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An altered balance between extracellular matrix (ECM) formation and breakdown is a key event in PsA, and changes in ECM protein metabolites may provide insight to tissue changes. Dietary fish oils (n-3 PUFA) might affect the inflammation driven tissue turnover. The aim was to evaluate ECM metabolites in patients with PsA compared to healthy individuals and investigate the effects of n-3 PUFA. The 24-week randomized, double-blind, placebo-controlled trial of PUFA included 142 patients with PsA. Fifty-seven healthy individuals were included for comparison. This study is a sub-study investigating biomarkers of tissue remodelling as secondary outcomes. Serum samples at baseline and 24\u00a0weeks and healthy individuals were obtained, while a panel of ECM metabolites reflecting bone and soft tissue turnover were measured by ELISAs: PRO-C1, PRO-C3, PRO-C4, C1M, C3M, C4M, CTX-I and Osteocalcin (OC). C1M, PRO-C3, PRO-C4 and C4M was found to be elevated in PsA patients compared to the healthy individuals (from 56 to 792%, all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), where no differences were found for OC, CTX-I, PRO-C1 and C3M. PRO-C3 was increased by 7% in patients receiving n-3 PUFA after 24\u00a0weeks compared to baseline levels (<jats:italic>p<\/jats:italic>\u2009=\u20090.002). None of the other biomarkers was changed with n-3 PUFA treatment. This indicates that tissue turnover is increased in PsA patients compared to healthy individuals, while n-3 PUFA treatment for 24\u00a0weeks did not have an effect on tissue turnover. Trial registration NCT01818804. Registered 27 March 2013\u2013Completed 18 February 2016. <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT01818804?term=NCT01818804&amp;rank=1\">https:\/\/clinicaltrials.gov\/ct2\/show\/NCT01818804?term=NCT01818804&amp;rank=1<\/jats:ext-link><\/jats:p>","DOI":"10.1007\/s00296-021-04861-z","type":"journal-article","created":{"date-parts":[[2021,4,22]],"date-time":"2021-04-22T08:05:46Z","timestamp":1619078746000},"page":"1065-1077","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Effect of n-3 PUFA on extracellular matrix protein turnover in patients with psoriatic arthritis: a randomized, double-blind, placebo-controlled trial"],"prefix":"10.1007","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4612-1014","authenticated-orcid":false,"given":"Signe","family":"Holm Nielsen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5016-3671","authenticated-orcid":false,"given":"Samra","family":"Sardar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0802-8422","authenticated-orcid":false,"given":"Anne Sofie","family":"Siebuhr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"Schlemmer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0623-5666","authenticated-orcid":false,"given":"Erik Berg","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7952-9297","authenticated-orcid":false,"given":"Anne-Christine","family":"Bay-Jensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5026-8740","authenticated-orcid":false,"given":"Morten A.","family":"Karsdal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1208-833X","authenticated-orcid":false,"given":"Jeppe Hagstrup","family":"Christensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5812-5234","authenticated-orcid":false,"given":"Salome","family":"Kristensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,4,22]]},"reference":[{"key":"4861_CR1","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1007\/s11926-006-0065-8","volume":"8","author":"L Mallbris","year":"2006","unstructured":"Mallbris L, Ritchlin CT, St\u00e5hle M (2006) Metabolic disorders in patients with psoriasis and psoriatic arthritis. 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