POETYK PSO-2 (deucravacitinib vs. apremilast)
Trial question
What is the effect of deucravacitinib versus apremilast in patients with moderate-to-severe plaque psoriasis?
Study design
Multi-center
Double blinded
RCT
Population
Characteristics of study participants
36.0% female
64.0% male
N = 765
765 patients (272 female, 493 male).
Inclusion criteria: adult patients with moderate-to-severe plaque psoriasis.
Key exclusion criteria: other forms of psoriasis; history of recent infection; prior exposure to deucravacitinib or apremilast.
Interventions
N=511 deucravacitinib (at a dose of 6 mg daily).
N=254 apremilast (at a dose of 30 mg BID).
Primary outcome
≥ 75% reduction in Psoriasis Area and Severity Index at week 16
53%
39.8%
53.0 %
39.8 %
26.5 %
13.3 %
0.0 %
Deucravacitinib
Apremilast
Significant
increase ▲
NNT = 7
Significant increase in ≥ 75% reduction in Psoriasis Area and Severity Index at week 16 (53% vs. 39.8%; AD 13.4%, 95% CI 6.2 to 20.7).
Secondary outcomes
Significant increase in static Physician's Global Assessment score of 0 or 1 at week 16 (49.5% vs. 33.9%; AD 15.8%, 95% CI 8.8 to 22.9).
Significant increase in ≥ 90% reduction in Psoriasis Area and Severity Index at week 16 (27% vs. 18.1%; AD 9%, 95% CI 3.1 to 14.9).
Significant increase in Dermatology Life Quality Index of 0 or 1 at week 16 (37.6% vs. 23.1%; AD 14.6%, 95% CI 7.8 to 21.3).
Safety outcomes
No significant difference in adverse events.
Conclusion
In adult patients with moderate-to-severe plaque psoriasis, deucravacitinib was superior to apremilast with respect to ≥ 75% reduction in Psoriasis Area and Severity Index at week 16.
Reference
Bruce Strober, Diamant Thaçi, Howard Sofen et al. Deucravacitinib versus placebo and apremilast in moderate to severe plaque psoriasis: Efficacy and safety results from the 52-week, randomized, double-blinded, phase 3 Program fOr Evaluation of TYK2 inhibitor psoriasis second trial. J Am Acad Dermatol. 2023 Jan;88(1):40-51.
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