Effects of Secukinumab on Enthesiophyte and Erosion Progression in Psoriatic Arthritis: A One-Year Double-Blind, Randomized, Placebo-Controlled Trial Using High-Resolution Peripheral Quantitative Computed Tomography

IF 10.9 1区医学 Q1 RHEUMATOLOGY Arthritis & Rheumatology Pub Date : 2025-03-14 DOI:10.1002/art.43154

Yingzhao Jin, Isaac T. Cheng, Ho So, Billy T. Lai, Shirley K. Ying, Kitty Y. Kwok, James Griffith, Vivian Hung, Cheuk-Chun Szeto, Jack J. Lee, Ling Qin, Lai-Shan Tam

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Abstract

Objective

This study aimed to ascertain the effect of secukinumab on erosion and enthesiophyte progression in psoriatic arthritis (PsA) by using high-resolution peripheral quantitative computed tomography (HR-pQCT).

Methods

This was a phase 4, double-blind, randomized, placebo-controlled trial. Patients with active PsA and ≥1 erosion in metacarpophalangeal joints (MCPJs) 2 to 4 were randomly assigned in a 1:1 ratio to subcutaneous secukinumab or placebo. HR-pQCT of MCPJs 2 to 4 were performed at baseline, week 24, and week 48. The primary outcome was the changes in the volume of erosions on MCPJs 2 to 4 measured by HR-pQCT at 24 and 48 weeks.

Results

Forty patients (mean ± SD age 51.9 ± 13.4 years, 20 [50%] male, mean ± SD disease duration 4.7 ± 6.7 years) were recruited. Thirty-four patients who completed study treatment were included in the per-protocol analysis. At baseline, week 24, and week 48, the secukinumab group showed a significant reduction in erosion volume, whereas no changes were observed in the placebo group (median change in the secukinumab group −0.1 [interquartile range −0.5 to 0.0] vs 0.0 [interquartile range −0.2 to 0.4] in the placebo group, P = 0.004). A similar trend was observed for enthesiophyte volume changes in the secukinumab group, whereas no differences were noted in the placebo group (median change in the secukinumab group −0.1 [interquartile range −0.8 to 0.0] vs 0.0 [interquartile range −0.4 to 1.3] in the placebo group, P = 0.067). Generalized estimating equations results showed that the odds ratio (OR) for enthesiophyte progression in the secukinumab group was 0.264 (95% confidence interval [CI] 0.080–0.878, P = 0.030), whereas the OR for partial erosion healing in the secukinumab group was 2.882 (95% CI 1.130–7.349, P = 0.027).

Conclusion

Secukinumab demonstrates a potential benefit in facilitating partial erosion repair and preventing enthesiophyte progression in PsA.

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secukinumab对银屑病关节炎并发溃疡和糜烂进展的影响——一项为期一年的双盲、随机、安慰剂对照试验，利用高分辨率外周定量计算机断层扫描

本研究旨在通过高分辨率外周定量计算机断层扫描（HR-pQCT）确定secukinumab对银屑病关节炎（PsA）糜烂和淋巴结进展的影响。

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来源期刊

Arthritis & Rheumatology RHEUMATOLOGY-

CiteScore

20.90

自引率

3.00%

发文量

371

期刊介绍： Arthritis & Rheumatology is the official journal of the American College of Rheumatology and focuses on the natural history, pathophysiology, treatment, and outcome of rheumatic diseases. It is a peer-reviewed publication that aims to provide the highest quality basic and clinical research in this field. The journal covers a wide range of investigative areas and also includes review articles, editorials, and educational material for researchers and clinicians. Being recognized as a leading research journal in rheumatology, Arthritis & Rheumatology serves the global community of rheumatology investigators and clinicians.