Deucravacitinib Effective for Psoriasis Regardless of Prior Biologic, Apremilast Use

Treatment of psoriasis with deucravacitinib is effective for patients over 52 weeks regardless of previous treatment with apremilast or biologics, new findings suggest, although there may be differences in response between treatment-experienced and treatment-naive subgroups.1

These findings were the result of a study authored in part by Teppei Hagino from the department of dermatology at Nippon Medical School Chiba Hokusoh Hospital in Japan. Hagino and colleagues expressed that while data have previously shown promise with deucravacitinib as an oral therapy, there had been a general lack of long-term real-world data on this medication.2

“The aim of this study was to assess the 52-week real-world effectiveness of deucravacitinib (6 mg/day) in patients with psoriasis stratified by a history of apremilast or biologic usage,” Hagino and colleagues wrote. “The study aimed to compare the long-term therapeutic effects of deucravacitinib in patients with different treatment histories, and to enable more personalized medicine for psoriasis.”1

Analyzing Results of Deucravacitinib

In Japan, the trial investigators conducted their prospective, single-center analysis the timeframe between December 2022 - September 2024. They sought to examine the impact of deucravacitinib in individuals aged 15 years and older with moderate-to-severe psoriasis diagnoses. Before their initiation of deucravacitinib, certain subjects had been treated with either apremilast or biologic therapies.

The analysis involved recruitment of subjects with psoriatic arthritis (PsA), psoriasis vulgaris, or erythrodermic psoriasis, all of whom continued being treated with deucravacitinib for a minimum of 4 weeks. Oral deucravacitinib was provided to these individuals at a 6 mg daily dose for up to 52 weeks without the use of concomitant topical therapies.

The investigative team gathered demographic and clinical information at the study’s initiation . They also looked at any comorbid conditions among patients, including smoking history, diabetes and cardiovascular disease, and prior systemic therapies. Assessments made by the team during the study included Psoriasis Area and Severity Index (PASI) and the Dermatology Life Quality Index (DLQI).

Treatment transition for subjects who shifted directly from apremilast or biologics took place without a washout period. As a result of this, investigators took note of participants’ DLQI and PASI values at the time of the switches at Week 0, designated the scores as baseline measurements.

Those participating in the analysis were assessed at a variety of time points, including weeks 0, 4, 16, 28, 40, and 52. The research team measured the proportion of participants attaining PASI 75, 90, and 100 as well as those reaching absolute PASI scores of ≤1 or ≤2. Those showing a baseline DLQI score of ≥2 were evaluated to determine the proportion with DLQI 0/1.

OVerall, deucravacitinib was shown by the team to have reduced PASI and DLQI scores among those treated over 52 weeks, regardless of previous history of therapy use. They concluded that the percentages of reductions in both types of scores had been comparable between those who had been on apremilast (92% and 77.9%, respectively) and those who were apremilast-naive (88.3% and 81.6%, respectively).

By the 52-week mark, rates of PASI 100 and absolute PASI ≤1 attainment among subjects were 30.8% and 61.5%, respectively, and slightly higher among those with previous apremilast use compared to those who had not used apremilast (20.5% and 46.2%, respectively). Additionally, it was noted that biologic-naive individuals saw greater reductions in their PASI and DLQI scores (91.6% and 82.8%, respectively), compared to rates among those experienced with biologics (57.6% and 63.6%, respectively).

The percentage of those who were biologic-naive achieving PASI 75, PASI 100, and absolute PASI ≤1 at Week 52 were 84.4%, 24.4%, and 53.3%, respectively. These percentages were also higher than the percentages of biologic-experienced participants (57.1%, 14.3%, and 28.6%, respectively).

“In summary, deucravacitinib reduced PASI and DLQI scores throughout the 52-week treatment period for psoriasis patients, both in apremilast-naive and -experienced subgroups, and in biologic-naive and -experienced subgroups, indicating the improvement of skin rash and QoL irrespective of prior usage of these treatments,” they wrote.1

References

1. Hagino T, Saeki H, Fujimoto E, Kanda N. Long-term real-world effectiveness of deucravacitinib in psoriasis: A 52-week prospective study stratified by prior apremilast or biologic therapy. J Dermatol. 2025; 00: 1–8. https://doi.org/10.1111/1346-8138.17665.

2. Hagino T, Saeki H, Fujimoto E, Kanda N. Long-term effectiveness and safety of deucravacitinib in psoriasis: a 52-week real-world study of genital, scalp, and nail lesions. Clin Exp Dermatol. 2024;llae530. https://doi.org/10.1093/ced/llae530.