Before joints become painful, psoriatic arthritis (PsA) often begins silently as enthesitis—inflammation where tendons and ligaments attach to bone. This hidden condition is invisible to routine exams but detectable by ultrasound.

Now, a study from The Second Affiliated Hospital of Henan University of Science and Technology shows that the IL-17A inhibitor secukinumab can rapidly reduce this subclinical enthesitis. In 76 moderate-to-severe plaque psoriasis patients without joint symptoms but with ultrasound-confirmed enthesitis, six weeks of secukinumab (300 mg) significantly improved all skin scores (PASI, DLQI, BSA, IGA; all P < 0.001). Ultrasound also revealed marked thinning at multiple enthesial sites, most notably at the right Achilles tendon (P = 2.71×10^-9).

These ultra-early changes suggest that blocking IL-17A quickly resolves inflammatory edema before irreversible structural damage occurs. The findings support using musculoskeletal ultrasound to screen at-risk psoriasis patients and support early intervention to potentially delay clinical PsA.

The work titled "Secukinumab Reduces Subclinical Enthesitis in Moderate-to-Severe Plaque Psoriasis: A Single-Center, Retrospective Ultrasound Study" was published in Skin on May 22, 2026.
DOI:https://doi.org/10.2738/SKIN.2026.0009