Assessment of Efficacy and Safety of Lipid Lowering Treatment and Its Importance in Risk Assessment and Prevention in a Hungarian Myositis Cohort

Background: Idiopathic inflammatory myopathies (IIM) also known as myositis are systemic autoimmune diseases characterized by chronic inflammation affecting the skin, muscles and internal organs. Besides traditional risk factors and immune-mediated myocarditis, continuous activity of the immune system increases cardiovascular diseases (CVD) risk resulting that cardiovascular events are leading causes of mortality in IIM pa-tients. Statins are the most widely used lipid lowering therapies, which reduce cardio-vascular risk, but the fear of muscular adverse events inhibit the frequency of use. Methods: Our aim was to assess the CVD risk in a myositis cohort using the SCORE2 prediction system, carotid artery Doppler ultrasound measurement and biomarkers; recom-mend individual lipid-lowering treatment; follow the efficacy and adverse events of ther-apy in a 6 months’ treatment period. Results: Study population (80 IIM patients) was a middle aged, female dominant myositis cohort with an average disease duration of 9 years and low median global disease activity. Based on the SCORE2 evaluation, 78.8% of patients had medium/high CVD risk as well as 73.13% had asymptomatic carotid plaque. After 6 months of adequate lipid-lowering therapy 37.5% of patients reached lower CVD risk category, the biomarker levels of atherosclerosis significantly decreased and no progression in carotid plaques have been de-tected. None of the patients reported muscular adverse event or IIM relapse. Conclusion: Our findings proved that CVD risk of patients with myositis is high, but carefully applied lipid-lowering treatment is the key to effective risk reduction. Risk strati-fication and recommendation of preventive treatment is the responsibility of treating physician.