Patients with moderate-to-severe plaque psoriasis may achieve better long-term outcomes with deucravacitinib compared to apremilast, according to a recent post-hoc analysis. The study highlights greater cumulative benefits in achieving a 75% reduction in the Psoriasis Area and Severity Index (PASI 75) scores and a static Physician Global Assessment score of 0 or 1 (sPGA 0/1).
Study Overview
The findings stem from a post-hoc analysis of the POETYK PSO-1 study, which evaluated the 52-week cumulative clinical benefits of deucravacitinib versus apremilast. Researchers also compared the outcomes of patients who remained on deucravacitinib versus those who either stayed on or switched from apremilast to deucravacitinib.
Research Leadership
The research, led by Dr. April W. Armstrong, a professor and chief of dermatology at UCLA and Chair Emeritus of the National Psoriasis Foundation’s Medical Board, demonstrated that deucravacitinib was well-tolerated, efficacious, and superior to apremilast in several aspects.
“We aimed to determine the overall cumulative clinical benefit of treatment initiated with deucravacitinib versus apremilast over 52 weeks in patients with moderate to severe plaque psoriasis and to compare the 52-week cumulative benefit of initiating and staying on deucravacitinib versus initiating apremilast and continuing or switching to deucravacitinib at week 24 of treatment using POETYK PSO-1 trial data,” Armstrong and her colleagues stated.
Study Design
The analysis was a post-hoc assessment of the POETYK PSO-1 clinical trial, which included adult patients with moderate-to-severe psoriasis for at least six months. The study compared two therapies over 52 weeks: deucravacitinib 6 mg once daily and apremilast 30 mg twice daily.
Primary endpoints were assessed at the 16-week mark and every four weeks thereafter. Patients on apremilast who did not achieve PASI 50 by week 24 were switched to deucravacitinib.
Outcome Measures
Clinical benefits were evaluated using cumulative response measures, focusing on the percentage of individuals achieving PASI 75 and sPGA 0/1 with at least a 2-point improvement from baseline. These metrics were recorded at baseline, weeks 1, 2, and 4, and every four weeks up to 52 weeks.
Results
Among the 332 patients treated with deucravacitinib, the study found significantly better outcomes compared to the 168 patients on apremilast. Deucravacitinib patients exhibited a 50% greater PASI 75 improvement rate and a 58% greater sPGA 0/1 improvement rate over the 52-week study period.
These findings were consistent regardless of patients’ prior exposure to systemic and biologic therapies.
Study Limitations
The researchers acknowledged limitations in their study, noting, “A limitation of this study is that the results were obtained using clinical trial data from patients with moderate to severe plaque psoriasis. Therefore, these findings may not be generalizable to real-world effectiveness nor to patients with other forms of psoriasis.”
The analysis underscores the potential of deucravacitinib to provide superior long-term benefits for patients with moderate-to-severe plaque psoriasis compared to apremilast.
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