Deucravacitinib, the first-in-class tyrosinase kinase 2 (TYK2) inhibitor has been approved by the US FDA for patients with moderate to severe plaque type psoriasis making it the only approved TYK2 inhibitor. It is indicated only for those patients who need systemic therapy or phototherapy. This approval is based on the results of the phase III POETYK PSO-1 and PSO-2 clinical trials where deucravacitinib was superior to placebo and apremilast in improving skin clearance.

Dose: 6 mg orally once daily, with or without food

Contraindication: Hypersensitivity to deucravacitinib or any of its components, severe hepatic impairment

Side effects: Upper respiratory infection, increased creatine phosphokinase (CPK), herpes simplex, mouth ulcers, folliculitis, acne

Warnings and precautions

• Avoid coadministration with other immunosuppressant drugs or live vaccines. All age-appropriate immunizations should be complete prior to starting treatment.
• Avoid deucravacitinib in patients with active or serious/opportunistic infection.
• Monitor the patient for signs and symptoms of infection. Discontinue treatment in case serious infection develops.
• Examine the patient for TB before starting treatment with deucravacitinib.
• Regularly monitor serum triglycerides and liver enzymes.
• Stop the drug if CPK levels increase significantly.

Sources: US FDA Sotyktu prescribing information; Bristol Myers Squibb Press Release, Sept. 9, 2022