Tiniakou E, et al. - Muscle strength was evaluated in 122 anti–3-hydroxy-3-methlyglutaryl coenzyme A reductase (anti-HMGCR)–positive individuals at each visit former and following the initiation of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors by the experts in order to ascertain the safety of PCSK9 inhibitors in individuals with anti-HMGCR–positive immune-mediated necrotizing myopathy (IMNM). Eight individuals of 122 who were receiving PCSK9 inhibitors for hyperlipidemia were recognized. For an average of 1.5 years, individuals were followed up, and none displayed a decrease in muscle strength. Prior to the initiation of PCSK9 inhibitors, the mean ± SD creatine kinase level was 956 ± 1,137 IU/liter, which was diminished to 419 ± 393 IU/liter at their latest visit. A comparable trend was followed by anti-HMGCR antibody titers. The initiation of the lipid-lowering medication was followed by unexpected spontaneous clinical betterment and a decrease in immunosuppression in 2 individuals. Therefore, for long-term use as a cholesterol-lowering agent, PCSK9 inhibitors was reliable in individuals with statin-associated IMNM.