Statin‐induced dermatomyositis for the practicing dermatologist: a review of the literature

Visconti, Michael J.; Bashyam, Arjun M.; Jorizzo, Joseph L.

doi:10.1111/ijd.14751

Cited by 6 publications

(4 citation statements)

References 31 publications

(27 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These scores may be skewed lower given the number of cases with cancer as a possible cause for DM. Reference lists of 114 eligible articles revealed 20 additional articles that were included. Among 134 articles, data from 165 patients were included in the systematic review (Table 1).…”

Section: Resultsmentioning

confidence: 99%

Causes and Clinical Presentation of Drug-Induced Dermatomyositis

Caravan,

Lopez,

Yeh

2024

JAMA Dermatol

View full text Add to dashboard Cite

ImportanceWhile several medications are known to induce dermatomyositis (DM), most existing studies are case reports or small case series from a single institution. There is also limited information on DM induced by immune checkpoint inhibitors, which are increasingly used in oncologic therapy.ObjectiveTo characterize causes and clinical presentation of drug-induced DM based on the current literature.Evidence ReviewA systematic review was performed in PubMed according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines, from inception to August 22, 2022. Articles meeting preestablished inclusion criteria (written in English and classified as original articles, case reports, literature reviews, and observation letters) were selected and data abstracted. Articles that met the scope of the review were also added from reference lists. When possible, study results were quantitatively combined.FindingsIn 134 studies (114 from the literature search and 20 additional studies pulled from reference lists) describing 165 cases, 88 patients (53.3%) were female, and the median (IQR) age was 61 (49-69) years. Among the cases of drug-induced DM, the most common associated medications were hydroxyurea (50 [30.3%]), immune checkpoint inhibitors (27 [16.4%]), statins (22 [13.3%]), penicillamine (10 [6.1%]), and tumor necrosis factor inhibitors (10 [6.1%]). Histopathologic testing, when undertaken, helped establish the diagnosis. There was a median (IQR) of 60 (21-288) days between drug initiation and drug-induced DM onset. History of cancer was reported in 85 cases (51.6%).Conclusions and RelevanceIn this systematic review, drug-induced DM was associated with multiple types of medications, including chemotherapies and immunotherapies. It is essential that dermatologists promptly recognize and diagnose drug-induced DM so that they can guide management to minimize interruption of therapy when possible.

show abstract

Section: Resultsmentioning

confidence: 99%

Causes and Clinical Presentation of Drug-Induced Dermatomyositis

Caravan,

Lopez,

Yeh

2024

JAMA Dermatol

View full text Add to dashboard Cite

show abstract

“…Autoimmune necrotizing myositis [10][11][12]138] is a feared complication of statin use. (Other autoimmune complications of statins are also reported [139][140][141][142][143]-which can affect muscle [144][145][146][147]-and in some cases, these accompany autoimmune myositis [13][14][15][16]148].) Autoimmunity is also a complication of COVID-19 [149][150][151][152] (encompassing, specifically, autoimmune conditions reported with statins [6,7,[153][154][155] including necrotizing myositis [8,9]) and is a factor in long-COVID [156][157][158][159]: in one "multi-omics" study of long-COVID, an autoimmune profile represented one of the four key patterns observed [160].…”

Section: Skeletal Muscle (Airway Dilator Muscles and Muscles Of Respi...mentioning

confidence: 99%

Statin Use in Relation to COVID-19 and Other Respiratory Infections: Muscle and Other Considerations

Golomb

Han

Langsjoen³

et al. 2023

JCM

View full text Add to dashboard Cite

Statins have been widely advocated for use in COVID-19 based on large favorable observational associations buttressed by theoretical expected benefits. However, past favorable associations of statins to pre-COVID-19 infection outcomes (also buttressed by theoretical benefits) were unsupported in meta-analysis of RCTs, RR = 1.00. Initial RCTs in COVID-19 appear to follow this trajectory. Healthy-user/tolerator effects and indication bias may explain these disparities. Moreover, cholesterol drops in proportion to infection severity, so less severely affected individuals may be selected for statin use, contributing to apparent favorable statin associations to outcomes. Cholesterol transports fat-soluble antioxidants and immune-protective vitamins. Statins impair mitochondrial function in those most reliant on coenzyme Q10 (a mevalonate pathway product also transported on cholesterol)—i.e., those with existing mitochondrial compromise, whom data suggest bear increased risks from both COVID-19 and from statins. Thus, statin risks of adverse outcomes are amplified in those patients at risk of poor COVID-19 outcomes—i.e., those in whom adjunctive statin therapy may most likely be given. High reported rates of rhabdomyolysis in hospitalized COVID-19 patients underscore the notion that statin-related risks as well as benefits must be considered. Advocacy for statins in COVID-19 should be suspended pending clear evidence of RCT benefits, with careful attention to risk modifiers.

show abstract

“…Statins are the most common hypolipidemic drugs in the world, and they are also primary and secondary preventive drugs for people at risk of cardiovascular disease 4 . Statin-induced myopathy is relatively common, but it is usually mild, with only a small proportion presenting as rhabdomyolysis 5–7 . Patients with rhabdomyolysis vary in severity, ranging from asymptomatic elevated serum CK, muscle pain, and myoglobinuria to life-threatening diseases 8 .…”

mentioning

confidence: 99%

“…4 Statin-induced myopathy is relatively common, but it is usually mild, with only a small proportion presenting as rhabdomyolysis. [5][6][7] Patients with rhabdomyolysis vary in severity, ranging from asymptomatic elevated serum CK, muscle pain, and myoglobinuria to life-threatening diseases. 8 This case demonstrates that rhabdomyolysis should be included in the differential diagnosis of muscle symmetrical and diffuse uptake of tracer and 68 Ga-FAPI PET/CT may have the potential to evaluate the extent and severity of rhabdomyolysis.…”

mentioning

confidence: 99%

68Ga-FAPI PET/CT in a Patient With Statin-Induced Rhabdomyolysis

et al. 2022

View full text Add to dashboard Cite

Rhabdomyolysis is a syndrome characterized by muscle necrosis and the release of muscle cell contents into blood circulation. There is ample clinical evidence that it is one of the adverse effects of statins. 68 Ga-FAPI PET/CT was performed on a 78-year-old man with newly diagnosed with mediastinal tumor and statin-induced rhabdomyolysis. 68 Ga-FAPI PET/CT showed symmetrical and diffuse increased FAPI uptake in whole-body muscles. Our case indicated that 68 Ga-FAPI PET/CT might be valuable in the evaluation of patients with rhabdomyolysis.

show abstract

Statin‐induced dermatomyositis for the practicing dermatologist: a review of the literature

Cited by 6 publications

References 31 publications

Causes and Clinical Presentation of Drug-Induced Dermatomyositis

Causes and Clinical Presentation of Drug-Induced Dermatomyositis

Statin Use in Relation to COVID-19 and Other Respiratory Infections: Muscle and Other Considerations

68Ga-FAPI PET/CT in a Patient With Statin-Induced Rhabdomyolysis

Contact Info

Product

Resources

About