Is there any contraindication to the use of ezetimibe in patients with a history of statin-induced necrotizing myopathy?

These types of questions are always great to discuss. The reality is there is a risk-benefit ratio to be considered. On one hand, there is a concern for the need for lipid-lowering to prevent cardiovascular disease, and some situations are more pressing than others. A diabetic with a known cardiovas...

Great question and pertinent clinically.

In our myositis clinic, we definitely have the same general approach as that endorsed by @Dr. First Last when considering the risk: benefit of various lipid-lowering agents, esp. since the use of statins is absolutely contraindicated in patients with HMGCR+ ne...

I am conflicted clinically, as an often overlooked point that none of the previous comments have addressed is the relative ease/expense of a PCSK9 inhibitor prescription. We find it exceptionally difficult to get preapproval through most commercial insurance providers. Thus, I do agree with the init...

I have not seen necrotizing myositis lately. In patients with mild statin-induced myopathy, I have used ezetimibe in the past without any problems.

I haven’t seen necrotizing myositis often. But when they have a history of it, I try to use a PCSK9 first, and if it isn’t covered will use Zetia with close follow-up.