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Truong TM, Pathak GN, Singal A, Taranto V, Rao BK. Deucravacitinib: The First FDA-Approved Oral TYK2 Inhibitor for Moderate to Severe Plaque Psoriasis. Ann Pharmacother 2024; 58:416-427. [PMID: 37341177 DOI: 10.1177/10600280231153863] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023] Open
Abstract
OBJECTIVE The objective of this study was to review the safety and efficacy of deucravacitinib, a tyrosine kinase 2 (TYK2) inhibitor for moderate to severe plaque psoriasis. DATA SOURCES Literature was reviewed from MEDLINE and Clinicaltrials.gov up to December 2022 using the terms "deucravacitinib" and "BMS-986165." STUDY SELECTION Relevant articles in English relating to the pharmacodynamics, pharmacokinetics, efficacy, and safety of deucravacitinib were included. A total of 6 trial results were included. STUDY SELECTION AND DATA EXTRACTION Deucravacitinib showed clinical efficacy across all the phase II and III clinical trials. Excluding the long-term extension study, there were 2248 subjects across all studies, with 63.2% of patients receiving deucravacitinib 6 mg daily. Of these subjects, the average proportion achieving a PASI 75 (a reduction of greater than 75% in the Psoriasis Area and Severity Index) at week 16 was 65.1%. Patients receiving deucravacitinib 6 mg once daily had a higher rate of achieving both PASI 75 response and a Static Physician's Global Assessment (sPGA) score of 0 or 1, compared with oral apremilast 30 mg twice daily. The safety profile of deucravacitinib includes mild adverse events (AEs), most commonly nasopharyngitis, with serious AEs reported ranging from 1.35% to 9.5%. RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE IN COMPARISON WITH EXISTING MEDICATIONS While many available therapies for moderate to severe plaque psoriasis rely on an injectable dosage form or extensive monitoring, deucravacitinib can potentially reduce patient medication-related burden. This review summarizes the efficacy and safety of oral deucravacitinib for the treatment of severe plaque psoriasis. CONCLUSION Deucravacitinib shows a consistent efficacy and safety profile as the first oral TYK2 inhibitor approved for adult patients with moderate to severe plaque psoriasis who are eligible for systemic therapy or phototherapy treatment.
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Affiliation(s)
- Thu Minh Truong
- Department of Dermatology, Rutgers Robert Wood Johnson Medical School, Somerset, NJ, USA
- School of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Gaurav N Pathak
- School of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Amit Singal
- School of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA
| | | | - Babar K Rao
- Department of Dermatology, Rutgers Robert Wood Johnson Medical School, Somerset, NJ, USA
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Imafuku S, Okubo Y, Tada Y, Ohtsuki M, Colston E, Napoli A, Shao Y, Banerjee S, Morita A. Deucravacitinib, an oral, selective, allosteric tyrosine kinase 2 inhibitor, in Japanese patients with moderate to severe plaque, erythrodermic, or generalized pustular psoriasis: Efficacy and safety results from an open-label, phase 3 trial. J Dermatol 2024; 51:365-379. [PMID: 38268101 DOI: 10.1111/1346-8138.17074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 11/01/2023] [Accepted: 11/25/2023] [Indexed: 01/26/2024]
Abstract
Deucravacitinib, an oral, selective, allosteric tyrosine kinase 2 inhibitor, is approved in Japan for adult patients with plaque (PP), generalized pustular (GPP), and erythrodermic (EP) psoriasis who have had an inadequate response to conventional systemic therapies. This approval is based on results from the global phase 3 POETYK PSO-1 and PSO-2 trials in which deucravacitinib was associated with significantly improved efficacy outcomes compared with placebo in adults with moderate to severe plaque psoriasis, and results described here from POETYK PSO-4, an open-label, single-arm, phase 3 trial (NCT03924427), which evaluated the efficacy and safety of deucravacitinib 6 mg once daily in adult Japanese patients with PP, GPP, or EP. The coprimary endpoints were the proportion of patients achieving a ≥75% reduction from baseline in the Psoriasis Area and Severity Index (PASI 75) and a static Physician's Global Assessment score of 0 (clear) or 1 (almost clear) (sPGA 0/1) with at least a two-point improvement from baseline at week 16. Nonresponder imputation was used for missing data. Efficacy responses, adverse events (AEs), and serious AEs (SAEs) were recorded for up to 52 weeks. Seventy-four patients were treated (PP, n = 63; GPP, n = 3; EP, n = 8). At week 16, 76.2%, 66.7%, and 37.5% of patients with PP, GPP, and EP, respectively, had achieved PASI 75, and 82.5%, 0.0%, and 50.0% had achieved sPGA 0/1. Responses were overall maintained through week 52. AEs occurred in 74.6% of patients with PP, 100% of patients with GPP, and 87.5% of patients with EP. The most common AEs were nasopharyngitis and acne. Rates of SAEs and discontinuations were low. There were no deaths. Deucravacitinib was effective and well tolerated in Japanese patients with moderate to severe PP and in a limited number of patients with GPP or EP.
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Affiliation(s)
- Shinichi Imafuku
- Department of Dermatology, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Yukari Okubo
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - Yayoi Tada
- Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan
| | - Mamitaro Ohtsuki
- Department of Dermatology, Jichi Medical University, Tochigi, Japan
| | | | | | - Yanqiu Shao
- Bristol Myers Squibb, Princeton, New Jersey, USA
| | | | - Akimichi Morita
- Department of Geriatrics and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Tsiogkas SG, Karamitrou EK, Grammatikopoulou MG, Zafiriou E, Bogdanos DP. Efficacy of tyrosine-kinase-2 and phosphodiesterase-4 inhibitors for scalp psoriasis: a systematic review and meta-analysis. Curr Med Res Opin 2024; 40:155-163. [PMID: 37997745 DOI: 10.1080/03007995.2023.2288280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 11/22/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVES Psoriasis of the scalp is challenging to manage. The only approved oral tyrosine kinase 2 and phosphodiesterase 4 inhibitors for psoriasis are deucravacitinib and apremilast. The aim of this study was to explore their efficacy for scalp psoriasis utilizing data from randomized controlled trials. METHODS We searched Medline, Scopus, Web of Science, CENTRAL, and ClinicalTrials.gov up to August 4, 2023. To determine risk of bias, the revised Risk of Bias assessment tool 2.0 was used. Inverse variance random effects meta-analyses were executed. Heterogeneity was assessed utilizing Q and I2 statistics. Pre-determined outcomes included the proportion of participants with cleared scalp skin (Scalp Physician's Global Assessment [ScPGA] of 0/1), mean change in Psoriasis Scalp Severity Index (PSSI), and mean improvement in Dermatology Life Quality Index (DLQI). RESULTS Ten RCTs fulfilled inclusion criteria. Both apremilast (RR = 2.41, 95% CI = 2.08-2.79, Tau2 = 0, I2 = 0) and deucravacitinib (RR = 3.86, 95% CI = 3.02-4.94, Tau2 = 0, I2 = 0) were more effective in inducing ScPGA of 0/1 at 16 weeks compared to placebo. Furthermore, deucravacitinib was more effective than apremilast (RR = 1.70, 95% CI = 1.44-2.00, Tau2 = 0, I2 = 0). An analysis could not be executed for the rest of the outcomes. CONCLUSIONS Apremilast and deucravacitinib are effective for scalp psoriasis. Deucravacitinib may be more efficient in clearing the scalp.
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Affiliation(s)
- Sotirios G Tsiogkas
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | | | - Maria G Grammatikopoulou
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Efterpi Zafiriou
- Department of Dermatology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Dimitrios P Bogdanos
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
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Yasen A, Tuoheti M, Tu B, Zhang C, Ding Y, Tang F, Wu Y. The correlation among Claudin-9, Tyrosine kinase-2, and Signal transducers and activators of transcription-3 expressions in non-functioning pituitary adenoma and invasiveness. Neuro Endocrinol Lett 2023; 44:537-546. [PMID: 38131177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 10/13/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Deeper studies on the pathological mechanism associated with invasiveness of non-functioning pituitary adenoma (NFPA) is imperative to find better treatments. This research was preliminarily conducted to investigate the correlation between the expression of Claudin-9 (CLDN9), Tyrosine kinase-2 (TYK2), Signal transducers and activators of transcription-3 (STAT3) and invasiveness in NFPA to illustrate the pathological mechanism. METHODS Clinical data and surgical specimens of 12 patients with NFPA were collected and divided into invasive and non-invasive NFPA groups, comprising six patients for each group. CLDN9, TYK2 and STAT3 transcription and expression levels in the NFPA tissues of the two groups were detected by quantitative real-time polymerase chain reaction (qRT-PCR), Western blotting (WB) and immunohistochemistry (IHC). The lentiviral plasmid transfection technique was used to develop a rat pituitary tumour GT1-1 cell line null control group (NC) and CLDN9-overexpressed experimental group (OE-CLDN9), and TYK2 and STAT3 transcription levels in the NC and OE-CLDN9 cell groups were detected using qRT-PCR. RESULTS The CLDN9 and STAT3 expressions were significantly higher in invasive than in non-invasive NFPA tissues, whereas the TYK2 expression in invasive NFPA tissues was significantly lower than that in non-invasive NFPA (p < 0.001); The STAT3 upregulated (p < 0.001) and the TYK2 downregulated (p < 0.01) after the CLDN9 overexpression. CONCLUSION Upregulated CLDN9 may increase the NFPA invasiveness through STAT3. In addition, low TYK2 expression might enhance the invasiveness in NFPA, which needs further studies to confirm. These results could provide a promising research leads for targeted treatment of NFPA.
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Affiliation(s)
- Abudukadier Yasen
- Department of Neurosurgery, Xinjiang Uygur Autonomous Region People's Hospital, Urumqi, Xinjiang, 830001, China
| | - Maimaitiyiming Tuoheti
- Department of Neurosurgery, Xinjiang Uygur Autonomous Region People's Hospital, Urumqi, Xinjiang, 830001, China
| | - Ba Tu
- Department of Pathology, Xinjiang Uygur Autonomous Region People's Hospital, Urumqi, Xinjiang, 830001, China
| | - Cheng Zhang
- Department of Neurosurgery, Xinjiang Uygur Autonomous Region People's Hospital, Urumqi, Xinjiang, 830001, China
| | - Yu Ding
- Department of Neurosurgery, Xinjiang Uygur Autonomous Region People's Hospital, Urumqi, Xinjiang, 830001, China
| | - Fey Tang
- Department of Neurosurgery, Xinjiang Uygur Autonomous Region People's Hospital, Urumqi, Xinjiang, 830001, China
| | - Yonggang Wu
- Department of Neurosurgery, Xinjiang Uygur Autonomous Region People's Hospital, Urumqi, Xinjiang, 830001, China
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Yarmolinsky J, Amos CI, Hung RJ, Moreno V, Burrows K, Smith‐Byrne K, Atkins JR, Brennan P, McKay JD, Martin RM, Davey Smith G. Association of germline TYK2 variation with lung cancer and non-Hodgkin lymphoma risk. Int J Cancer 2022; 151:2155-2160. [PMID: 35747941 PMCID: PMC9588593 DOI: 10.1002/ijc.34180] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/20/2022] [Accepted: 06/07/2022] [Indexed: 01/11/2023]
Abstract
Deucravacitinib, a novel, selective inhibitor of TYK2 is currently under review at the FDA and EMA for treatment of moderate-to-severe plaque psoriasis. It is unclear whether recent safety concerns (ie, elevated rates of lung cancer and lymphoma) related to similar medications (ie, other JAK inhibitors) are shared with this novel TYK2 inhibitor. We used a partial loss-of-function variant in TYK2 (rs34536443), previously shown to protect against psoriasis and other autoimmune diseases, to evaluate the potential effect of therapeutic TYK2 inhibition on risk of lung cancer and non-Hodgkin lymphoma. Summary genetic association data on lung cancer risk were obtained from a GWAS meta-analysis of 29 266 cases and 56 450 controls in the Integrative Analysis of Lung Cancer Risk and Aetiology (INTEGRAL) consortium. Summary genetic association data on non-Hodgkin lymphoma risk were obtained from a GWAS meta-analysis of 8489 cases and 374 506 controls in the UK Biobank and InterLymph consortium. In the primary analysis, each copy of the minor allele of rs34536443, representing partial TYK2 inhibition, was associated with an increased risk of lung cancer (OR 1.15, 95% CI 1.09-1.23, P = 2.29 × 10-6 ) and non-Hodgkin lymphoma (OR 1.18, 95% CI 1.05-1.33, P = 5.25 × 10-3 ). Our analyses using an established partial loss-of-function mutation to mimic TYK2 inhibition provide genetic evidence that therapeutic TYK2 inhibition may increase risk of lung cancer and non-Hodgkin lymphoma. These findings, consistent with recent reports from postmarketing trials of similar JAK inhibitors, could have important implications for future safety assessment of deucravacitinib and other TYK2 inhibitors in development.
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Affiliation(s)
- James Yarmolinsky
- Medical Research Council Integrative Epidemiology UnitUniversity of BristolBristolUK
- Population Health SciencesBristol Medical School, University of BristolBristolUK
| | | | - Rayjean J. Hung
- Lunenfeld‐Tanenbaum Research InstituteSinai HealthTorontoOntarioCanada
- University of TorontoTorontoOntarioCanada
| | - Victor Moreno
- Biomarkers and Susceptibility Unit, Oncology Data Analytics ProgramCatalan Institute of Oncology (ICO), L'Hospitalet de LlobregatBarcelonaSpain
- Colorectal Cancer Group, ONCOBELL ProgramBellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de LlobregatBarcelonaSpain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP)MadridSpain
- Department of Clinical Sciences, Faculty of MedicineUniversity of BarcelonaBarcelonaSpain
| | - Kimberley Burrows
- Medical Research Council Integrative Epidemiology UnitUniversity of BristolBristolUK
- Population Health SciencesBristol Medical School, University of BristolBristolUK
| | - Karl Smith‐Byrne
- Cancer Epidemiology Unit, Oxford Population HealthUniversity of OxfordOxfordUK
| | - Joshua R. Atkins
- Genomic Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO)LyonFrance
| | - Paul Brennan
- Genomic Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO)LyonFrance
| | | | - James D. McKay
- Genomic Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO)LyonFrance
| | - Richard M. Martin
- Medical Research Council Integrative Epidemiology UnitUniversity of BristolBristolUK
- Population Health SciencesBristol Medical School, University of BristolBristolUK
- University Hospitals Bristol, NHS Foundation Trust, National Institute for Health Research Bristol Biomedical Research Centre, University of BristolBristolUK
| | - George Davey Smith
- Medical Research Council Integrative Epidemiology UnitUniversity of BristolBristolUK
- Population Health SciencesBristol Medical School, University of BristolBristolUK
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Gooderham MJ, Hong HCH, Litvinov IV. Selective TYK2 Inhibition in the Treatment of Moderate to Severe Chronic Plaque Psoriasis. Skin Therapy Lett 2022; 27:1-5. [PMID: 36469536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Moderate to severe chronic plaque psoriasis may be difficult to control using current therapies, which has led to development of a novel class of therapy, selective tyrosine kinase 2 (TYK2) inhibitors, to address this unmet need. Oral deucravacitinib is a first-inclass selective TYK2 inhibitor, which has shown efficacy in moderate to severe chronic plaque psoriasis from two phase III pivotal trials (POETYK PSO-1 and PSO-2), whereby response rates were significantly higher with deucravacitinib vs. placebo or apremilast for Psoriasis Area Severity Index (PASI) 75 and static Physician's Global Assessment (sPGA) 0/1. Deucravacitinib was generally well tolerated and safe compared to placebo and apremilast. Although deucravacitinib is a type of Janus kinase (JAK) inhibitor, it only blocks specific cytokine-driven responses, potentially reducing off-target effects more commonly associated with other JAK inhibitors on the market. Incidence rates of serious adverse events, such as serious infections, malignancies, thrombosis, cardiovascular events, creatinine kinase elevation, hematologic changes, and lipid profile abnormalities were absent or low.
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Affiliation(s)
- Melinda J Gooderham
- Skin Centre for Dermatology, Peterborough, ON, Canada
- Probity Medical Research, Waterloo, ON, Canada
| | - H Chih-Ho Hong
- Probity Medical Research, Waterloo, ON, Canada
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
| | - Ivan V Litvinov
- Division of Dermatology, Department of Medicine, McGill University, Montreal, QC, Canada
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