medwireNews: Deucravacitinib, a novel selective tyrosine kinase 2 (TYK2) inhibitor, may be a promising treatment option for patients with psoriatic arthritis (PsA), suggest phase 2 data presented in a poster at the ACR Convergence 2020 virtual meeting.
Philip Mease, from the University of Washington in Seattle, USA, and co-authors explained that deucravacitinib selectively “binds to the regulatory domain of the intracellular kinase TYK2,” thereby “limiting off-target effects observed with other kinase inhibitors.”
The double-blind trial included 203 patients with active PsA (≥3 tender and ≥3 swollen joints) despite prior treatment with at least one nonsteroidal anti-inflammatory drug, corticosteroid, and/or conventional synthetic DMARD, or one tumor necrosis factor inhibitor. Participants were randomly assigned to receive deucravacitinib at a daily dose of 6 mg or 12 mg or placebo.
The primary endpoint of an ACR20 response at week 16 was achieved by 52.9% of patients treated with deucravacitinib 6 mg and 62.7% of those given the 12 mg dose. These rates were significantly higher than the 31.8% rate among placebo-treated patients.
Both deucravacitinib doses were also associated with significantly better ACR50 (24.3 and 32.8 vs 10.6%) and ACR70 (14.3 and 19.4 vs 1.5%) response rates at the 16-week timepoint than placebo.
And similar results were observed for other secondary endpoints. For instance, quality of life was significantly improved with deucravacitinib 6 mg and 12 mg relative to placebo, as indicated by a higher rate of HAQ-DI responders at week 16, and greater improvements in the physical and mental component scores of the 36-item short form questionnaire.
Mease and colleagues said that deucravacitinib “was generally well tolerated,” with 31.4% and 25.4% of patients who received the 6 mg and 12 mg doses, respectively, having a treatment-related adverse event (AE), compared with 9.1% of the patients who received placebo.
The most common AEs in the deucravacitinib 6 mg, 12 mg, and placebo groups were nasopharyngitis (5.7, 17.9, and 7.6%), headache (7.1, 1.5, and 4.5%), rash (4.3, 6.0, and 0.0%), and sinusitis (7.5% in deucravacitinib 12 mg group only).
The team observed “[n]o herpes zoster infections, opportunistic infections, or thromboembolic AEs” in patients treated with deucravacitinib.
A total of 4.3% and 6.0% of participants in the deucravacitinib 6 mg and 12 mg arms, respectively, discontinued treatment due to AEs, as did 1.5% of those in the placebo group.
The study authors concluded that “[d]eucravacitinib is a promising option for the treatment of patients with active PsA.”
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