Deucravacitinib, an oral, selective tyrosine kinase 2 (TYK2) inhibitor, in moderate to severe plaque psoriasis: 52-week efficacy results from the phase 3 POETYK PSO-1 and PSO-2 trials Richard B Warren,1 April W Armstrong,2 Melinda Gooderham,3 Bruce Strober,4 Diamant Thaçi,5 Shinichi Imafuku,6 Howard Sofen,7 Lynda Spelman,8 Neil J Korman,9 Min Zheng,10 Elizabeth Colston,11 John Throup,11 Sudeep Kundu,11 Renata M Kisa,11 Subhashis Banerjee,11 Andrew Blauvelt12 1Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester NIHR Biomedical Research Centre, The University of Manchester, Manchester, UK; 2University of Southern California, Los Angeles, CA, USA; 3SKiN Center for Dermatology, Queen’s University, and Probity Medical Research, Peterborough, ON, Canada; 4Yale University, New Haven, CT, and Central Connecticut Dermatology Research, Cromwell, CT, USA; 5University of Lübeck, Lübeck, Germany; 6Fukuoka University Hospital, Fukuoka, Japan; 7UCLA School of Medicine, Los Angeles, CA, USA; 8Veracity Clinical Research, Woolloongabba, QLD, Australia; 9Case Western Reserve University and University Hospitals, Cleveland, OH, USA; 10Second Affiliated Hospital, Zhejiang University School of Medicine, National Key Clinical Department of Dermatology, Hangzhou, Zhejiang Province, China; 11Bristol Myers Squibb, Princeton, NJ, USA; 12Oregon Medical Research Center, Portland, OR, USA Presented at the 2022 Winter Clinical Dermatology Conference — Hawaii® (WC22); January 14−19, 2022; Kauai, HI, and Virtual This is an encore of the 2021 EADV 30th Congress presentation This poster may not be reproduced without written permission from the authors.Email for Richard B Warren, MD, PhD: richard.warren@manchester.ac.uk Introduction • Tyrosine kinase 2 (TYK2) is an intracellular enzyme that mediates signaling of cytokines (interleukin [IL]-23, IL-12, and Type I interferons) involved in psoriasis pathogenesis1 • Deucravacitinib is an oral agent that selectively inhibits TYK2 via an allosteric mechanism by uniquely binding to the regulatory domain rather than to the more conserved active domain where Janus kinase (JAK) 1/2/3 inhibitors bind (Figure 1)1 — ≥100-fold greater selectivity for TYK2 vs JAK 1/3 and ≥2000-fold greater selectivity for TYK2 vs JAK 2 in cells1,2 • In the phase 3 POETYK PSO-1 and PSO-2 trials, deucravacitinib was significantly more efficacious than placebo and apremilast based on the coprimary endpoints of ≥75% reduction from baseline in Psoriasis Area and Severity Index (PASI 75) and static Physician’s Global Assessment (sPGA) score of 0/1 at Week 16 and was well tolerated in patients with moderate to severe plaque psoriasis3 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 evaluate the efficacy of deucravacitinib over 52 weeks in POETYK PSO-1 and PSO-2, including: — Efficacy of continuous deucravacitinib treatment and switching from placebo to deucravacitinib at Week 16 through Week 52 (PSO-1) — Maintenance of efficacy on continued treatment and durability of response through Week 52 after treatment withdrawal among Week 24 PASI 75 responders (PSO-2) Methods Key design elements • The POETYK PSO-1 and PSO-2 study designs are shown in Figure 2 • Key eligibility criteria — Adults with moderate to severe plaque psoriasis — PASI ≥12, sPGA ≥3, body surface area (BSA) ≥10% — Stratified by geographic region, body weight, and prior biologic use • Coprimary endpoints were the proportion of patients who achieved PASI 75 and sPGA 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 QD55% of patients had moderate to severe scalp psoriasis (ss-PGA ≥3) at baseline and were evaluated for ss-PGA 0/1 responses.4 NRI, nonresponder imputation; QD, once daily; ss-PGA 0/1, scalp-specific Physician’s Global Assessment score of 0 or 1. • Patients who switched from placebo to deucravacitinib at Week 16 achieved DLQI 0/1 responses at Week 52 comparable to those observed in patients who received continuous deucravacitinib treatment from Day 1 (Figure 7) Figure 7. POETYK PSO-1: DLQI 0/1 response through Week 52 in patients randomized to deucravacitinib and placebo (NRI) Deucravacitinib (n = 332) Placebo (n = 166) Baseline DLQI, mean (SD) 12.0 (6.7) 11.4 (6.6) Weeks 0 10 20 30 40 50 60 70 80 90 100 0 4 8 12 16 20 24 28 32 36 40 44 48 52 43.2% 46.1% 1 2 R e sp o n se r at e , % 41.0% 10.6% Primary endpoint Deucravacitinib (n = 332) Placebo (n = 166) Placebo-deucravacitinib (n = 141) NRI was used to impute missing data. DLQI score of 0 or 1 among patients with a baseline score of 2. DLQI 0/1 is indicative of no impact on a patient’s life. DLQI 0/1, Dermatology Life Quality Index score of 0 or 1; NRI, nonresponder imputation. • PASI 75 and sPGA 0/1 responses were maintained on continuous treatment through Week 52 in the majority of deucravacitinib-treated patients who achieved PASI 75 at Week 24 (Figure 8) • Median time to loss of PASI 75 response was 12 weeks in the randomized withdrawal arm Figure 8. POETYK PSO-2: maintenance and durability of response through Week 52 among Week 24 PASI 75 responders (NRI) 0 10 20 30 40 50 60 70 80 90 100 24 28 32 36 40 44 48 52 R e sp o n se r at e , % Weeks PASI 75 0 10 20 30 40 50 60 70 80 90 100 24 28 32 36 40 44 48 52 R e sp o n se r at e , % Weeks sPGA 0/1a 70.3% 80.4% 31.3% 23.5% Deucravacitinib (n = 148) Placebo (withdrawal; n = 150) Deucravacitinib (n = 118) Placebo (withdrawal; n = 119) NRI was used to impute missing data. In total, 58.7% of deucravacitinib-treated patients achieved PASI 75 at Week 24 and 49.8% of deucravacitinib-treated patients achieved sPGA 0/1 responses at Week 24. Mean half-life of deucravacitinib is approximately 10 hours. asPGA response is defined as a score of 0 or 1, with ≥2-point improvement from baseline. This figure shows data for all sPGA 0/1 responders among Week 24 PASI 75 responders. NRI, nonresponder imputation; PASI 75, ≥75% reduction from baseline in Psoriasis Area and Severity Index; QD, once daily; sPGA 0/1, static Physician’s Global Assessment score of 0 or 1. Conclusions • In the phase 3 POETYK PSO-1 and PSO-2 trials, deucravacitinib was efficacious through 52 weeks in patients with moderate to severe plaque psoriasis — Clinical responses improved through Week 24 and were maintained in patients who received continuous deucravacitinib treatment through Week 52 — Week 52 responses in patients who switched from placebo to deucravacitinib treatment at Week 16 were comparable to those observed with continuous deucravacitinib treatment from Day 1 • Durable responses were observed after withdrawal of treatment in Week 24 responders • The results of this 52-week efficacy analysis are consistent with those of the primary analyses of PSO-1 and PSO-2 at Week 163 • Deucravacitinib, a once-daily oral drug, has the potential to become an efficacious and well-tolerated treatment choice for patients with moderate to severe plaque psoriasis References 1. Burke JR, et al. Sci Transl Med. 2019;11:1-16. 2. Wrobleski ST, et al. J Med Chem. 2019;62:8973-8995. 3. Armstrong A, et al. Presented at the Annual Meeting of the American Academy of Dermatology; April 23-25, 2021. 4. Blauvelt A, et al. Presented at EADV 30th Congress; 29 September−2 October 2021. Poster P1391. Acknowledgments • These clinical trials were sponsored by Bristol Myers Squibb • Writing and editorial assistance were provided by Lisa Feder, PhD, of Peloton Advantage, LLC, an OPEN Health company, Parsippany, NJ, USA, funded by Bristol Myers Squibb Disclosures • RBW: Consulting fees: AbbVie, Almirall, Amgen, Boehringer Ingelheim, Celgene, Eli Lilly, Janssen, Leo Pharma, Novartis, Pfizer, Sanofi, UCB, and Xenoport; Research grants: AbbVie, Almirall, Amgen, Celgene, Eli Lilly, Janssen, Leo Pharma, Novartis, Pfizer, and UCB; Honorarium: Biogen • AWA: Grants and personal fees: AbbVie, Bristol Myers Squibb, Eli Lilly, Janssen, Leo Pharma, and Novartis; Personal fees: Boehringer Ingelheim/Parexel, Celgene, Dermavant, Genentech, GlaxoSmithKline, Menlo Therapeutics, Merck, Modernizing Medicine, Ortho Dermatologics, Pfizer, Regeneron, Sanofi Genzyme, Science 37, Sun Pharma, and Valeant; Grants: Dermira, Kyowa Hakko Kirin, and UCB, outside the submitted work • MG: Advisory board, principal investigator, and lecture fees: AbbVie, Galderma, Leo Pharma, Pfizer, and Regeneron; Advisory board and lecture fees: Actelion; Principal investigator and consulting fees: Akros Pharma; Advisory board, principal investigator, lecture fees, and consulting fees: Amgen, Boehringer Ingelheim, Celgene, Eli Lilly, Janssen, Novartis, Sanofi Genzyme, and Valeant; Principal investigator: Arcutis, Bristol Myers Squibb, Dermira, GlaxoSmithKline, MedImmune, Merck, Roche Laboratories, and UCB; Principal investigator and lecture fees: Glenmark • BS: Consultant (honoraria): AbbVie, Almirall, Amgen, Arcutis, Arena, Aristea, Asana, Boehringer Ingelheim, Bristol Myers Squibb, Connect Biopharma, Dermavant, Eli Lilly, Equillium, GlaxoSmithKline, Immunic Therapeutics, Janssen, Leo Pharma, Maruho, Meiji Seika Pharma, Mindera, Novartis, Ortho Dermatologics, Pfizer, Regeneron, Sanofi Genzyme, Sun Pharma, UCB, Ventyxbio, and vTv Therapeutics; Speaker: AbbVie, Eli Lilly, Janssen, and Sanofi Genzyme; Co-scientific director (consulting fee): CorEvitas’ (Corrona) Psoriasis Registry; Investigator: AbbVie, Cara, CorEvitas’ (Corrona) Psoriasis Registry, Dermavant, Dermira, and Novartis • DT: Grant/research support, consultant, scientific advisory board speakers bureau: AbbVie, Almirall, Amgen, Biogen Idec, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, Galapagos, Galderma, Janssen-Cilag, Leo Pharma, Novartis, Pfizer, Regeneron, Roche, Sandoz-Hexal, Sanofi, Target-Solution, and UCB • SI: Grants and personal fees: AbbVie, Eisai, Janssen, Kyowa Kirin, Leo Pharma, Maruho, Sun Pharma, Taiho Yakuhin, Tanabe Mitsubishi, and Torii Yakuhin; Personal fees: Amgen (Celgene), Bristol Myers Squibb, Eli Lilly, Daiichi-Sankyo, Novartis, and UCB • HS: Clinical Investigator: AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, Janssen, Leo Pharma, Novartis, and Sun Pharma • LS: Consultant, paid investigator, and/or speaker: Amgen, Anacor, AbbVie, Ascend, Astellas, AstraZeneca, Blaze Bioscience, Bristol Myers Squibb, Boehringer Ingelheim, Botanix, Celgene, Dermira, Eli Lilly, Galderma, Genentech, GlaxoSmithKline, Hexima, Janssen, Leo Pharma, Mayne, Medimmune, Merck (MSD), Merck-Serono, Novartis, Otsuka, Pfizer, Phosphagenics, Photon MD, Regeneron, Roche, Samumed, Sanofi Genzyme, SHR, Sun Pharma ANZ, Trius, UCB, and Zai Lab • NJK: Advisory board, consulting fees: AbbVie, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Eli Lilly, Janssen, Leo Pharma, Novartis, Principia, Regeneron, Sanofi Genzyme, Sun Pharma, and UCB; Grant support/ principal investigator: AbbVie, Amgen, Argenx, Bristol Myers Squibb, Celgene, Chemocentryx, Eli Lilly, Galderma, Kyowa Hakko Kirin, Leo Pharma, Menlo, Principia, Prothena, Rhizen, Syntimmune, Trevi, and Xbiotech; Speaker: AbbVie, Eli Lilly, Janssen, Novartis, Regeneron, and Sanofi Genzyme • MZ: Consultant (honoraria), clinical investigator, and lecture fees: AbbVie, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly China, Leo Pharma China, Novartis China, Pfizer, Sanofi China, and Xian-Janssen • EC, JT, SK, RMK, and SB: Employees and shareholders: Bristol Myers Squibb • AB: Scientific adviser and/or clinical study investigator: AbbVie, Aligos, Almirall, Arena, Athenex, Boehringer Ingelheim, Bristol Myers Squibb, Dermavant, Eli Lilly, Evommune, Forte, Galderma, Incyte, Janssen, Leo Pharma, Novartis, Pfizer, Rapt, Regeneron, Sanofi Genzyme, Sun Pharma, and UCB