TY - JOUR
T1 - Lipid-lowering Therapies in Myositis
AU - Mizus, Marisa C.
AU - Tiniakou, Eleni
N1 - Funding Information:
MCM was supported by NIH Grant Number T32-AR048522. ET was supported by the Jerome L Greene Foundation.
Publisher Copyright:
© 2020, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Purpose of Review: The use of lipid-lowering therapies in patients with idiopathic inflammatory myopathies (IIM) is complicated and there are no guidelines for diagnosing, monitoring, or treating atherosclerotic cardiovascular disease (ASCVD) in this group of patients. Recent Findings: The use of lipid-lowering therapies, especially statins, is recommended in patients with increased risk for ASCVD, which includes patients with inflammatory diseases, based on recent American College of Cardiology/American Heart Association (ACC/AHA) guidelines for ASCVD management. Summary: There is accumulating evidence that patients with IIM are at increased risk for ASCVD, similar to other inflammatory diseases. Lipid-lowering therapies have side effects that may be pronounced or confounding in myositis patients, potentially limiting their use. Statins are specifically contraindicated in patients with anti 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) antibodies. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have been shown to be safe and potentially beneficial in patients with IIM. Here, we propose a framework for (1) ASCVD risk assessment and treatment based on ACC/AHA ASCVD primary prevention guidelines; (2) myositis disease monitoring while undergoing lipid-lowering therapy; and (3) management of statin intolerance, including, indications for the use of PCSK9 inhibitors.
AB - Purpose of Review: The use of lipid-lowering therapies in patients with idiopathic inflammatory myopathies (IIM) is complicated and there are no guidelines for diagnosing, monitoring, or treating atherosclerotic cardiovascular disease (ASCVD) in this group of patients. Recent Findings: The use of lipid-lowering therapies, especially statins, is recommended in patients with increased risk for ASCVD, which includes patients with inflammatory diseases, based on recent American College of Cardiology/American Heart Association (ACC/AHA) guidelines for ASCVD management. Summary: There is accumulating evidence that patients with IIM are at increased risk for ASCVD, similar to other inflammatory diseases. Lipid-lowering therapies have side effects that may be pronounced or confounding in myositis patients, potentially limiting their use. Statins are specifically contraindicated in patients with anti 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) antibodies. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have been shown to be safe and potentially beneficial in patients with IIM. Here, we propose a framework for (1) ASCVD risk assessment and treatment based on ACC/AHA ASCVD primary prevention guidelines; (2) myositis disease monitoring while undergoing lipid-lowering therapy; and (3) management of statin intolerance, including, indications for the use of PCSK9 inhibitors.
KW - Atherosclerotic cardiovascular disease
KW - HMGCR
KW - Idiopathic inflammatory myopathy
KW - Lipid-lowering therapy
KW - Myositis
KW - PCSK9 inhibitors
KW - Statins
UR - http://www.scopus.com/inward/record.url?scp=85089908892&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85089908892&partnerID=8YFLogxK
U2 - 10.1007/s11926-020-00942-3
DO - 10.1007/s11926-020-00942-3
M3 - Review article
C2 - 32845379
AN - SCOPUS:85089908892
SN - 1523-3774
VL - 22
JO - Current rheumatology reports
JF - Current rheumatology reports
IS - 10
M1 - 70
ER -