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Safety Profile of TYK2 Inhibitors in Plaque Psoriasis Treatment

Opinion
Video

Laura Bush, DMSc, PA-C, and Terry Faleye, MPAS, PA-C, reviews the safety data of TYK2 inhibitors compared to other systemic agents in the same class.

Alexa Hetzel, MS, PA-C: Laura, what’s the safety profile for 2 inhibitors compared to other systemic treatments?

Laura Bush, DMSc, PA-C: Yeah, so like Lakshi said, what was nice about the 52-week studies is that there was no new safety. It has a pretty good safety profile. As far as adverse effects [AEs], the top 5 AEs were very similar in nature to apremilast as far as there was no greater adverse effects seen. There was some folliculitis and acne seen, so I counsel my patients on that. There were some elevated triglycerides, so if I think a patient is going to have a problem with that, I will check that. But that was not seen to worsen over the time period. There were some increases in incidents of herpes zoster, so I will counsel my patient on that and what to watch out for. But overall, it had a pretty strong safety profile for an oral agent, and it had significant less [adverse effects]. I think it’s a win.

Alexa Hetzel, MS, PA-C: Have you seen patients with acne?

Laura Bush, DMSc, PA-C: I have seen a couple, and you can basically treat through the acne.

Alexa Hetzel, MS, PA-C: I [had] one patient who really cared; I treated her, [and] it was no big deal. [However], another patient didn’t care and it went away on its own, which was nice. If somebody doesn’t mind so much, it’s kind of transient and I haven’t seen it reflare up, but it’s something to be aware of. Have you seen any zoster cases, Terry?

Terry Faleye, MPAS, PA-C: I have not, thank goodness. I don’t want them to have that. I’ve seen a few cases of folliculitis and acne and was able to manage through it, and we kind of come out on the other side and just continue on. [However], I haven’t had any discontinuations due to therapy in that regard.

Laura Bush, DMSc, PA-C: Yeah, and even in the zoster cases, they weren’t severe zoster that were reported when I looked at the studies.

Terry Faleye, MPAS, PA-C: Yeah, it just speaks to, like we talked about, the [mechanism of action] in regards to the drug and just knowing it is definitely having that TYK2 [tyrosine kinase 2] and that selective TYK2 inhibition. We’re not seeing the same type of events or potential adverse effects that we would see with the JAKs [Janus kinase inhibitors]. For a long time, there was that weird reputation [where] people were [saying] it’s part of the JAK kinase family. It’s them understanding it acts differently and it’s that selectivity that makes it different.

Alexa Hetzel, MS, PA-C: I always use the Kardashian reference to help people understand. You have the last name, Kardashian, which is the whole family. That’s where a lot of the JAK inhibitors are binding to the ATP site. So that last name is what makes them a little more dramatic and notable. Then…because Rob [Kardashian] is the least dramatic—at least for now—he’s [the] TYK2, because he’s not as dramatic as the rest of his sisters. And we’re much more specific with the deucravacitinib binding to just that 1 individual person instead of the whole family as an umbrella.

Laura Bush, DMSc, PA-C: I’ll always remember the JAK family now.

Jennifer Conner, MPAS, PA-C: That is very brilliant.

Laura Bush, DMSc, PA-C: I’m glad you said that; that is a great analogy.

Alexa Hetzel, MS, PA-C: It just makes it so easy for people, and as soon as I bring up Kardashians, they’re smiling. It breaks down that tension you can sometimes get in the room, [then move forward].

Terry Faleye, MPAS, PA-C: And everybody can relate to each member within that whole.

Alexa Hetzel, MS, PA-C: Even if you don’t watch the show.

Terry Faleye, MPAS, PA-C: Yeah, exactly.

Alexa Hetzel, MS, PA-C: I don’t watch the show, but I know them.

Transcript edited for clarity.

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