Plaque psoriasis is an autoimmune condition that causes patches of scaly, itchy skin all over the body. People with this condition typically receive topical medications, systemic medications, or both to keep it under control, but the effect may taper off after some time.
Doctors may now prescribe a newly approved oral medication, deucravacitinib (Sotyktu), to treat moderate to severe plaque psoriasis. Deucravacitinib belongs to a class of medication known as tyrosine kinase 2 (TYK2) inhibitors.
In this article, Dr. Ami D. Patel answers some common questions about TYK2 inhibitors for psoriasis, including their effects, benefits, and risks.
TYK2 is an enzyme responsible for causing inflammation in the body. This enzyme is part of a pathway in the body’s immune response system. TYK2 inhibitors block the function of these enzymes, with the goal being to reduce or prevent inflammation.
Psoriasis is a chronic skin condition that causes the surface of the skin to appear thick, red or purple, and inflamed. The skin may also appear scaly. The exact cause is unknown, but research shows that a combination of genetics, environmental factors, and a person’s immune system plays a role.
TYK2 inhibitors target specific inflammatory markers that health experts have identified as those that create psoriasis.
Biologics, such as etanercept and infliximab, help someone manage psoriasis by reducing inflammation. The difference between biologics and TYK2 inhibitors is that biologics disturb the inflammatory process at a different site. They block an action called tumor necrosis factor (TNF-alpha). Within the biologics class of drugs, there are various drugs that target different areas and processes within the inflammatory cascade. A major difference is that health experts believe TYK2 inhibitors target multiple markers at the same time.
Other treatments, such as biologics, are available as an injection. People may also take apremilast (Otezla), a twice-daily oral treatment option. Doctors may recommend TYK2 inhibitors, a once-daily oral medication, as an alternative. Compared with topical agents, TYK2 inhibitors provide someone with moderate or severe plaque an option that treats the whole body.
Finding a suitable long-term treatment can derive from trial and error of multiple agents and various formulations. Doctors may consider TYK2 inhibitors when traditional options have proven ineffective. They may also recommend them as part of a combination therapy when additional treatments are necessary.
Finding the right long-term treatment can come from a trial and error process involving multiple agents and various formulations. Doctors can consider TYK2 inhibitors when traditional options have proven to be ineffective or when necessary as part of additional treatments. Because this treatment targets the body’s immune response and slows the development of psoriasis, it may take a few weeks to start noticing improvements.
Results may vary from person to person, but in trials, most patients saw the best results at approximately 16 weeks.
Once a person starts the medication, a follow-up plan with a healthcare specialist depends on an individual’s psoriasis severity, treatment goals, medical history, and how well they tolerate the medication. Individuals may also have more frequent appointments initially.
The most common side effect includes upper respiratory tract infections, such as pneumonia. Some uncommon, reported side effects include oral ulcers or acne. If a person experiences rare but serious side effects, such as a reactivation of the herpes virus or tuberculosis, they should report them to a doctor immediately.
Due to the combination of factors that contribute to psoriasis, it is difficult for any single medication to remove psoriasis completely. In clinical trials with deucravacitinib, over 50% of the people who participated experienced a 75% improvement in their symptoms by the end of 16 weeks. Additionally, they were able to maintain these results for at least a year.
Psoriasis symptoms may return if an individual stops taking TYK2 inhibitors.
According to the severity of a person’s symptoms, the amount of time necessary to see results may vary. It would be best to discuss realistic treatment goals with the doctor. If TYK2 inhibitors stop working, it is important to ask the doctor about alternatives or trying this medication in combination with other treatments.
Dr. Ami D. Patel is a board certified pharmacotherapy specialist and a licensed clinical pharmacist specializing in internal medicine and preventative healthcare. She is passionate about providing evidence-based education and empowering people to take control of their health. She is the host of a podcast and provides consulting on polycystic ovarian syndrome (PCOS) through her company, PCOS Holistic Coach.