Deucravacitinib efficacious in scalp psoriasis

Key takeaways:

• Patients taking deucravacitinib vs. placebo or apremilast had significantly better scalp psoriasis improvement.
• Patients who switched from placebo to deucravacitinib at week 16 also saw significant improvement.

The efficacy of deucravacitinib was superior to placebo and apremilast in treating scalp psoriasis, according to pooled results of two studies.

“Scalp psoriasis occurs in [approximately] 80% of patients with psoriasis, has a substantial negative impact on patient mental health and quality of life, and is generally considered difficult to treat,” Andrew Blauvelt, MD, MBA, investigator at Oregon Medical Research Center, and colleagues wrote. “The scalp is typically one of the first areas affected by psoriasis, and scalp psoriasis is accompanied by itch and bothersome scaling.”

The phase 3 52-week, double-blind, global PSO-1 and PSO-2 clinical trials randomly assigned patients 1:2:1 to receive oral placebo, 6 mg deucravacitinib once a day or 30 mg apremilast twice a day. At week 16, patients in the placebo cohorts were switched to deucravacitinib.

Previous analyses evaluated the drug’s general effect, but did not focus specifically on scalp psoriasis, Blauvelt told Healio.

In this subset of data, the ss-PGA and Psoriasis Scalp Severity Index (PSSI) were used to assess scalp psoriasis symptoms and severity.

At week 16, 70.3% and 59.7% of those in the two deucravacitinib groups achieved ss-PGA 0/1 compared with 17.4% and 17.3% of those in the placebo groups and 39.1% and 36.7% of those in the apremilast groups (P < .0001 for all).

In addition, PSSI 90 was achieved by 50.6% of the deucravacitinib group in a pooled study population compared with 10.5% of the placebo group and 26.1% of the apremilast group at week 16 (P < .0001 for both).

Through 52 weeks of treatment, maintenance response was evaluated in the PSO-1 trial and showed 65.6% of the deucravacitinib subjects achieved ss-PGA 0/1 and 58.9% achieved PSSI 90. In patients who had switched from placebo to deucravacitinib at week 16, 69.7% achieved ss-PGA and 64.2% achieved PSSI 90 at week 52.

Total scalp lesion clearance at week 16 occurred in 39.9% of the deucravacitinib group, 6.8% of the placebo group and 21% of the placebo group; this was maintained in the continuous deucravacitinib group at 52 weeks.

Limitations of the study included that the patients had to have at least 10% of total body surface area involvement and moderate to severe disease, according to Blauvelt.

“We don’t yet have data on patients with lower levels of total BSA and moderate to severe scalp psoriasis, although this particular study is currently being done,” he told Healio.