Long-term impact of secukinumab on the prevention of psoriatic arthritis in patients with psoriasis: a 5-year pooled analysis of the ERASURE, FIXTURE and SCULPTURE studies

Ulrich Mrowietz¹, Laura Coates², Diamant Thaçi³, Mark Lebwohl⁴, Bardur Sigurgeirsson⁵, Richard B. Warren⁶, Richard G. Langley⁷, Andreas Clemens⁸, Cynthia Vizcaya⁸, Weibin Bao⁹, Kim Hoyt¹⁰, Lara Gómez¹¹ and Robert Bissonnette¹², ¹Department of Dermatology, University Medical Center Schleswig-Holstein, Kiel, Germany, ²Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, England, United Kingdom, ³Institute and Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany, ⁴Icahn School of Medicine at Mount Sinai, New York, NY, ⁵University of Iceland, Faculty of Medicine, Department of Dermatology,, Reykjavik, Iceland, ⁶Dermatology Centre, Northern Care Alliance, NHS Foundation Trust & Division of Musculoskeletal and Dermatological Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom, ⁷Dalhousie University, Halifax, NS, Canada, ⁸Novartis Pharma AG, Basel, Switzerland, ⁹Novartis Pharmaceuticals Corporation, Hanover, NJ, ¹⁰Novartis Pharmaceuticals Corporation, East Hanover, NJ, ¹¹Novartis Farmaceutica, Madrid, Spain, ¹²Innovaderm, Montreal, Québec, Canada

Meeting: ACR Convergence 2025

Keywords: Biologicals, clinical trial, Interleukins, prevention, Psoriatic arthritis

Session Information

Date: Monday, October 27, 2025

Title: (1434–1466) Spondyloarthritis Including Psoriatic Arthritis – Treatment Poster II

Session Type: Poster Session B

Session Time: 10:30AM-12:30PM

Background/Purpose: Secukinumab is a fully human monoclonal antibody that selectively inhibits interleukin-17A, demonstrating robust and sustained efficacy in moderate to severe psoriasis (PsO) and psoriatic arthritis (PsA) with a good safety profile in long-term trials.1-3 Besides its efficacy in PsA, secukinumab may have a preventive effect in patients with PsO without clinical signs of PsA. Pooled clinical trials of secukinumab (ERASURE, FIXTURE and SCULPTURE) provide valuable data sets that can help in understanding PsA prevention with secukinumab treatment. This study aimed to explore the efficacy of secukinumab in preventing PsA in patients with PsO using pooled data from the ERASURE, FIXTURE and SCULPTURE trials and to indirectly compare these data with historical data in patients who were biologic-naïve.4

Methods: Patients with moderate to severe PsO (with no medical history of PsA at baseline) who were treated with secukinumab 300 mg through up to 5-year follow-up were included in this analysis. The incidence of PsA within the studies was assessed using exposure-adjusted incidence rates (EAIRs; incidence rate/100 patient-years [PY]). The preferred term ‘psoriatic arthropathy’ in the reported adverse events was used to capture the incident PsA. The time to develop PsA was estimated using Kaplan-Meier analysis. Efficacy was measured using Psoriasis Area and Severity Index (PASI) 90 and 100 responders (as observed data).

Results: Overall, 673 patients with active PsO without PsA were included in the analysis (mean age: 45.2 years; male: 71.8%; mean body mass index: 28.9 kg/m2; mean time since diagnosis: 16.1 years). In total, 8% (N&#3f54), 11.3% (N&#3f76), 34.5% (N&#3f232) and 46.2% (N&#3f311) patients had < 2, 2- < 5, 5- < 15 and ≥15 years of disease duration, respectively. Overall, 18.3% of patients were biologic-experienced before the start of secukinumab. All patients had a PASI score of ≥10. After 5 years of treatment and a total exposure of 1831 PY, most patients (659/673 patients; 97.9%) did not experience PsA (Fig. 1). This translates into an EAIR of 0.76 (95% CI: 0.42,1.28). An 8-year prospective observational study previously reported a yearly PsA incidence rate of 2.7/100 patients in biologic-naïve patients with PsO without PsA.4 When we indirectly compared these data with current data from pooled clinical trials, we found that incidence rate of PsA development was ~72% lower with secukinumab. At Year 5 of secukinumab treatment, 36.5% and 63.9% of patients achieved skin clearance (PASI 100) and PASI 90, respectively (Table 1).

Conclusion: These findings support the hypothesis that secukinumab may prevent PsA development in patients with PsO and suggest a potential protective effect against PsA. Additionally, secukinumab-treated patients demonstrated effective and sustained long-term control over skin clearance. References:1. Langley RG, et al. Br J Dermatol. 2023;188:198-2072. Bissonnette R, et al. J Eur Acad Dermatol Venereol. 2018;32:1507-14. 3. Sun R, et al. Dermatol Ther (Heidelb). 2024;14:729-43. 4. Eder L. Arthritis Rheumatol. 2016;68:915-23.

Table 1. Efficacy of secukinumab in patients with psoriasis without PsA at baseline over a 5-year follow-up period.

Figure 1: Kaplan-Meier Curve for PsA development in patients with psoriasis without PsA at baseline over a 5-year follow-up period.

Disclosures: U. Mrowietz: AbbVie, 1, 5, 6, Aditxt, 1, Almirall, 1, Amgen, 1, Biogen, 1, Boehringer-Ingelheim, 1, Bristol-Myers Squibb(BMS), 1, Eli Lilly, 1, Immunic Therapeutics, 1, Janssen-Cilag, 1, LEO Pharma, 1, Merck/MSD, 1, Novartis, 1, Phi-Stone, 1, selectION, 1, Sharp & Dohme, 1, 5, 6, UCB, 1, UNION therapeutics, 1, 5, 6; L. Coates: AbbVie, 2, 5, 6, Amgen, 2, 5, 6, Biogen, 6, BMS, 2, Boehringer Ingelheim, 2, Celgene, 2, 5, 6, Domain, 2, Eli Lilly and Company, 2, 5, 6, Galapagos, 2, 6, Gilead, 2, 5, 6, GSK, 6, Janssen, 2, 5, 6, Medac, 6, MoonLake Immunotherapeutics, 2, Novartis, 2, 5, 6, Pfizer, 2, 5, 6, UCB, 2, 5, 6; D. Thaçi: AbbVie, 1, 2, 5, 12, Investigator, Almirall, 1, 2, 12, Investigator, Amgen, 1, 2, 12, Investigator, Boehringer-Ingelheim, 1, 2, 12, Investigator, Bristol Myers Squibb, 1, 2, 12, Investigator, Celltrion, 1, 2, 12, Investigator, Eli Lilly and Company, 1, 2, 12, Investigator, Fresenius-Kabi, 2, 5, Galderma, 1, 2, 12, Investigator, Johnson & Johnson, 1, 2, 12, Investigator, Kyowa Kirin, 1, 2, 12, Investigator, L’Oreal, 1, 2, 12, Investigator, LEO Pharma, 1, 2, 5, 12, Investigator, New Bridge, 1, 2, 12, Investigator, Novartis, 1, 2, 12, Investigator, Pfizer, 1, 2, 12, Investigator, Regeneron, 1, 2, 12, Investigator, Samsung, 1, 2, 12, Investigator, Sanofi, 1, 2, 12, Investigator, Sun-Pharma, 1, 2, 5, Target-RWE, 1, 2, 12, Investigator, UCB, 1, 2, 12, Investigator, Vichy, 1, 2, 12, Investigator; M. Lebwohl: AbbVie, 5, Almirall, 2, AltruBio Inc, 2, Apogee Therapeutics, 2, Arcutis Biotherapeutics, 2, 5, AstraZeneca, 2, Atomwise, 2, Avotres, 2, 5, Boehringer Ingelheim, 2, 5, Bristol Myers Squibb, 2, Cara Therapeutics, 5, Castle Biosciences, 2, Celltrion Biosciences, 2, Clexio Biosciences, 5, CorEvitas, 2, Dermavant, 2, 5, Dermsquared, 2, Eli Lilly, 5, Evommune, Inc, 2, Facilitation of International Dermatology Education, 2, Forte Biosciences, 12, Facilitation of International Dermatology Education, Galderma, 12, Facilitation of International Dermatology Education, Genentech, 12, Facilitation of International Dermatology Education, Incyte, 5, 12, Facilitation of International Dermatology Education, Inozyme, 5, Janssen, 5, LEO Pharma, 12, Facilitation of International Dermatology Education, Meiji Seika Pharma, 12, Facilitation of International Dermatology Education, Mindera, 12, Facilitation of International Dermatology Education, Mirium Pharmaceuticals, 2, Mount Sinai, 3, Pfizer, 5, 12, Facilitation of International Dermatology Education, Sanofi-Regeneron, 5, 12, Facilitation of International Dermatology Education, Seanergy, 12, Facilitation of International Dermatology Education, Strata, 12, Facilitation of International Dermatology Education, Takeda, 12, Facilitation of International Dermatology Education, Trevi Therapeutics, 12, Facilitation of International Dermatology Education, UCB, 5, Verrica Pharmaceuticals, 2; B. Sigurgeirsson: Novartis, 12,; R. Warren: AbbVie, 2, 5, 6, Almirall, 2, 5, 6, Amgen, 2, 5, Arena, 2, Astellas, 2, Avillion, 2, Biogen, 2, Boehringer Ingelheim, 2, Bristol Myers Squibb, 2, 6, Celgene, 2, 5, DICE Therapeutics, 2, Eli Lilly and Company, 2, 5, 6, GSK, 2, Janssen, 2, 5, 6, LEO Pharma, 2, 5, Meiji Pharma, 2, Novartis, 2, 5, 6, Pfizer, 2, 5, RAPT Therapeutics, 2, Sanofi, 2, Sun Pharma, 2, UCB, 2, 5, Union, 2; R. Langley: AbbVie, 1, 6, 12, Principal investigator, Amgen, 1, 6, 12, Principal investigator, Boehringer-Ingelheim, 1, 12, Principal investigator, Celgene, 1, 6, 12, Principal Investigator, Eli Lilly and Company, 1, 6, 12, Principal Investigator, LEO Pharma, 1, 6, 12, Principal Investigator, Merck, 1, 6, 12, Principal Investigator, Novartis, 1, 6, 12, Principal Investigator, Pfizer, 1, 6, 12, Principal Investigator, UCB, 1, 12, Principal Investigator; A. Clemens: Novartis, 3; C. Vizcaya: Novartis, 3; W. Bao: Novartis, 3, 11; K. Hoyt: Novartis, 3; L. Gómez: Novartis, 3; R. Bissonnette: AbbVie, Alumis, Amgen, AnaptysBio, Arcutis, BMS/Celgene, Dermavant, Eli Lilly, J&J (Janssen), LEO Pharma, Nimbus, Takeda, UCB Pharma, VentyxBio, Vyne, 12,, 1, 2, 5, 6, Innovaderm Research, 3, 8, Xencor, Zai Lab and Zura Bio, 12,, 1, 2, 5, 6.

To cite this abstract in AMA style:

Mrowietz U, Coates L, Thaçi D, Lebwohl M, Sigurgeirsson B, Warren R, Langley R, Clemens A, Vizcaya C, Bao W, Hoyt K, Gómez L, Bissonnette R. Long-term impact of secukinumab on the prevention of psoriatic arthritis in patients with psoriasis: a 5-year pooled analysis of the ERASURE, FIXTURE and SCULPTURE studies [abstract]. Arthritis Rheumatol. 2025; 77 (suppl 9). https://acrabstracts.org/abstract/long-term-impact-of-secukinumab-on-the-prevention-of-psoriatic-arthritis-in-patients-with-psoriasis-a-5-year-pooled-analysis-of-the-erasure-fixture-and-sculpture-studies/. Accessed .

ACR Meeting Abstracts - https://acrabstracts.org/abstract/long-term-impact-of-secukinumab-on-the-prevention-of-psoriatic-arthritis-in-patients-with-psoriasis-a-5-year-pooled-analysis-of-the-erasure-fixture-and-sculpture-studies/