Study Highlights Deucravacitinib’s Efficacy for Psoriasis Stratified by Age, BMI

Deucravacitinib treatment of psoriasis may be effective for older, middle-aged, and younger patients, new findings suggest, though responsiveness to treatment in those with a body mass index (BMI) ≥25 may be slightly diminished compared to those with a BMI < 25.1

These data represent the conclusion of a recent analysis authored, in part, by Teppei Hagino, from the department of dermatology at Nippon Medical School Chiba Hokusoh Hospital in Japan. Hagino et al. highlighted prior research that had demonstrated deucravacitinib’s efficacy in real-world settings, but noted that the drug’s long-term effectiveness stratified by BMI and by age had not yet been fully explored.2

Therefore, his team of investigators had sought to examine the impact of these factors on deucravacitinib’s effectiveness, given that the advancement of personalized treatment of psoriasis is the primary aim for dermatologists.

“The aim of this study was to evaluate the 52-week real-world effectiveness of deucravacitinib in psoriasis patients, stratified by age (≥65 years vs <65 years) and BMI (≥25 vs <25),” Hagino and colleagues wrote.1

Study Design Details

The investigators conducted their prospective study of deucravacitinib’s efficacy in Japan during the timeframe between December 2022 - August 2024, with patients aged 15 years or older that reported clinical diagnoses of moderate-to-severe psoriasis being included in the trial.

Those with psoriatic arthritis (PsA), psoriasis vulgaris, and erythrodermic psoriasis were all included in the analysis. The participants with a history of recent systemic therapy use were switched to deucravacitinib without the use of a washout period, which meant that pre-treatment Psoriasis Area and Severity Index (PASI) scores from their previous medication uses were not consistently available to the researchers.

As a result of this fact, the research team implemented PASI scores at the time of the subjects’ switch to deucravacitinib as baseline values. Those taking part in the study were provided oral deucravacitinib administration at a daily dose of 6 mg, with treatment lasting up to 52 weeks.

Prior to treatment initiation, the team assessed the participants’ baseline characteristics, looking at such factors as BMI, sex, age, and various clinical features such as prior history of treatment with apremilast or biologics, duration of psoriasis, existence of PsA, and involvement of the nails, genital region, or scalp.

The investigators further assessed comorbidities such as diabetes and cardiovascular disease, as well as participants’ smoking status. They also evaluated subjects’ baseline static Physician's Global Assessment (sPGA), PASI, and Dermatology Life Quality Index (DLQI) scores.

The 52-week study period featured a monitoring period in which PASI and DLQI scores were looked into by the investigative team. The team calculated the proportion of those participating achieving a PASI 75, PASI 90, or PASI 100 score improvement from baseline at the 4, 16, 24, 40, and 52-week marks.

The researchers also assessed subjects’ absolute PASI values of ≤2 or ≤1 as well as the percentage of those attaining sPGA 0/1 or DLQI 0/1 among those showing an initial sPGA or DLQI scores of ≥2. Such outcomes were also assessed using subgroups that the team based on BMI (≥25 compared to <25) and on age (≥65 years compared to <65 years).

Findings on BMI and Age

The research team concluded that at the 52-week mark, the rates of PASI 75, PASI 90, and PASI 100 achievement among those in the 65 years or older cohort were shown to be 86.36%, 59.09%, and 13.64%, respectively. This was compared to the rates of those younger than 65, reported as 86.36%, 65.22%, and 39.13%, respectively.

The findings were noted by the team to suggest a slightly lower PASI 100 rate in those deemed as older. In their assessment of the 2 BMI cohorts, the investigators reported that the corresponding rates at the 52-week mark had been 81.82%, 73.33%, and 18.18% among subjects showing a BMI of ≥25.

This was compared to those with BMI <25, the rates were noted as 88.24%, 82.86%, and 29.41%. The research team further noted that at the earlier 4, 16, 24, and 40-week points in time, participants’ rates of achievement had tended to be slightly lower among those in the higher BMI cohort.

Nevertheless, the team concluded that, overall, deucravacitinib showed clinical effectiveness in the improvement of psoriasis-related indices.

“The present results indicate that deucravacitinib may be effective for elderly psoriasis patients as well as younger or middle-aged patients, while treatment responsiveness in patients with a BMI ≥25 may be slightly lower compared with those with a BMI < 25,” they wrote.1

References

1. Hagino T, Onda M, Saeki H, Fujimoto E, Kanda N. Real-world 52-week effectiveness of deucravacitinib in psoriasis: A stratified analysis by age and body mass index. J Dermatol. 2025; 00: 1–9. https://doi.org/10.1111/1346-8138.17617.
2. Hagino T, Saeki H, Fujimoto E, Kanda N. Effectiveness and safety of deucravacitinib treatment for moderate-to-severe psoriasis in real-world clinical practice in Japan. J Dermatolog Treat. 2024; 35:2307489.