Clinical Overview: Deucravacitinib for the Treatment of Moderate to Severe Plaque Psoriasis

Introduction

The FDA has officially accepted the investigational drug, deucravacitinib for review. Deucravacitinib is designed to work as a tyrosine kinase 2 (TYK2) inhibitor for the treatment of patients with moderate to severe plaque psoriasis.¹

Deucravacitinib will be the first TYK2 inhibitor approved for treatment of disease. Currently, deucravacitinib is in the midst of the POETYK PSO-2 trials.

Patients participating in these trials have achieved a Psoriasis Area and Severity Index (PASI 75), which means that after 16 weeks of treatment, they have at least 75% improvement in symptoms.²

The researchers have also observed a static Physician’s Global Assessment (sPGA) score of clear or almost clear. When deucravacitinib was compared to apremilast, 58.7% and 53.6% of patients achieved PASI 75 throughout the 2 trials compared to apremilast, with which 35.1% and 40.2% of patients achieved the same, respectively.³

Deucravacitinib increased and maintained its efficacy at the 6-month and 1-year check-in. Overall, this drug will be a possible solution for patients with psoriasis who wish to have the convenience of an oral medication.

Mechanism of Action

TYK2 is an intracellular kinase involved in signaling of the cytokines that lead to plaque psoriasis. Deucravacitinib selectively inhibits TYK2 via allosteric mechanism inhibiting interleukin (IL)-12, IL-23, and type 1 interferon (IFN) pathways.² Deucravacitinib binds to the nonconserved regulatory domain of the kinase effectively antagonizing TYK2.

Dosage and Administration⁴

Deucravacitinib’s proposed dosing is 3 mg twice daily, 6 mg twice daily, 12 mg once daily by mouth (in trial stages).

Adverse Events (AEs)

The most common AEs include headache, nasopharyngitis, rash, and sinusitis.²

Warning and Precautions

Researchers suggest that this TYK2 Inhibitor appears to be a safer alternative to JAK class of medications.

Pregnancy and Lactation

Deucravacitinib has not yet been tested in pregnant or breastfeeding individuals.

About the Author

Christina Nault is a 2024 PharmD candidate at the University of Connecticut.

References

1. POS0198 EFFICACY AND SAFETY OF DEUCRAVACITINIB, AN ORAL, SELECTIVE TYROSINE KINASE 2 INHIBITOR, IN PATIENTS WITH ACTIVE PSORIATIC ARTHRITIS: RESULTS FROM A PHASE 2, RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL. BMJ Journals. Accessed March 7, 2022. https://ard.bmj.com/content/80/Suppl_1/314.2
2. Bristol Myers Squibb Announces Positive Topline Results from Second Pivotal Phase 3 Psoriasis Study Showing Superiority of Deucravacitinib Compared to Placebo and Otezla. Bristol Myers Squibb. February 2, 2021. Accessed March 7, 2022. https://news.bms.com/news/details/2021/Bristol-Myers-Squibb-Announces-Positive-Topline-Results-from-Second-Pivotal-Phase-3-Psoriasis-Study-Showing-Superiority-of-Deucravacitinib-Compared-to-Placebo-and-Otezla-apremilast/default.aspx
3. Bristol Myers’ next-gen immunology med busts Amgen’s Otezla in head-to-head study. April 23, 2021. Accessed March 7, 2022. https://endpts.com/bristol-myers-next-gen-immunology-med-busts-amgens-otezla-in-head-to-head-study-is-a-showdown-coming/
4. Deucravacitinib in Moderate to Severe Psoriasis: Clinical and Quality-of-Life Outcomes in a Phase 2 Trial. PubMed. January 13, 2022. Accessed March 7, 2022. https://pubmed.ncbi.nlm.nih.gov/35025062/