Ruscitti Piero, Gianneramo Camilla, Palumbo Pierpaolo, Bruni Manfredo, Gentile Martina, Lanzi Sabrina, Vagnozzi Emanuele, Loda Alessia, Magnanimi Lina Maria, Fargnoli Maria Concetta, Barile Antonio, Cipriani Paola, Esposito Maria
Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Delta 6 Building, Via Dell' Ospedale, PO Box 67100, L'Aquila, Italy.
Department of Emergency and Interventional Radiology, San Salvatore Hospital, Abruzzo Health Unit 1, L'Aquila, Italy.
Radiol Med. 2025 Sep 18. doi: 10.1007/s11547-025-02086-9.
To evaluate the effectiveness of IL-17 and IL-23 inhibitors in psoriatic nail and enthesis involvement by ultrasonography with the use of high-frequency probes (HFUS). To correlate the obtained HFUS findings with disease activity of patients with psoriatic arthritis (PsA).
Consecutive early naïve patients with PsA underwent HFUS on nails and entheses before and after 24 weeks of treatment with IL-17 or IL-23 inhibitor. The Brown University Nail Enthesis Scale (BUNES), considering morphometry and Power Doppler (PD), and the Madrid Sonography Enthesitis Index (MASEI) score were used to evaluate these features. HFUS findings were correlated with the extension of the disease on skin by Psoriasis Area and Severity Index (PASI) and joints by Disease Activity Index for Psoriatic Arthritis (DAPSA).
Twenty early naïve patients with PsA were treated for 24 weeks with an IL-17 or IL-23 inhibitor. A significant reduction of BUNES PD was observed considering the whole cohort of patients receiving these drugs (p = 0.044), whereas, despite a trend, no significant difference was reported comparing BUNES morphometry. The BUNES PD correlated with PASI (r = 0.466, p = 0.030) and with DAPSA (r = 0.444, p = 0.032), whereas BUNES morphometry did not. A significant reduction of MASEI was observed considering the whole assessed cohort of patients treated with these drugs (p = 0.045). The MASEI correlated with both PASI (r = 0.429, p = 0.037) and DAPSA (r = 0.499, p = 0.017).
This proof-of-concept study demonstrated that the assessment by HFUS may provide additional accurate information about the effectiveness of IL-17 and IL-23 inhibitors in psoriatic nail and enthesis involvement.
通过使用高频探头（HFUS）的超声检查来评估白细胞介素-17（IL-17）和白细胞介素-23（IL-23）抑制剂在银屑病甲和附着点受累方面的有效性。将获得的HFUS检查结果与银屑病关节炎（PsA）患者的疾病活动度相关联。
连续纳入初治的早期PsA患者，在接受IL-17或IL-23抑制剂治疗24周前后，对其指甲和附着点进行HFUS检查。使用考虑形态学和能量多普勒（PD）的布朗大学指甲附着点量表（BUNES）以及马德里超声附着点炎指数（MASEI）评分来评估这些特征。HFUS检查结果与银屑病面积和严重程度指数（PASI）评估的皮肤疾病范围以及银屑病关节炎疾病活动指数（DAPSA）评估的关节疾病范围相关联。
20例初治的早期PsA患者接受了IL-17或IL-23抑制剂治疗24周。在接受这些药物治疗的整个患者队列中，观察到BUNES的PD有显著降低（p = 0.044），而尽管有趋势，但比较BUNES形态学时未报告有显著差异。BUNES的PD与PASI（r = 0.466，p = 0.030）和DAPSA（r = 0.444，p = 0.032）相关，而BUNES形态学则不然。在接受这些药物治疗的整个评估患者队列中，观察到MASEI有显著降低（p = 0.045）。MASEI与PASI（r = 0.429，p = 0.037）和DAPSA（r = 0.499，p = 0.017）均相关。
这项概念验证研究表明，HFUS评估可能为IL-17和IL-23抑制剂在银屑病甲和附着点受累方面的有效性提供额外的准确信息。
