How do you treat anti-HMGCoA myopathy?

IVIg is a great treatment for anti-HMGCoA antibody necrotizing myopathy. However, traditional treatments like methotrexate, azathioprine, as well as rituximab can be tried. We published a paper on IVIG results on refractory HMGCR and SRP positive patients with excellent results.

Kocoloski et al., PMID 34581697.

The longitudinal case-series published by Dr. @Dr. First Last and his colleagues provided notable quantitative support for useful role of IVIG in immune-mediated necrotizing myositis (IMNM), including the subtypes typically associated with statin-exposures. These data are also echoed by other authors, including reports showing the benefit of initial induction therapy for IMNM using combination IVIG and pulse-dose glucocorticoids (such as de Souza et al., PMID 30778655) or even IVIG monotherapy (such as Mamen and Tiniakou, PMID 26488714).

Statin-associated IMNM can often present with an aggressive polymyositis which causes significant morbidity, muscle damage, and residual weakness even after control. As such, it may be beneficial to consider...

IVIG.