Abstract
Abstract
Objectives
Statin-associated immune-mediated necrotizing myopathy (IMNM) is a distinct idiopathic inflammatory myopathy (IIM) associated with anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (anti-HMGCR) antibodies. The present study determined all-cause mortality among patients with statin-associated IMNM.
Methods
In this retrospective cohort study of 142 adult patients with IIM evaluated at a tertiary academic medical centre, statin-associated IMNM was defined by IMNM with recent statin exposure. IIM was defined by standard criteria. The primary outcome was all-cause mortality. Age-adjusted Cox proportional hazards models were the primary analyses with additional adjustments for age, diabetes mellitus and hyperlipidaemia with propensity score-weighted Cox models.
Results
Among 142 patients with IIM, 41 were statin-associated IMNM who were older and had shorter disease duration (P
Conclusions
Statin-associated IMNM is associated with higher mortality than other myositis subtypes; this excess attenuates after adjustment for age and cardiometabolic comorbidity, indicating these pre-existing conditions identify a higher-risk clinical phenotype.