Secukinumab reduces bone erosion and prevents enthesiophyte progression in psoriatic arthritis: Study

A new study published in the journal of Arthritis & Rheumatology found with high-resolution peripheral quantitative CT (HR-pQCT), that individuals with psoriatic arthritis (PsA) who received secukinumab showed a substantial reduction in the amount of bone erosion and an improvement in the partial healing of erosions after a year.

Psoriatic arthritis can cause severe bone destruction and loss of physical function if inflammation is not managed. Conventional radiography has a limited sensitivity for detecting enthesophytes and bone erosions. A new method for analyzing bone microstructure in detail and with great consistency for evaluating enthesophyte and bony erosion is high-resolution peripheral quantitative CT.

After 6 months of anti-IL-17 medication, a prior single arm research showed encouraging results in stopping bone deterioration on HR-pQCT. This study used high-resolution peripheral quantitative computed tomography (HR-pQCT) to determine the impact of secukinumab on erosion and enthesiophyte development in psoriatic arthritis.

This experiment randomized patients 1:1 to assign patients with active PsA and ≥ 1 erosion in the metacarpophalangeal joints (MCPJ) 2-4 either subcutaneous secukinumab or placebo. The MCPJ 2-4 HR-pQCT was conducted at baseline, week 24, and week 48. Changes in the volume of erosions on MCPJ 2-4 as determined by HR-pQCT at 24 and 48 weeks were the main result.

This study recruited 40 patients (mean age: 51.9±13.4 years, 20 [50%] male, duration of disease: 4.7±6.7 years). The per-protocol analysis includes thirty-four participants who finished trial therapy. The secukinumab group had a substantial decrease in erosion volume at baseline, week 24, and week 48, whereas the placebo group exhibited no changes.

The secukinumab group showed a similar trend in enthesiophyte volume changes, but the placebo group showed no differences (change in the secukinumab group: -0.1 in the placebo group, p=0.067). According to GEE data, the secukinumab group's odds ratio (OR) for enthesiophyte advancement was 0.264, while its OR for partial erosion repair was 2.882.

Overall, in PsA, secukinumab shows promise in aiding partial erosion healing and inhibiting the growth of enthesiophytes. The beneficial effects of secukinumab in treating bone disorders in PsA patients are highlighted by its ability to slow the creation of new bone and lessen bone degradation. 

Source:

Jin, Y., Cheng, I. T., So, H., Lai, B. T., Ying, S. K., Kwok, K. Y., Griffith, J., Hung, V., Szeto, C.-C., Lee, J. J., Qin, L., & Tam, L.-S. (2025). Effects of secukinumab on enthesiophyte and erosion progression in psoriatic arthritis -a one-year double-blind, randomized, placebo-controlled trial utilizing high-resolution peripheral quantitative computed tomography. Arthritis & Rheumatology. https://doi.org/10.1002/art.43154