Deucravacitinib Improves Joint Symptoms in Psoriatic Arthritis

Patients with plaque psoriasis who screened positive for psoriatic arthritis in the POETYK PSO-1 and POETYK PSO-2 trials reported greater improvements in joint activity and joint pain scores when treated with deucravacitinib (Sotyktu) versus placebo or apremilast (Otezla), according to a study presented at the American College of Rheumatology annual meeting.

In this MedPage Today video, Michael Putman, MD, of the Medical College of Wisconsin in Milwaukee, discusses the phase II study results, and why he thinks treatment with deucravacitinib will continue to be successful for psoriatic arthritis in future trials.

Following is a transcript of his remarks:

So I want to talk about abstract 2253 today, which evaluated the use of deucravacitinib among patients with psoriatic arthritis. Now I’m excited about deucravacitinib in the TYK [tyrosine kinase] inhibitor class, I think it’s one of the next big things that’s coming down the pipeline for rheumatology. But the psoriatic [arthritis] data as usual, has been a little slow to materialize. We have a whole lot on psoriasis.

Later in 2022 they did publish the results of a phase II trial that looked pretty good for deucravacitinib among patients with psoriatic arthritis. But they’re sitting on all this psoriasis data, that over a thousand people that went through POETYK-1 and POETYK-2, which is the trials program for psoriasis. And at the meeting this year, we saw the subset of patients from those trials who had joint symptoms, which I thought was very useful.

So this was presented, and what they found was 185 patients who had psoriatic arthritis, that’s 11% of the psoriasis trials agenda, but that’s enough to say something useful. And so what they looked at were the joint scores, specifically the visual analog scale scores. And they compared them to both placebo and apremilast, which is useful. I love head-to-head studies and that sort of stood out to me here.

Deucravacitinib relatively easily beat placebo, but it also beat apremilast for joint pain and joint scores. So there’s a decrease of negative 9, give or take, for apremilast on a visual analog scale and [negative] 23 on a visual analog scale for deucravacitinib.

So to me that’s pretty encouraging. I have kind of expected that this would be good for joints, but looks like it’s about twice as good as apremilast, as just sort of a baseline. So looking forward to phase IIIs and hoping to be able to use this in the future. But I think very encouraging data.

The translation of phase II trials to phase III trials that are successful and then to FDA approval is actually remarkably poor. So when you read a phase II study, you should always take with a grain of salt. There’s sort of a mass of information though behind some that makes you more encouraged. So for this one, the phase II trials for TYKs have been really encouraging.

And then the other thing is there’s sort of a biologic plausibility here that I think is really helpful. We know that JAK/STAT [Janus kinase/signal transducers and activators of transcription] pathway has been really helpful. TYK is sort along that, but beside it, so we’re kind of praying that we’ll get some of the benefits without the side effects. And the last thing, especially for this, is that this worked in psoriasis. It’s very clear that this works for psoriasis, and so I expect it to work for psoriatic [arthritis] as well.

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