{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T23:45:20Z","timestamp":1789429520434,"version":"build-2803163510"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,3,12]],"date-time":"2024-03-12T00:00:00Z","timestamp":1710201600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Myasthenia gravis is a rare chronic autoimmune neuromuscular disorder mainly caused by autoantibodies to the nicotinic acetylcholine receptor. Cholesterol is an essential molecule that affects the distribution and proper functioning of this receptor. Several reports have described the potential worsening of myasthenia gravis in patients treated with statins.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>The patient was an obese 72 years old man, past smoker, diagnosed with ischaemic heart disease, type 2 diabetes mellitus and lipid metabolism disorder. Statin treatment was not implemented because of chronic myasthenia gravis and PCSK9i monotherapy [Repatha (evolucamab), 140\u2005mg] was implemented to treat dyslipidaemia. Within 24\u2005h after the first dose of PCSK9i the patient developed severe muscle weakness, joint pain, fever, and general discomfort, lasting for several days. Despite strong advice against the second dose administration, this was self-administered approximately 2 weeks later, leading to report significant worsening of the muscle problems, leading to the patient admittion to the neurology department where he was being treated for myasthenia gravis attack.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Based on the neurologist's conclusion, it can be assumed that in this case, treatment with PCSK9i resulted in significant worsening of the patient's chronic disease.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2024.1343775","type":"journal-article","created":{"date-parts":[[2024,3,12]],"date-time":"2024-03-12T04:43:16Z","timestamp":1710218596000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Case Report: Neurological adverse events in subject with myasthenia gravis after PCSK9 inhibitor administration"],"prefix":"10.3389","volume":"11","author":[{"given":"V\u011bra","family":"Ad\u00e1mkov\u00e1","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Vit\u00e1skov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaroslav A.","family":"Hub\u00e1\u010dek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,3,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1007\/s00059-016-4430-8","article-title":"Einfluss der lipidstoffwechselparameter auf die entstehung und progression der koronaren herzerkrankung: ein update [impact of lipid metabolism parameters on the development and progression of coronary artery disease: an update]","volume":"41","author":"Sinning","year":"2016","journal-title":"Herz"},{"key":"B2","doi-asserted-by":"publisher","first-page":"7427","DOI":"10.2174\/0929867328666210222092628","article-title":"Lipid-lowering therapies for atherosclerosis: statins, fibrates, ezetimibe and PCSK9 monoclonal antibodies","volume":"28","author":"Ali","year":"2021","journal-title":"Curr Med Chem"},{"key":"B3","doi-asserted-by":"publisher","first-page":"821","DOI":"10.1007\/s11883-022-01057-z","article-title":"Expanding biology of PCSK9: roles in atherosclerosis and beyond","volume":"24","author":"Seidah","year":"2022","journal-title":"Curr Atheroscler Rep"},{"key":"B4","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1093\/eurheartj\/ehz455","article-title":"2019 ESC\/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk","volume":"41","author":"Mach","year":"2020","journal-title":"Eur Heart J"},{"key":"B5","doi-asserted-by":"publisher","first-page":"S31","DOI":"10.3909\/ricm19S1S0002","article-title":"PCSK9 Inhibitors: mechanism of action, efficacy, and safety","volume":"19","author":"Roth","year":"2018","journal-title":"Rev Cardiovasc Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"8364","DOI":"10.3390\/ijms23158364","article-title":"Statins neuromuscular adverse effects","volume":"23","author":"Attardo","year":"2022","journal-title":"Int J Mol Sci"},{"key":"B7","doi-asserted-by":"publisher","first-page":"2788","DOI":"10.1161\/CIRCULATIONAHA.106.624890","article-title":"Risks associated with statin therapy: a systematic overview of randomized clinical trials","volume":"114","author":"Kashani","year":"2006","journal-title":"Circulation"},{"key":"B8","doi-asserted-by":"publisher","first-page":"S327","DOI":"10.33549\/physiolres.932865","article-title":"Statin-associated myopathy: from genetic predisposition to clinical management","volume":"63","author":"Vrablik","year":"2014","journal-title":"Physiol Res"},{"key":"B9","doi-asserted-by":"publisher","first-page":"574","DOI":"10.5603\/CJ.a2021.0110","article-title":"Efficacy and safety of PCSK9 inhibition in cardiovascular disease: a meta-analysis of 45 randomized controlled trials","volume":"29","author":"Geng","year":"2022","journal-title":"Cardiol J"},{"key":"B10","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1002\/cpt.1193","article-title":"Adverse events associated with PCSK9 inhibitors: a real-world experience","volume":"105","author":"G\u00fcrg\u00f6ze","year":"2019","journal-title":"Clin Pharmacol Ther"},{"key":"B11","doi-asserted-by":"publisher","first-page":"2570","DOI":"10.1056\/NEJMra1602678","article-title":"Myasthenia gravis","volume":"375","author":"Gilhus","year":"2016","journal-title":"N Engl J Med"},{"key":"B12","doi-asserted-by":"publisher","first-page":"e2108672119","DOI":"10.1073\/pnas.2108672119.","article-title":"International Myasthenia Gravis Genomics Consortium, et al. 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