Deucravacitinib Improves PASI Scores in Patients with Plaque Psoriasis

Jeffrey M Sobell, MD

Credit: Tufts Medical Center

Patients with moderate to severe plaque psoriasis receiving deucravacitinib exhibited efficacy improvements, including Psoriasis Area and Severity Index (PASI) scores and static Physician Global Assessment (sPGA) response rates, according to data presented at the 2023 Fall Clinical Dermatology Conference.¹ These results, which were observed at week 16, continued to improve to week 24 and were maintained through week 52 in those receiving a continuous dose of the treatment.

The drug is an oral selective, allosteric tyrosine kinase 2 (TYK2) inhibitor, which mediates the signaling of cytokines associated with the pathogenesis of psoriasis.

“Deucravacitinib uniquely binds to the regulatory domain of TYK2 rather than do the catalytic domain where Janus kinase (JAK) inhibitors bind, representing the first in a new class of small molecules,” wrote a team of investigators led by Jeffrey M Sobell, MD, dermatologist and associate professor at Tufts Medical Center in Boston, MA.

In the POETYK PSO-2 and PSO-2 trials, investigators evaluated the efficacy of treatment by using measures of disease severity, PASI scores and body surface area (BSA) involvement at baseline among adult patients with moderate to severe plaque psoriasis receiving either deucravacitinib or placebo. Disease severity was defined as a PASI score of ≥12, BSA involvement ≥10%, and sPGA ≥3. Patients initially randomized to receive placebo crossed over to deucravacitinib at week 16.

Primary endpoints included the a 75% reduction of PASI (PASI 75) from baseline and an sPGA score of 0 or 1 with a ≥2-point improvement from baseline at the 16-week mark. Efficacy was evaluated based on the achievement of PASI 75, PASI 90, and PASI 100. Nonresponse was defined as patients with missing data or those who discontinued treatment prior to week 16. Comparison groups included patients treated with deucravacitinib through week 24 and placebo through week 16 and those who received continuous treatment from baseline though week 52, and placebo crossovers.

Patients enrolled in the studies had comparable demographics across treatment groups as well as PASI and BSA subgroups. Patients in the deucravacitinib group had higher response rates compared with placebo at week 16, regardless of the extent of baseline PASI score or BSA involvement. PASI 17, PASI 90, PASI 100, and sPGA 0 response rates were similar overall in the subgroup analysis and had minor numerical differences reported across baseline BSA and PASI scores. Patients receiving deucravacitinib had higher PASI and BSA scores throughout the study period compared with placebo.

References

1. ^{Sobell J, Elewski B, Banerjee S, Balagula E, et al. Deucravacitinib, an oral, selective, allosteric tyrosine kinase 2 inhibitor, in moderate to severe plaque psoriasis: efficacy by baseline body surface area (BSA) involvement and baseline Psoriasis Area and Severity Index (PASI). Presented at: Fall Clinical Dermatology 2023 Conference. Las Vegas, NV. October 19 – 22, 2023.}