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03-08-2018 | Rheumatology | News | Article

Secukinumab may reduce synovial inflammation in PsA patients

medwireNews: Treatment with the interleukin (IL)-17A inhibitor secukinumab is associated with a reduction in synovial inflammation among patients with psoriatic arthritis (PsA), results of the PSARTROS study suggest.

“Despite unequivocal evidence that IL-17 inhibition works on the signs and symptoms of PsA, its local effects on the joint are inadequately characterized,” say Axel Hueber (Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany) and study co-authors.

The team investigated the impact of 24 weeks of secukinumab treatment on inflammation and bone changes in 20 patients with PsA, 90% of whom had synovitis at baseline.

Participants experienced a significant improvement in global Psoriatic Arthritis Magnetic Resonance Imaging Score (PsAMRIS), from a median of 6 points at baseline to 4 points at week 24, as well as a significant improvement in PsAMRIS synovitis score from a median of 3 to 2 points.

Synovial inflammation measured by power Doppler ultrasound, including OMERACT EULAR ultrasound score, synovial hypertrophy, and power Doppler activity, also improved significantly with 24 weeks of secukinumab treatment.

Moreover, the PsAMRIS bone erosion score remained stable over 24 weeks of secukinumab treatment, as did erosion numbers and volume measured by high-resolution peripheral quantitative computed tomography, report the researchers in Arthritis Research & Therapy.

The observation that these “highly sensitive techniques” did not demonstrate any signs of progression in bone erosion provides “solid evidence” that “reduction of synovitis by secukinumab is followed by protection from progression of structural damage,” they say.

Hueber and team caution that their investigation was limited by a number of factors, including lack of a control arm, small patient numbers, and short duration of follow-up.

Nonetheless, they point out that their study “provides the first comprehensive and in-depth imaging analysis of the joints of PsA patients during [biologic] DMARD therapy.”

And the investigators conclude that their data “underline a causative role of IL-17 in triggering joint disease in the context of psoriasis.”

By Claire Barnard

medwireNews is an independent medical news service provided by Springer Healthcare. © 2018 Springer Healthcare part of the Springer Nature group

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