
In a study of 71 patients with anti-HMGCR antibody-positive immune-mediated necrotizing myopathy (IMNM), anti-HMGCR isotypes (IgG, IgA, IgM) were assessed to understand their association with disease activity and prognosis. Elevated baseline anti-HMGCR IgG levels correlated with poorer disease outcomes, including higher Physician’s Global Assessment (PGA) and muscle visual analog scale (VAS) scores, and lower Manual Muscle Testing (MMT8) scores. Anti-HMGCR IgM positivity was linked to younger age at onset and increased neck weakness. Longitudinally, changes in anti-HMGCR IgG levels correlated with changes in disease activity markers and creatine kinase levels. Anti-HMGCR IgM was associated with a refractory disease course and poorer prognosis. These findings highlight the prognostic significance of anti-HMGCR isotypes in IMNM
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