Causes of creatine kinase levels greater than 1000 IU/L in patients referred to rheumatology

Patients with severely elevated creatine kinase (CK) concentrations are commonly referred to rheumatologists to evaluate for the presence of an idiopathic inflammatory myopathy (IIM). However, no…

Idiopathic inflammatory myopathies (IIMs) may be complicated with life-threatening conditions requiring intensive care unit (ICU) admission.  The outcomes of such…

The main cause of mortality in patients with Dermatomyositis, Polymyositis, Anti-Synthetase Syndrome, Anti-MDA5, etc is respiratory failure. This may be due to infection, the unrelenting autoimmune attack, or both.
Unfortunately, once intubated, very few survive.

The GAUSS-3 trial, recently published in JAMA, examined cholesterol-lowering interventions in patients with a high LDL (>120 mg/dl) and a history of statin…

Given the widespread use of statins, it should not be surprising that it is the most common cause of an elevated CK. This is seldom very high, and patients may not experience bothersome myalgia.
For those who are very symptomatic, or if the CK exceeds 10 times above upper limit of the normal range, the statin may need to be replaced.
Unfortunately, Ezetimibe reduces LDL but this is not commensurate with reduction in cardiovascular events, while Evolocumab promises to be pricey.
For more details on statin-induced myopathy, read the following posts.

Statin-Induced Autoimmune Myopathy

The CDC estimates nearly 71% of adults with cardiovascular disease and 54% of adults with hypercholesterolemia use a cholesterol-lowering medication, and that “statin” use has grown significantly in recent years. During 2003–2012, statin use has increased from 20% to 28% in adults over age 40 years.

Statin-associated Myopathy

Can these muscle symptoms be prevented?