Deucravacitinib offers new hope for those with moderate-to-severe plaque psoriasis.
Raj Chovatiya, MD, PhD, and assistant professor of dermatology at the Northwestern University Feinberg School of Medicine in Chicago, Illinois, discusses Bristol Myers Squibb's deucravacitinib, a new oral therapy for the treatment of psoriasis. He also discusses a select number of autoimmune disorders such as lupus, psoriatic arthritis and inflammatory bowel disease.
Hi there, my name is Dr. Raj Chovatiya, and I'm an assistant professor of dermatology and director of the Center for Eczema and Itch at the Northwestern University Feinberg School of Medicine. So, let's spend a couple of minutes today talking about what I think is one of the most exciting advancements that we've had this year in dermatology, and there have been a lot, deucravacitinib. So, deucravacitinib, what is it? It's a first-in-class selective oral inhibitor of tyrosine kinase 2, or TYK2, which you may have heard of. Now, TYK2 is a member of the larger Janus kinase family. So, it's a family that includes other proteins like JAK one, 2, and 3, and TYK2 is exciting because it's actually responsible for the signaling of a lot of important cytokines we think about in psoriasis, IL-23,IL-12, type-1 interferons, things that we've learned a lot more about over the past couple of decades. Now, deucravacitinib is particularly unique because it's an allosteric inhibitor, meaning that it actually binds to a regulatory domain of TYK2 and avoids broader inhibition of the active sites of other JAK proteins. The other exciting thing is in addition to psoriasis, which we'll talk about in just a second, there's multiple immune-mediated diseases in which deucravacitinib is being studied. So, psoriatic arthritis, lupus, and inflammatory bowel disease to name a few. Now, when you think about psoriasis, a condition that affects millions, we know there's a huge comorbid health burden, really a lot of chronic need for this condition, and in particular, not many options available for targeted directed oral therapy. So, the POETYK phase 3 trial program, which studied deucravacitinib compared to placebo and currently the other targeted oral therapy on the market, apremilast for psoriasis, found that the majority of patients after 16 weeks treated with deucravacitinib achieved that PASI 75 benchmark we're looking for, almost at rates up to about 60%.
Additionally, the majority of people got to the point of being clear, almost clear on that PGA scale that we talk about, greater than 50%. And these responses even continued to increase when we looked at week 24 and beyond. A lot of other cool endpoints were met, including the Psoriasis Symptoms and Signs Diary and the Dermatology Life Quality Index, and what I think is an exciting bit of information: we always have one-year data to talk about, we now have 2-year data to talk about. It looks like the efficacy is really maintained throughout that entire time course. Now, the other question that a lot of folks have is adverse events. What does that look like? The good news is this agent that's achieving biologic-like efficacy in an oral form, mild to moderate severity, the most common things were sort of some of the common things we see in a lot of trials. And these are pharyngitis, upper respiratory tract infection and headache. And the good news is across all the phase 3 trials, things that we think about with a lot of other JAK inhibitors include malignancy, major adverse cardiovascular events, venous thromboembolic events, serious infections, and these are all generally low and consistent across active treatment groups. To me, a really big, exciting advancement in the field and I really can't wait to see patients have more options when it comes to control of their moderate to severe psoriasis.