Deucravacitinib improves PASI scores in patients with plaque psoriasis

Patients with moderate-to-severe plaque psoriasis receiving deucravacitinib showed improvements in efficacy, including Psoriasis Area and Severity Index (PASI) scores and static Physicians’ Global Assessment (sPGA) response rates, according to data presented at the Fall 2023 Clinical Dermatology Conference.¹ These results, observed at week 16, continued to improve until week 24 and were maintained until 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 cytokine signaling associated with the pathogenesis of psoriasis.

Deucravacitinib binds only to the regulatory domain of TYK2 rather than the catalytic domain where Janus kinase (JAK) inhibitors bind, representing the first in a new class of small molecules, wrote a team of researchers 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, researchers assessed treatment effectiveness using measures of disease severity, PASI scores, and body surface area (BSA) involvement at baseline in adult patients with moderate to severe plaque psoriasis receiving either deucravacitinib or deucravacitinib. placebo. Disease severity was defined as a PASI score of 12, BSA impairment of 10%, and sPGA of 3. Patients initially randomized to placebo were crossed over to deucravacitinib at week 16.

Primary endpoints included a 75% reduction in PASI (PASI 75) from baseline and an sPGA score of 0 or 1 with a 2-point improvement from baseline at 16 weeks. Efficacy was assessed based on achievement of PASI 75, PASI 90 and PASI 100 levels. Non-response was defined as patients with missing data or those who stopped treatment before 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 through week 52, and crossovers with placebo.

Patients enrolled in the studies had comparable demographic characteristics across the treatment groups as well as the PASI and BSA subgroups. Patients in the deucravacitinib group had higher response rates than 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 overall similar in the subgroup analysis and had minor numerical differences reported between baseline BSA and PASI scores. Patients receiving deucravacitinib had higher PASI and BSA scores throughout the study period compared to placebo.

The 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 Based on Baseline Body Surface Area (BSA) Involvement and Area and Severity Index basic psoriasis (PASI). Presented at: Fall Clinical Dermatology Conference 2023. Las Vegas, Nevada. From October 19 to 22, 2023.}