{
  "abstract": "Objective To evaluate the long-term efficacy of interleukin (IL)-17A inhibition with secukinumab on structural bone changes and clinical outcomes in psoriatic arthritis (PsA).Methods We conducted a phase-IV non-interventional study on adult patients with active PsA using high-resolution peripheral quantitative CT (HR-pQCT) and MRI of the hand over 48 months. All participants received secukinumab treatment and were followed up according to clinical practice, with repeated HR-pQCT and MRI. Number and volume of erosions, bone density, cortical and trabecular microarchitecture and bone biomechanical properties were assessed based on HR-pQCT scans. MRI synovitis, tenosynovitis, osteitis, periarticular inflammation, erosions and osteoproliferation were quantified by Psoriatic Arthritis MRI Score (PsAMRIS)-Outcome Measures in Rheumatology (OMERACT) score. Study outcomes included drug survival and changes from baseline in disease activity, functional status and imaging-detected inflammation and damage.Results 32 patients with PsA (40.6% female, mean age 56±7.5 years) were enrolled. Drug survival rate was 68.8% at 48 months. Secukinumab was highly effective in all PsA disease domains, with significant improvements in Disease Activity Score 28 (p<0.001), Leeds Enthesitis Index (p=0.027), Psoriasis Area and Severity Index (p=0.001), C reactive protein (p=0.09), Psoriatic Arthritis Impact of Disease (p<0.001) and pain (p<0.001). Functional status measured by the Health Assessment Questionnaire remained stable. On HR-pQCT, bone density, microarchitecture and biomechanics were preserved. There was no progression of bone erosions (all changes were not significant). On MRI, PsAMRIS erosion and osteoproliferation subitems increased marginally (+1.4 and +0.8, respectively), while inflammatory changes remained stably low. No major safety signals emerged.Conclusion Multimodal imaging with HR-pQCT and MRI showed no relevant progression of structural bone damage over 48 months in patients with PsA treated with secukinumab, suggesting that anti-IL-17A therapy induces sustained osteoprotective effects in PsA.",
  "authors": [
    {
      "affiliations": [
        "Department of Medicine 3—Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany",
        "Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany"
      ],
      "name": "Louis Schuster"
    },
    {
      "affiliations": [
        "Department of Medicine 3—Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany",
        "Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany"
      ],
      "name": "Alp Temiz"
    },
    {
      "affiliations": [
        "Department of Medicine 3—Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany",
        "Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany"
      ],
      "name": "Melek Yalcin Mutlu"
    },
    {
      "affiliations": [
        "Department of Medicine 3—Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany",
        "Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany"
      ],
      "name": "Koray Tascilar"
    },
    {
      "affiliations": [
        "Department of Medicine 3—Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany",
        "Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany"
      ],
      "name": "Sara Bayat"
    },
    {
      "affiliations": [
        "Department of Medicine 3—Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany",
        "Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany"
      ],
      "name": "Giulia Corte"
    },
    {
      "affiliations": [
        "Department of Medicine 3—Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany",
        "Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany"
      ],
      "name": "Jürgen Rech"
    },
    {
      "affiliations": [
        "Division of Rheumatology, Klinikum Nürnberg, Paracelsus Private Medical University, Nuremberg Campus, Nuremberg, Germany"
      ],
      "name": "Axel Hueber"
    },
    {
      "affiliations": [
        "Department of Medicine 3—Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany",
        "Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany"
      ],
      "name": "Anna-Maria Liphardt"
    },
    {
      "affiliations": [
        "Department of Rheumatology and Clinical Immunology, Charité – Universitätsmedizin Berlin, Berlin, Germany"
      ],
      "name": "Arnd Kleyer"
    },
    {
      "affiliations": [
        "Department of Rheumatology and Clinical Immunology, Charité – Universitätsmedizin Berlin, Berlin, Germany"
      ],
      "name": "David Simon"
    },
    {
      "affiliations": [
        "Institute of Radiology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany",
        "Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA"
      ],
      "name": "Frank Roemer"
    },
    {
      "affiliations": [
        "Department of Medicine 3—Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany",
        "Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany"
      ],
      "name": "Georg Schett"
    },
    {
      "affiliations": [
        "Department of Medicine 3—Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany",
        "Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany"
      ],
      "name": "Filippo Fagni"
    }
  ],
  "title": "Long-term osteoprotective effects of IL-17A blockade with secukinumab in psoriatic arthritis: data from the PSARTROS-II study",
  "uid": "a5dca9bc-81a1-53fb-b04a-12093e6cc9e7"
}