Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California.
SKiN Centre for Dermatology, Department of Dermatology at Queen's University, and Probity Medical Research, Peterborough, Ontario, Canada.
J Am Acad Dermatol. 2023 Jan;88(1):29-39. doi: 10.1016/j.jaad.2022.07.002. Epub 2022 Jul 9.
Effective, well-tolerated oral psoriasis treatments are needed.
To compare the efficacy and safety of deucravacitinib, an oral, selective, allosteric tyrosine kinase 2 inhibitor, versus placebo and apremilast in adults with moderate to severe plaque psoriasis.
Participants were randomized 2:1:1 to deucravacitinib 6 mg every day (n = 332), placebo (n = 166), or apremilast 30 mg twice a day (n = 168) in the 52-week, double-blinded, phase 3 POETYK PSO-1 trial (NCT03624127). Coprimary end points included response rates for ≥75% reduction from baseline in Psoriasis Area and Severity Index (PASI 75) and static Physician's Global Assessment score of 0 or 1 (sPGA 0/1) with deucravacitinib versus placebo at week 16.
At week 16, response rates were significantly higher with deucravacitinib versus placebo or apremilast for PASI 75 (194 [58.4%] vs 21 [12.7%] vs 59 [35.1%]; P < .0001) and sPGA 0/1 (178 [53.6%] vs 12 [7.2%] vs 54 [32.1%]; P < .0001). Efficacy improved beyond week 16 and was maintained through week 52. Adverse event rates with deucravacitinib were similar to those with placebo and apremilast.
One-year duration, limited racial diversity.
Deucravacitinib was superior to placebo and apremilast across multiple efficacy end points and was well tolerated in moderate to severe plaque psoriasis.
需要有效的、耐受良好的口服银屑病治疗方法。
比较口服、选择性、变构酪氨酸激酶 2 抑制剂德瓦鲁单抗与安慰剂和阿普米司特在中重度斑块型银屑病成人患者中的疗效和安全性。
在这项为期 52 周、双盲、3 期 POETYK PSO-1 试验(NCT03624127)中,将患者以 2:1:1 的比例随机分配至德瓦鲁单抗 6mg/d(n=332)、安慰剂(n=166)或阿普米司特 30mg,每日 2 次(n=168)。主要终点包括德瓦鲁单抗与安慰剂相比在第 16 周时达到以下终点的患者比例:从基线水平下降≥75%的银屑病面积和严重程度指数(PASI 75)应答率和静态医师整体评估(sPGA)评分 0 或 1(sPGA 0/1)。
在第 16 周,与安慰剂或阿普米司特相比,德瓦鲁单抗的 PASI 75 应答率显著更高(194[58.4%] vs 21[12.7%] vs 59[35.1%];P<0.0001)和 sPGA 0/1 应答率(178[53.6%] vs 12[7.2%] vs 54[32.1%];P<0.0001)。疗效在第 16 周后继续改善,并在第 52 周时保持。德瓦鲁单抗的不良事件发生率与安慰剂和阿普米司特相似。
为期 1 年,种族多样性有限。
在多项疗效终点中,德瓦鲁单抗均优于安慰剂和阿普米司特,在中重度斑块型银屑病患者中具有良好的耐受性。