A Prospective Study to Assess the Efficacy of IL-17 Inhibitors on Subclinical Enthesitis in Patients With Moderate to Severe Psoriasis Based on Power Doppler (PD) Ultrasonography (PDUS)

Inclusion criteria

• Adult patients ( ≥ 18 years of age) with chronic plaque-type psoriasis
• Meet one of the following conditions: Psoriasis Area and Severity Index \[PASI\] score \> 6, or scalp involvement, or nail involvement.
• Inflammatory changes on ultrasound consistent with OMERACT definition at least at one peripheral attachment point at screening, defined as thickening and/or abnormal echogenicity of tendons or ligaments at the site of their insertion into the bone (within 2 mm of the talar cortex), and active Doppler signals that may indicate structural damage such as bone erosion, syndesmophytes/calcifications
• Psoriasis is inadequately controlled by current topical therapy or phototherapy
• Able to sign the informed consent

Exclusion criteria

• Diagnosis of PsA2 according to CASPAR
• Any known rheumatic disease, positive rheumatoid factor/anti-citrullinated protein antibodies, prior treatment with anti-rheumatic drugs
• Treatment with systemic corticosteroids within 12 weeks or 5 half-lives of screening
• Obesity impeded ultrasound examination
• Pregnant or lactating women or women with plan for conception 5 months before or after treatment
• Participated in other clinical trials
• Concurrent significant medical problems, including but not limited to the following: uncontrolled hypertension (systolic blood pressure ≥ 160 mmHg and/or diastolic blood pressure ≥ 95 mmHg), congestive heart failure (NYHA class III or IV), total white blood cell count \< 2500/μl, or platelets \< 100,000/μl or neutrophils \< 1500/μl or hemoglobin \< 8.5 g/dL at screening.
• Any liver function abnormality: aspartate aminotransferase (AST) \> 2xULN, alanine aminotransferase (ALT) \> 2xULN, total bilirubin (TBIL) \> 2xULN
• Abnormal renal function: serum creatinine \> 2.0 mg/dl
• History of ongoing, chronic or recurrent infectious disease or evidence of tuberculosis infection, defined as a positive PPD skin test or Mycobacterium tuberculosis interferon-gamma release assay (IGRA) test.
• Current or relevant history of human immunodeficiency virus (HIV), hepatitis B or hepatitis C infection.
• History of lymphoproliferative disease, or any known malignancy, or history of malignancy of any organ system within the past 5 years
• Unable or unwilling to undergo repeated venipuncture
• History of alcohol or drug abuse or evidence of abuse within 6 months prior to baseline
• History of hypersensitivity to any component of the study drug
• Did not accept live vaccines within 4 weeks prior to enrollment, do not have plan of vaccination program during the study, and no live vaccines are planned \> 6 months after the last dose of the study (herpes zoster vaccine \> 12 months)