Polymyositis, Dermatomyositis, and Statins: A Review

Abstract

BACKGROUND: Statins are a well-recognized cause of a variety of skeletal myopathic effects, which generally resolve when discontinuing the treatment. Among autoimmune manifestations associated with statins, there are typical polymyositis (PM) and typical dermatomyositis (DM).OBJECTIVE: To perform a review on published case reports and case series about statin-associated PM and DM.METHODS: This literature comprehensive search was conducted mainly on PubMed, but also congress abstracts and university websites were considered. Given the paucity of cases, the search was extended to include articles in all languages with English abstract.RESULTS: Twenty-eight PM and 30 DM cases have been described with prevalence in female (64%) and senile age. The drugs most frequently involved were atorvastatin and simvastatin. The differential diagnosis should be made among the main myositis subtypes: immuno-mediated necrotizing myopathy (IMNM), inclusion body myositis (IBM), and overlap syndrome with myositis (OM), including anti-synthetase syndrome (ASS).CONCLUSIONS: Even though the onset of polymyositis or dermatomyositis is a rare phenomenon, it is advisable to consider their presence in patients taking statins and with a non-reversible elevation of creatine phosphokinase.