A Review of the Indications, Safety, and Efficacy of Deucravacitinib: an Expert Consensus Panel

Background:Deucravacitinib is a novel, allosteric, selective TYK2 inhibitor FDA-approved for the treatment of moderate-to-severe plaque psoriasis in adults. Currently, deucravacitinib is under investigation in numerous clinical trials to establish its efficacy and safety for other indications. Thus, this expert consensus panel was assembled to provide clinical guidance on the applications of and clinical considerations for deucravacitinib. Objective:The aim of this study was to assess the literature and formulate consensus statements covering the indications, safety, and efficacy of deucravacitinib. Methods:A comprehensive literature search of PubMed, Scopus, and Google Scholar was completed for English-language original research articles regarding deucravacitinib. The expert panel, which included eight dermatologists with advanced knowledge on both dermatologic and rheumatologic conditions, reviewed the pertinent literature and developed consensus statements regarding the additional indications, safety, and efficacy of deucravacitinib. Using a modified Delphi process, each statement had supermajority approval and was designated a strength of recommendation based on the Strength of Recommendation Taxonomy criteria. Key Findings:The panel unanimously voted to adopt 14 consensus statements and recommendations: 11 were a strength of "A", 1 was a strength of "B", and two were a strength of "C". The 14 consensus statements created by the expert panel provide expert recommendations regarding the efficacy, safety, and additional potential indications for deucravacitinib. Additionally, the expert panel notes that deucravacitinib is generally safe, as it can be safely combined with conventional synthetic DMARDs, immunosuppressants, and biologics and currently does not have data that support elevated malignancy risk, tuberculosis reactivation, increased risk for herpes zoster, or associated laboratory abnormalities. Conclusion:Deucravacitinib is an established treatment for plaque psoriasis that has shown strong evidence supporting safety and efficacy for psoriatic arthritis, cutaneous lupus, and systemic lupus erythematosus. Overall, deucravacitinib is a versatile and safe medication that may warrant further therapeutic consideration by clinicians. The expert panel concludes that deucravacitinib is an exciting medication that will likely have a larger role in the treatment of various conditions in the future.