Although the short-term effects of tumor necrosis factor alpha (TNF-α) and interleukin-17A (IL-17A) inhibition on the structural changes in psoriatic arthritis (PsA) using high-resolution peripheral quantitative computed tomography (HR-pQCT) have been reported, no studies have investigated the long-term structural changes in PsA patients receiving routine care. We reported longitudinal changes of erosions and enthesiophytes using HR-pQCT and their relationship with treatments in PsA patients over a 5-year period. HR-pQCT examination at the second and third metacarpal heads (MCH2 and MCH3) was performed in 60 PsA patients at baseline and after 5 years. The size of each individual lesion was quantified. Erosion and enthesiophyte progression were defined as change exceeding the smallest detectable change (SDC). A total of 108 bone erosions and 99 enthesiophytes were detected at baseline. Three new bone erosions but no new enthesiophytes were evident at 5 years. A significant increase in mean (±SD) erosion (0.58 ± 1.50 mm3, P < 0.001) and enthesiophyte (0.47 ± 0.76 mm3, P < 0.001) volume was observed. Erosion and enthesiophyte progression were found in 37/111 (33.3%) and 50/99 (50.5%) lesions, respectively. During this 5-year period, 26 (43%) out of the 60 patients achieved sustained Disease Activity index for PSoriatic Arthritis (DAPSA) low disease activity (LDA) (SDL group, defined as achieving DAPSA-LDA at both baseline and 5 years). Fourteen (23%) out of 60 patients received a TNF inhibitor throughout the 5-year period (TNFi group). Fewer erosions progressed (12/51 [23.5%] vs 25/60 [41.7%], P = 0.047) and the increased in enthesiophyte volume was significantly less (0.28 ± 0.67 vs 0.61 ± 0.80 mm3, P = 0.048) in the SDL group than in the non-SDL group. However, no significant difference between the TNFi and non-TNFi groups was detected in terms of the change in volume or progression of bone erosion and enthesiophyte. Damage accrual in terms of bone erosion and enthesiophyte was observed in PsA patients over a period of 5 years despite receiving routine clinical care. Nonetheless, sustained control of disease activity may be able to prevent these bony damages.

中文翻译：

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银屑病关节炎患者的进行性骨结构变化及其与治疗的关系：一项纵向HR-pQCT研究。

尽管使用高分辨率外周定量计算机断层扫描（HR-pQCT）可以抑制肿瘤坏死因子α（TNF-α）和白介素17A（IL-17A）对银屑病关节炎（PsA）结构变化的短期影响据报道，尚无研究调查接受常规护理的PsA患者的长期结构变化。我们报告了在5年内使用HR-pQCT对PsA患者进行侵蚀和内生菌的纵向变化及其与治疗的关系。在基线和5年后对60例PsA患者进行了第二和第三掌骨头（MCH2和MCH3）的HR-pQCT检查。量化每个单个病变的大小。侵蚀和内生菌的进展被定义为超过最小可检测变化（SDC）的变化。在基线时共检测到108处骨侵蚀和99例附生植物。在5年时，发现了3个新的骨侵蚀，但没有新的内生菌。观察到平均（±SD）侵蚀（0.58±1.50 mm3，P <0.001）和内生植物（0.47±0.76 mm3，P <0.001）的体积显着增加。分别在37/111（33.3％）和50/99（50.5％）的病变中发现糜烂和内生菌的进展。在这5年中，60例患者中有26例（43％）达到了持续性PSSAR疾病活动指数（DAPSA）低疾病活动（LDA）（SDL组，定义为在基线和5年内均达到DAPSA-LDA ）。60名患者中有14名（23％）在整个5年期间接受了TNF抑制剂治疗（TNFi组）。侵蚀进展减少（12/51 [23.5％]与25/60 [41.7％]，P = 0。047），SDL组的内生菌数量增加明显少于非SDL组（0.28±0.67 vs 0.61±0.80 mm3，P = 0.048）。然而，就骨侵蚀和内生植物的体积变化或进展而言，未检测到TNFi组和非TNFi组之间的显着差异。尽管接受常规临床护理，但在5年的时间里，在PsA患者中仍观察到了因骨侵蚀和内生真菌而引起的应计损害。尽管如此，持续控制疾病活动可能能够预防这些骨质损害。尽管接受常规临床护理，但在5年的时间里，在PsA患者中仍观察到了因骨侵蚀和内生真菌而引起的应计损害。尽管如此，持续控制疾病活动可能能够预防这些骨质损害。尽管接受常规临床护理，但在5年的时间里，在PsA患者中仍观察到了因骨侵蚀和内生真菌而引起的应计损害。尽管如此，持续控制疾病活动可能能够预防这些骨质损害。