A recent study published in the Journal of Rheumatology found that secukinumab significantly reduced erosion volume and prevented enthesophyte progression in patients with psoriatic arthritis compared to placebo. The phase 4, double-blind, randomized, placebo-controlled trial used high-resolution peripheral quantitative computed tomography to assess structural changes in metacarpophalangeal joints over 48 weeks.
The study enrolled 40 patients with active psoriatic arthritis and at least one erosion in metacarpophalangeal joints 2 to 4, with participants randomly assigned in a 1:1 ratio to receive subcutaneous secukinumab or placebo. High-resolution peripheral quantitative computed tomography imaging of metacarpophalangeal joints 2 to 4 was performed at baseline, week 24, and week 48 to measure changes in erosion and enthesiophyte volumes. The secukinumab group showed significant reduction in erosion volume throughout the study period, while no changes were observed in the placebo group. The median change in erosion volume was -0.1 (interquartile range -0.5 to 0.0) in the secukinumab group versus 0.0 (interquartile range -0.2 to 0.4) in the placebo group (P = 0.004).
Similar trends were observed for enthesophyte volume changes, with the secukinumab group demonstrating a median change of -0.1 (interquartile range -0.8 to 0.0) compared to 0.0 (interquartile range -0.4 to 1.3) in the placebo group (P = 0.067). Generalized estimating equations analysis revealed that the odds ratio for enthesophyte progression in the secukinumab group was 0.264 (95% confidence interval 0.080-0.878, P = 0.030), while the odds ratio for partial erosion healing in the secukinumab group was 2.882 (95% confidence interval 1.130-7.349, P = 0.027).
Secukinumab is a fully human monoclonal antibody targeting IL-17A that has demonstrated robust efficacy across multiple immune-mediated conditions, including moderate-to-severe psoriasis, peripheral and axial forms of psoriatic arthritis, radiographic axial spondyloarthritis, and nonradiographic axSpA. Treatment with SEC has been associated with a rapid onset of action, sustained clinical responses, and a favorable safety profile. A randomized, double-blind, placebo-controlled phase 3 trial by Brunner et al. demonstrated that secukinumab significantly prolonged time to disease flare in children and adolescents with enthesitis-related arthritis and juvenile psoriatic arthritis who had an inadequate response to conventional therapy. Among 86 biologic-naïve patients initially treated with open-label secukinumab, week 12 responders were randomized to continue secukinumab or switch to placebo. Flare rates were notably lower in the secukinumab group compared with placebo (27% vs 55%; HR 0.28, 95% CI 0.13–0.63; p<0.001). The safety profile was consistent with adult indications in psoriatic arthritis and axial spondyloarthritis, with exposure-adjusted incidence rates of 290.7 adverse events and 8.2 serious adverse events per 100 patient-years.
The findings demonstrated that secukinumab provided potential benefits in facilitating partial erosion repair and preventing enthesophyte progression in patients with psoriatic arthritis, offering evidence for its structural protective effects beyond clinical symptom improvement.
References
- Jin Y, Cheng IT, So H, Lai BT, Ying SK, Kwok KY, et al. 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. Arthritis Rheumatol. 2025 Aug;77(8):1015-1025.
- Brunner HI, Foeldvari I, Alexeeva E, Ayaz NA, Calvo Penades I, Kasapcopur O et al. Secukinumab in enthesitis-related arthritis and juvenile psoriatic arthritis: a randomised, double-blind, placebo-controlled, treatment withdrawal, phase 3 trial. Ann Rheum Dis. 2023 Jan;82(1):154-160.
- Martire MV, Marin J, Maldonado-Ficco H, Benegas M, Giorgis P, Vila D,et al. Access, Effectiveness, Safety, and Survival of Secukinumab in Patients With Axial Spondyloarthritis and Axial Psoriatic Arthritis: A Real-World Study in Argentina. J Rheumatol. 2025 Aug 1;52(8):829-837.