Can a Biologic Prevent Bone Changes?

Secukinumab (Cosentyx) was associated with decreased synovial inflammation and reduced progression of catabolic and anabolic bone changes among patients with psoriatic arthritis (PsA), according to the findings of a recent study.

In the prospective, open-label study, the researchers investigated the efficacy of secukinumab among 20 participants with active PsA for 24 weeks. The researchers collected demographic and clinical measures of joint disease, skin disease, and composite measures. Synovitis, periarticular inflammation, bone erosion, enthesiophyte formation, and bone structure of the hand was assessed using magnetic resonance imaging (MRI), power Doppler ultrasound (PDUS), and high-resolution peripheral quantitative computer tomography (HR-pQTC) at baseline and week 24.
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After 24 weeks of treatment, minimal disease activity was observed in 46% of participants and low disease activity scores on the Disease Activity in Psoriatic Arthritis was achieved by 52% of participants. MRI synovitis and signal PDUS decreased significantly, and bone erosions in MRI and HR-pQCT and enthesiophytes in HR-pQTC did not show progression. In addition, structural integrity and functional bone strength remained stable.

“IL-17 inhibition by secukinumab over 24 weeks led to a significant decrease of synovial inflammation and no progression of catabolic and anabolic bone changes in the joints of patients with PsA,” the researchers concluded.

Reference

Kampylafka E, d’Oliveira I, Lerchen V, et al. Resolution of synovitis and arrest of catabolic and anabolic bone changes in patients with psoriatic arthritis by IL-17A blockade with secukinumab: results from the prospective PSARTROS study [published online July 27, 2018]. Arthritis Res Ther. doi:10.1186/s13075-018-1653-5