ford ES, Giles WH (2003) A comparison of the prevalence of the metabolic syndrome using two proposed definitions. Diabetes Care 26:575–581CrossRefGoogle Scholar
  23. 23.
    Charles-Schoeman C, Amjadi SS, Paulus HE, for the International Myositis Assessment and Clinical Studies Group (2012) Treatment of dyslipidemia in idiopathic inflammatory myositis: results of the International Myositis Assessment and Clinical Studies Group survey. Clin Rheumatol 31:1163–1168CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Rheumatology, Faculdade de Medicina FMUSPUniversidade de Sao PauloSao PauloBrazil

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