Background: Idiopathic inflammatory myopathies (IIM) are a group of diseases with cardiovascular (CVD) mortality as the leading cause of death. Statin therapy has been shown to reduce CVD risk, but its use in patients with myopathy is limited due to potential muscular adverse events. According to the latest recommendations, it is necessary to assess CVD status and risk factors at the time if IIM diagnosis and during follow-up, emphasizing the importance of regular screening. However, international recommendations for risk reduction in this patient group are still lacking.

Objectives: Our aim was to assess the CVD risk in a myositis cohort using the SCORE-2 prediction system, carotid artery Doppler ultrasound measurement and biomarkers; recommend individual lipid-lowering treatment; follow the efficacy and adverse events of therapy in a 6 months’ treatment period.

Methods: A cross-sectional study was conducted involving 80 patients with IIM. CVD risk was determined based on the SCORE-2 evaluation, laboratory tests, blood pressure measurements, carotid ultrasound imaging and disease activity assessment (IMACS core set). Patients with high and very high risk (SCORE-2 ≥ 7.5 and/or asymptomatic atherosclerosis) were initiated on 10 mg of rosuvastatin or 10 mg of ezetimibe (statins were contraindicated) daily. Follow-up assessments were performed after six months to evaluate treatment efficacy and potential side effects.

Results: The study included 80 patients with a mean age of 56.2 ±13.4 years and a disease duration of 9 (5-15) years. Among the patients, 49% (n=39) had polymyositis (including antisynthetase syndrome and necrotizing myopathy), and 51% (n=41) had dermatomyositis. The median disease activity was 1 (0-2.15), CK was 90.5 (62-185) IU/ml. Based on the SCORE-2 evaluation, 78.8% of patients had medium/high CVD risk as well as 73.13% had asymptomatic carotid plaque. Traditional risk factors included hypertension (71.3%) and diabetes (25%). After 6 months of adequate lipid-lowering therapy total cholesterol level (5.7 mmol/l vs. 4.7 mmol/l, p<0,001), non-HDL cholesterol (4.1 mmol/l vs. 3.1 mmol/l, p=0.003), along with early atherosclerosis biomarkers (oxLDL, sICAM-1, APO-B) decreased significantly, and no progression in carotid plaques have been detected. SCORE-2 results showed 37.5% of patients shifted into a lower risk category, indicating significant CVD risk reduction. A lipid-lowering therapy was well tolerated, with no notable muscle-related side effects observed during follow-up. Patients’ VAS (Visual Analog Scale) scores for muscle pain and CK levels) remained stable over time.

Conclusion: As concluding remark, we can state that CVD risk of patients with myositis is high, but carefully applied lipid-lowering treatment is the key of effective risk reduction. Risk stratification and recommendation of preventive treatment is the responsibility of treating rheumatologist.

REFERENCES: NIL.

Acknowledgements: NIL.

Disclosure of Interests: Katalin Szabó: None declared, Dorottya Szinay: None declared, Henrik Molnár: None declared, Tibor Gábor Béldi: None declared, Viktor Bencs: None declared, Hajnalka Lőrincz: None declared, Mariann Harangi: None declared, Melinda Nagy-Vincze: None declared, Zoltán Griger Octapharma, CSL-Behring, Abbvie, Takeda, Lilly, Astra-Zeneca.

© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.