Deucravacitinib, an Oral, Selective Tyrosine Kinase 2 (TYK2) Inhibitor, Versus Placebo and Apremilast in Moderate to Severe Plaque Psoriasis: Onset of Action in the Phase 3 POETYK PSO-1 and POETYK PSO-2 Trials Neil J Korman,1 Kim Papp,2 Jerry Bagel,3 Peter Foley,4 Akimichi Morita,5 Subhashis Banerjee,6 Elizabeth Colston,6 Tao Wang,6 John Throup,6 Diamant Thaçi7 1Case Western Reserve University and University Hospitals, Cleveland, OH, USA; 2Clinical Research and Probity Medical Research, Waterloo, ON, Canada; 3Windsor Dermatology, East Windsor, NJ, USA; 4Skin Health Institute, Carlton, VIC, Australia; 5Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan; 6Bristol Myers Squibb, Princeton, NJ, USA; 7University of Lübeck, Lübeck, Germany Introduction • Deucravacitinib — Novel, oral, selective tyrosine kinase 2 (TYK2) inhibitor with a unique mechanism of action distinct from Janus kinase (JAK) 1/2/3 inhibitors1 • Binds to the TYK2 regulatory domain with high selectivity and inhibits TYK2 via an allosteric mechanism (Figure 1)1 — ≥100-fold greater selectivity for TYK2 vs JAK 1/3 and ≥2000-fold greater selectivity for TYK2 vs JAK 21,2 • Inhibits TYK2-mediated signaling of cytokines involved in psoriasis pathogenesis (eg, interleukin 23 [IL-23], IL-12, and Type I interferons)1 — Previously demonstrated good efficacy and tolerability in Phase 2 trials in moderate to severe plaque psoriasis3 and in active psoriatic arthritis4 Figure 1. Mechanism of action of deucravacitinib Deucravacitinib (allosteric inhibitor) Regulatory domain Catalytic domain ATP-binding active site (other kinase inhibitors) TYK2 ATP, adenosine triphosphate; TYK2, tyrosine kinase 2. Objective • To assess the onset of action of deucravacitinib using data from the Phase 3 POETYK PSO-1 and PSO-2 trials Methods Study designs • POETYK PSO-1 (NCT03624127) and PSO-2 (NCT03611751) were double-blind, placebo- controlled, 52-week trials that randomized patients with moderate to severe plaque psoriasis (body surface area [BSA] involvement ≥10%, Psoriasis Area and Severity Index [PASI] ≥12, static Physician’s Global Assessment [sPGA] score ≥3) 1:2:1 to placebo, deucravacitinib 6 mg once daily, or apremilast 30 mg twice daily (Figure 2) — Patients were stratified by geographic region, body weight, and prior biologic use — Patients receiving placebo switched to deucravacitinib at Week 16 and patients receiving apremilast failing to meet study-specific efficacy thresholds (≥50% reduction from baseline in PASI [PASI 50] score in PSO-1, ≥75% reduction from baseline in PASI [PASI 75] score in PSO-2) switched to deucravacitinib at Week 24 • Coprimary endpoints were the proportion of patients who achieved PASI 75 and sPGA score of 0 or 1 (0/1) responses vs placebo at Week 16 Figure 2. Study designs POETYK PSO-1 (N=666) POETYK PSO-2 (N=1020) Deucravacitinib 6 mg QDPlacebo (n=166) Deucravacitinib 6 mg QD