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All participants received secukinumab treatment and were followed up according to clinical practice, with repeated HR-pQCT and MRI. Number and volume of erosions, bone density, cortical and trabecular microarchitecture and bone biomechanical properties were assessed based on HR-pQCT scans. MRI synovitis, tenosynovitis, osteitis, periarticular inflammation, erosions and osteoproliferation were quantified by Psoriatic Arthritis MRI Score (PsAMRIS)-Outcome Measures in Rheumatology (OMERACT) score. Study outcomes included drug survival and changes from baseline in disease activity, functional status and imaging-detected inflammation and damage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>32 patients with PsA (40.6% female, mean age 56\u00b17.5 years) were enrolled. Drug survival rate was 68.8% at 48 months. Secukinumab was highly effective in all PsA disease domains, with significant improvements in Disease Activity Score 28 (p&lt;0.001), Leeds Enthesitis Index (p=0.027), Psoriasis Area and Severity Index (p=0.001), C reactive protein (p=0.09), Psoriatic Arthritis Impact of Disease (p&lt;0.001) and pain (p&lt;0.001). Functional status measured by the Health Assessment Questionnaire remained stable. On HR-pQCT, bone density, microarchitecture and biomechanics were preserved. There was no progression of bone erosions (all changes were not significant). On MRI, PsAMRIS erosion and osteoproliferation subitems increased marginally (+1.4 and +0.8, respectively), while inflammatory changes remained stably low. No major safety signals emerged.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Multimodal imaging with HR-pQCT and MRI showed no relevant progression of structural bone damage over 48 months in patients with PsA treated with secukinumab, suggesting that anti-IL-17A therapy induces sustained osteoprotective effects in PsA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rmdopen-2025-005857","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T15:20:19Z","timestamp":1772032819000},"page":"e005857","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Long-term osteoprotective effects of IL-17A blockade with secukinumab in psoriatic arthritis: data from the PSARTROS-II study"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5878-8465","authenticated-orcid":false,"given":"Louis","family":"Schuster","sequence":"first","affiliation":[{"name":"Department of Medicine 3\u2014Rheumatology and Immunology, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg (FAU) and Universit\u00e4tsklinikum Erlangen, Erlangen, Germany"},{"name":"Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg (FAU) and Universit\u00e4tsklinikum Erlangen, Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0804-3198","authenticated-orcid":false,"given":"Alp","family":"Temiz","sequence":"additional","affiliation":[{"name":"Department of Medicine 3\u2014Rheumatology and Immunology, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg (FAU) and Universit\u00e4tsklinikum Erlangen, Erlangen, Germany"},{"name":"Deutsches Zentrum 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Universit\u00e4tsklinikum Erlangen, Erlangen, Germany"},{"name":"Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg (FAU) and Universit\u00e4tsklinikum Erlangen, Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2799-184X","authenticated-orcid":false,"given":"Sara","family":"Bayat","sequence":"additional","affiliation":[{"name":"Department of Medicine 3\u2014Rheumatology and Immunology, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg (FAU) and Universit\u00e4tsklinikum Erlangen, Erlangen, Germany"},{"name":"Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg (FAU) and Universit\u00e4tsklinikum Erlangen, Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2218-6503","authenticated-orcid":false,"given":"Giulia","family":"Corte","sequence":"additional","affiliation":[{"name":"Department of Medicine 3\u2014Rheumatology and Immunology, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg (FAU) and Universit\u00e4tsklinikum Erlangen, Erlangen, Germany"},{"name":"Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg (FAU) and Universit\u00e4tsklinikum Erlangen, Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2569-2029","authenticated-orcid":false,"given":"J\u00fcrgen","family":"Rech","sequence":"additional","affiliation":[{"name":"Department of Medicine 3\u2014Rheumatology and Immunology, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg (FAU) and Universit\u00e4tsklinikum Erlangen, Erlangen, 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