Deucravacitinib Therapy May Address Plaque Psoriasis When Apremilast Fails

Deucravacitinib was found to be efficacious at treating patients with moderate to severe plaque psoriasis who had inadequate response to apremilast, according to results of a study presented at the 2022 Annual Meeting of the American Academy of Dermatology (AAD), held from March 25 to 29, 2022 in Boston, Massachusetts.

Deucravacitinib is a novel, selective tyrosine kinase two (TKY2) inhibitor that has a distinct mechanism of action. During phase 2 and 3 trials, deucravacitinib was found to be effective for the treatment of moderate to severe plaque psoriasis and psoriatic arthritis.

In the pivotal phase 3 trials POETYK PSO-1 (n=666) and PSO-2 (n=1020), adults with moderate to severe plaque psoriasis were randomly assigned in a 1:2:1 ratio to receive 30 mg apremilast twice daily, 6 mg deucravacitinib once daily, or placebo for 24 weeks. All patients were eligible for a long-term extension through week 52. Patients who were poor responders to apremilast at week 24 were switched to deucravacitinib during the extension period. Efficacy was evaluated at week 16, 24, and 52 using Psoriasis Area and Severity Index (PASI), Physician’s Global Assessment (sPGA), and patient-reported outcomes.

In the PSO-1 and PSO-2 trials, 50 and 75 patients switched to deucravacitinib after failing to reach the PASI 50 and PASI 75 response outcomes on apremilast therapy, respectively.

After switching to deucravacitinib, the response rates at 52 weeks were 46.3% and 42.3% achieving PASI 75 and 29.6% and 18.0% achieved PASI 90 endpoints, respectively. Compared with baseline, PASI scores decreased by an average -73.1% among patients in the PSO-1 trial and by -67.0% among patients in the PSO-2 trial.

In addition, after switching to deucravacitinib, 42.6% of PSO-1 and 27.0% of PSO-2 participants who failed to respond to apremilast achieved an sPGA cleared or almost cleared status (0/1).

Using the Dermatology Life Quality Index (DLQI), 25.5% of PSO-1 and 24.3% of PSO-2 participants reported little symptom impact on their life (0/1) and the change from baseline in the Psoriasis Symptoms and Signs (PSSD) scores decreased by -30.8 and -28.5 points, respectively.

These data indicated to the investigators that deucravacitinib was effective at treating moderate to severe plaque psoriasis among patients who had inadequate response to apremilast at week 24.

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.

Reference

Armstrong AW, Warren RB, Sofen H, et al. Deucravacitinib, an oral, selective tyrosine kinase 2 (TYK2) inhibitor, in patients with moderate to severe plaque psoriasis who had inadequate responses to apremilast at week 24 in the phase 3 POETYK PSO-1 and PSO-2 trials. Presented at: the 2022 AAD Annual Meeting; March 25-29, 2022. Abstract/Poster 34658.