{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T05:37:32Z","timestamp":1772602652549,"version":"3.50.1"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,5,16]],"date-time":"2022-05-16T00:00:00Z","timestamp":1652659200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,5,16]],"date-time":"2022-05-16T00:00:00Z","timestamp":1652659200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arthritis Res Ther"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Objective<\/jats:title>\n                <jats:p>To investigate the imaging characteristics and clinically assess heel enthesitis in spondyloarthritis (SpA) by applying in a post hoc analysis the Heel Enthesitis Magnetic Resonance Imaging Scoring system (HEMRIS) in blinded and centrally-read MRI data from the ACHILLES trial (NCT02771210).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>ACHILLES included patients (\u226518 years) with active psoriatic arthritis or axial SpA with clinical and MRI-positive heel enthesitis refractory to standard treatment. Patients were randomized to receive subcutaneous secukinumab 150\/300 mg or placebo. At week 24, patients on placebo were switched to secukinumab treatment. MRI-positive heel enthesitis was confirmed in all patients by local investigators. MRIs were performed at 3 timepoints: screening and weeks 24 and 52. In the present analysis, all MRIs were re-evaluated by 2 blinded central readers in a consensus read fashion for a priori defined MRI parameters based on HEMRIS.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>At screening, 171\/204 (83.8%) of patients presented with entheseal inflammation and\/or structural damage, considering both the Achilles tendon and plantar fascia. Pathologies were more evident in the Achilles tendon area compared to the plantar aponeurosis. The most frequent pathologies were intra-tendon hypersignal and retrocalcaneal bursitis. The mean total entheseal inflammation score at screening in the Achilles tendon area was 2.99 (<jats:italic>N<\/jats:italic>=204) and the mean change (standard deviation [SD]) from screening to weeks 24 and 52 was \u2212 0.91 (1.99) and \u2212 0.83 (2.12) in the secukinumab group vs \u2212 0.48 (1.86) and \u2212 0.80 (1.98) in the placebo-secukinumab group, respectively. The mean total structural damage score at screening was 1.36 (<jats:italic>N<\/jats:italic>=204) and the mean change (SD) from screening to weeks 24 and 52 was 0.00 (0.65) and \u2212 0.06 (0.56) in the secukinumab group vs 0.08 (0.48) and 0.04 (0.75) in the placebo-secukinumab group, respectively.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Based on the newly developed HEMRIS, entheseal inflammation and\/or structural damage was confirmed in 83.3% of ACHILLES patients. Pathologies were more evident in the Achilles tendon area compared to plantar fascia, with the inflammatory parameters being more responsive with secukinumab treatment compared to placebo. The present analysis, with detailed information on individual MRI parameters, contributes to the scientific debate on heel enthesitis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>ClinicalTrials.gov <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT02771210\">NCT02771210<\/jats:ext-link>.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13075-022-02797-8","type":"journal-article","created":{"date-parts":[[2022,5,16]],"date-time":"2022-05-16T05:03:38Z","timestamp":1652677418000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Magnetic resonance imaging characteristics in patients with spondyloarthritis and clinical diagnosis of heel enthesitis: post hoc analysis from the phase 3 ACHILLES trial"],"prefix":"10.1186","volume":"24","author":[{"given":"X.","family":"Baraliakos","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Sewerin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"de Miguel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Pournara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Kleinmond","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Shekhawat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Jentzsch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Wiedon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Behrens","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of the ACHILLES study group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,5,16]]},"reference":[{"key":"2797_CR1","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1016\/S0889-857X(03)00044-9","volume":"29","author":"D McGonagle","year":"2003","unstructured":"McGonagle D. Diagnosis and treatment of enthesitis. Rheum Dis Clin North Am. 2003;29:549\u201360.","journal-title":"Rheum Dis Clin North Am."},{"key":"2797_CR2","doi-asserted-by":"publisher","first-page":"1137","DOI":"10.1016\/S0140-6736(97)12004-9","volume":"352","author":"D McGonagle","year":"1998","unstructured":"McGonagle D, Gibbon W, Emery P. Classification of inflammatory arthritis by enthesitis. Lancet. 1998;352:1137\u201340.","journal-title":"Lancet."},{"key":"2797_CR3","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1159\/000341536","volume":"225","author":"DG McGonagle","year":"2012","unstructured":"McGonagle DG, Helliwell P, Veale D. Enthesitis in psoriatic disease. Dermatology. 2012;225:100\u20139.","journal-title":"Dermatology."},{"key":"2797_CR4","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1002\/art.39458","volume":"68","author":"AS Kehl","year":"2016","unstructured":"Kehl AS, Corr M, Weisman MH. 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P Sewerin received grant\/research support from AbbVie, Celgene, Chugai, Janssen-Cilag, Lilly, Novartis, Pfizer, and UCB; was a consultant for AbbVie, Biogen, BMS, Celgene, Chugai, Hexal, Janssen-Cilag, Lilly, Novartis, Pfizer, Roche, Sanofi-Genzyme, Swedish Orphan Biovitrum, and UCB; and on the speaker\u2019s bureau of AbbVie, Biogen, BMS, Celgene, Chugai, Hexal, Janssen-Cilag, Lilly, Novartis, Pfizer, Roche, Sanofi-Genzyme, Swedish Orphan Biovitrum, and UCB. E De Miguel received grant\/research support from AbbVie, Novartis, and Pfizer; was a consultant for AbbVie, Novartis, and Pfizer; and on the speakers bureau of AbbVie, BMS, MSD, Novartis, Pfizer, UCB, and Roche. E Pournara, C Kleinmond, A Shekhawat, C Jentzsch and A Wiedon are employees of Novartis and may own Novartis stock. F Behrens received grant\/research support from AbbVie, Pfizer, Roche, Chugai, Janssen, and Novartis; consultancies\/speakers fee from AbbVie, Pfizer, Roche, Chugai, UCB, BMS, Celgene, MSD, Novartis, Biotest, Janssen, Sanofi, Genzyme, Lilly, Boehringer, and Galapagos.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"111"}}