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Patients with moderate-to-severe plaque psoriasis exhibit superior long-term response rates to Deucravacitinib (6 mg once daily) than Adalimumab (40 mg every other week) after two years of treatment.
In an interim analysis, it was observed that among adults with moderate-to-severe plaque psoriasis (PsO), those who had received Deucravacitinib (oral tyrosine kinase 2 inhibitor) treatment exhibited superior long-term response rates at the end of two years compared to those who had been treated with Adalimumab (monoclonal antibody). The researchers conducted a comparison of the long-term effectiveness of Deucravacitinib and Adalimumab.
Open-label long-term extension (LTE) trials were utilized in an indirect treatment comparison. To make sure that the study designs were comparable, the researchers examined subjects who were randomly assigned to receive a placebo at the beginning but later switched to either Deucravacitinib or Adalimumab following the 16th week. The major endpoint of interest was achieving a decline of ≥75% in the Psoriasis Area and Severity Index score (PASI 75) at the 112-week mark after randomization.
Secondary endpoints included PASI 75 at week 52 and a decrease of ≥90% in PASI score (PASI 90) at both weeks 52 and 112. In cases where PASI data were missing, imputation was performed. An indirect comparison, adjusted for matching, was carried out by reweighting individual patient-level data from the POETYK PSO-LTE trial to align baseline traits with those from the REVEAL extension trial.
Before the reweighting process, it was observed that, on average, subjects in the POETYK PSO-LTE trial (comprising 329 individuals) were older, had lower body weights, had undergone more prior systemic treatments, and had greater baseline PASI scores. Additionally, they had higher rates of PASI 75 and PASI 90 responses to the placebo at week 16 compared to patients in the REVEAL extension trial (which included 345 individuals).
After the reweighting was applied, the adjusted PASI 75 response rates at week 112 were significantly greater for Deucravacitinib in comparison to Adalimumab (67.2% vs. 54.0%), with a mean difference of 13.2 percentage points. Deucravacitinib also exhibited a numerically greater adjusted PASI 90 response rate at week 112 (41.3% vs. 34.0%), with a mean difference of 7.3 percentage points. However, the two treatments showed comparable adjusted PASI 75 and PASI 90 response rates at week 52.
Among adults dealing with moderate to severe PsO, those who received Deucravacitinib treatment exhibited superior long-term response rates at the end of two years when compared to those treated with Adalimumab. While the response rates for Deucravacitinib remained consistent over this period, the response rates for Adalimumab declined in the second year. Hence, individuals grappling with PsO may experience lasting therapeutic benefits from oral Deucravacitinib treatment, as it has shown sustained effectiveness over the long term.
Dermatology and Therapy
Matching-Adjusted Indirect Comparison of the Long-Term Efficacy of Deucravacitinib Versus Adalimumab for Moderate to Severe Plaque Psoriasis
April W. Armstrong et al.
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