Bang Chul-Hwan, Park Chul-Jong, Kim Yoon-Seob
Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
Department of Dermatology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 14647, Republic of Korea.
J Clin Med. 2025 Mar 5;14(5):1746. doi: 10.3390/jcm14051746.
Deucravacitinib, a selective oral tyrosine kinase 2 (TYK2) inhibitor, has demonstrated strong efficacy in the treatment of moderate-to-severe psoriasis. It works through an allosteric mechanism to selectively inhibit TYK2, leading to the suppression of the IL-23/Th17/IL-17 axis and a reduction in key pro-inflammatory cytokines such as IL-17A, IL-17F, IL-22, and IL-23. This review focuses on the clinical implications of deucravacitinib in East Asian patients, highlighting its efficacy, safety, and differences in treatment outcomes compared to other populations. Data from pivotal trials such as POETYK PSO-3 and PSO-4, which included East Asian populations, demonstrated robust efficacy and safety profiles, often surpassing results observed in global trials like POETYK PSO-1 and PSO-2. Subgroup analyses and network meta-analyses further corroborate these findings, providing a comprehensive understanding of its therapeutic potential in this demographic. Factors such as lower body mass index, genetic predispositions, and environmental influences may contribute to these differences in response. The safety profile of deucravacitinib is favorable, with low rates of serious adverse events and stable laboratory parameters. This review underscores the need for further research to investigate the genetic, metabolic, and environmental factors that may influence treatment outcomes, aiming to optimize personalized treatment strategies for East Asian patients with psoriasis.
氘可来昔替尼是一种选择性口服酪氨酸激酶2(TYK2)抑制剂,已在中重度银屑病治疗中显示出强大疗效。它通过变构机制选择性抑制TYK2,导致IL-23/Th17/IL-17轴的抑制以及关键促炎细胞因子如IL-17A、IL-17F、IL-22和IL-23的减少。本综述重点关注氘可来昔替尼在东亚患者中的临床意义,突出其疗效、安全性以及与其他人群相比治疗结果的差异。来自纳入东亚人群的关键试验如POETYK PSO-3和PSO-4的数据显示出强大的疗效和安全性,常常超过在POETYK PSO-1和PSO-2等全球试验中观察到的结果。亚组分析和网状荟萃分析进一步证实了这些发现,全面了解了其在该人群中的治疗潜力。较低的体重指数、遗传易感性和环境影响等因素可能导致这些反应差异。氘可来昔替尼的安全性良好,严重不良事件发生率低且实验室参数稳定。本综述强调需要进一步研究以调查可能影响治疗结果的遗传、代谢和环境因素,旨在为东亚银屑病患者优化个性化治疗策略。