Deucravacitinib for treating moderate to severe plaque psoriasis

Deucravacitinib for treating moderate to severe plaque psoriasis

Deucravacitinib

• is an oral Tyrosine kinase 2 (TYK2) selective inhibitor
• has shown a good efficacy and safety profile up to 52 weeks in moderate to severe psoriasis (1)

NICE state:

• deucravacitinib is recommended as an option for treating moderate to severe plaque psoriasis in adults, only if:
  • the Psoriasis Area and Severity Index (PASI) score is 10 or more and the Dermatology Life Quality Index (DLQI) score is more than 10
  • the condition has not responded to other systemic treatments, including ciclosporin, methotrexate and phototherapy, or these options are contraindicated or not tolerated
  • the company provides deucravacitinib according to the commercial agreement
• consider stopping deucravacitinib between 16 weeks and 24 weeks if there has not been at least a 50% reduction in the PASI score (PASI 50) from when treatment started.
• consider stopping deucravacitinib at 24 weeks if the psoriasis has not responded adequately. An adequate response is defined as
  • a 75% reduction in the PASI score (PASI 75) from when treatment started or
  • a 50% reduction in the PASI score (PASI 50) and a 5-point reduction in DLQI from when treatment started
• the NICE committee state:
  • "...Clinical trial evidence shows that deucravacitinib improves symptoms of plaque psoriasis compared with placebo and apremilast. Deucravacitinib was indirectly compared with apremilast, dimethyl fumarate and several systemic biological treatments. The indirect comparison suggests it improves symptoms better than apremilast and dimethyl fumarate, and works as well as some biological treatments but not as well as others..."

Notes:

• TYK2 is a member of the Janus kinases family that is responsible for mediating the immune response associated with psoriasis through interleukin (IL)-12, IL-23 and type I interferons (IFN-alpha and IFN-beta)

Reference:

• Le AM, Puig L, Torres T. Deucravacitinib for the Treatment of Psoriatic Disease. Am J Clin Dermatol. 2022 Nov;23(6):813-822. doi: 10.1007/s40257-022-00720-0. Epub 2022 Aug 12. PMID: 35960487; PMCID: PMC9372960.
• NICE (June 2023). Deucravacitinib for treating moderate to severe plaque psoriasis