Deucravacitinib, an oral, selective, allosteric tyrosine kinase 2 inhibitor, in moderate to severe plaque psoriasis: efficacy by baseline demographic and disease characteristics in the phase 3 POETYK PSO-1 and PSO-2 trials Melinda Gooderham,1 Lynda Spelman,2 Shinichi Imafuku,3 Marco Romanelli,4 Joseph F. Merola,5 April W. Armstrong,6 Elizabeth Colston,7 Subhashis Banerjee,7 Thomas Scharnitz,7 Andrew Blauvelt8 1SKiN Centre for Dermatology, Queen’s University, and Probity Medical Research, Peterborough, ON, Canada; 2Veracity Clinical Research, Brisbane, QLD, Australia; 3Fukuoka University Hospital, Fukuoka, Japan; 4University of Pisa, Pisa, Italy; 5Brigham and Women's Hospital, Brigham Dermatology Associates, and Harvard Medical School, Boston, MA, USA; 6University of Southern California, Los Angeles, CA, USA; 7Bristol Myers Squibb, Princeton, NJ, USA; 8Oregon Medical Research Center, Portland, OR, USA Introduction • Deucravacitinib, an oral, selective, allosteric tyrosine kinase 2 (TYK2) inhibitor, is approved in the US, EU, and other countries for the treatment of adults with moderate-to-severe plaque psoriasis who are candidates for systemic therapy1,2 • Deucravacitinib has a unique mechanism of action distinct from Janus kinase (JAK) inhibitors3,4 (Figure 1) — Binds to the TYK2 regulatory domain and inhibits TYK2 via an allosteric mechanism3 — Inhibits TYK2-mediated signaling of cytokines involved in psoriasis pathogenesis (interleukin-23 and Type I interferons)3 • Deucravacitinib was significantly more efficacious than placebo or apremilast and was well tolerated in patients with moderate to severe plaque psoriasis in the 52-week, phase 3 POETYK PSO-1 (NCT03624127) and POETYK PSO-2 (NCT03611751) trials5,6 Objective • The current pooled analyses of the POETYK PSO-1 and PSO-2 trials at Weeks 24 and 52 were performed to evaluate the efficacy of deucravacitinib across baseline patient demographics and disease characteristics Methods Study designs • The study designs for POETYK PSO-1 and PSO-2 are summarized in Figure 2 • Key eligibility criteria included the following: — Age ≥18 years — Diagnosis of moderate to severe plaque psoriasis • Baseline Psoriasis Area and Severity Index (PASI) ≥12, static Physician’s Global Assessment (sPGA) ≥3, and body surface area (BSA) involvement ≥10% • Patient randomization was stratified by geographic region, body weight, and prior biologic use • In POETYK PSO-1, 97.8% and 97.2% of patients completed 24 weeks of deucravacitinib and apremilast treatment, respectively; in POETYK PSO-2, 96.3% and 95.9% of patients completed 24 weeks of deucravacitinib and apremilast treatment, respectively • In POETYK PSO-1, 89.5% of patients completed 52 weeks of deucravacitinib treatment • All patients were eligible for a long-term extension trial after 52 weeks of treatment Figure 2. POETYK PSO-1 and PSO-2 study designs POETYK PSO-1 (N = 666) Deucravacitinib 6 mg QDPlacebo (n = 166) Deucravacitinib 6 mg QD Apremilast 30 mg BID 1 :2 :1 r an d o m iz at io n 52Weeks Deucravacitinib 6 mg QD (n = 332) 16 24 ≥PASI 50 Apremilast 30 mg BIDa (n = 168) Primary endpoint 0 20); sPGA score (3 [moderate], 4 [severe]); BSA involvement (10-20%, >20%) • In patients who received continuous deucravacitinib treatment from Day 1, data were also analyzed at Week 52 (POETYK PSO-1) • Differences between treatment groups were calculated using a stratified Cochran-Mantel-Haenszel test • Missing data were imputed using nonresponder imputation Results Patients • Baseline patient demographics and disease characteristics were largely similar across treatment groups in both trials (Table 1) Table 1. Baseline patient demographics and disease characteristics Pooled POETYK PSO-1 and PSO-2 Parameter Placebo (n = 421) Deucravacitinib (n = 843) Apremilast (n = 422) Total (N = 1686) Age, mean (SD), y 47.5 (13.7) 46.5 (13.5) 45.7 (12.8) 46.6 (13.4) <65 y, n (%) 370 (87.9) 763 (90.5) 384 (91.0) 1517 (90.0) ≥65 y, n (%) 51 (12.1) 80 (9.5) 38 (9.0) 169 (10.0) Weight, mean (SD), kg 90.6 (21.1) 90.6 (21.9) 91.1 (22.0) 90.7 (21.7) Female, n (%) 127 (30.2) 277 (32.9) 155 (36.7) 559 (33.2) Race, n (%) White 360 (85.5) 741 (87.9) 368 (87.2) 1469 (87.1) Asian 42 (10.0) 83 (9.8) 40 (9.5) 165 (9.8) Black or African American 12 (2.9) 10 (1.2) 10 (2.4) 32 (1.9) Other 7 (1.7) 9 (1.1) 4 (0.5) 20 (1.2) Disease duration, mean (SD), y 18.9 (12.9) 18.6 (12.7) 18.5 (12.1) 18.6 (12.6) Prior systemic therapy, n (%) Biologic 146 (34.7) 295 (35.0) 145 (34.4) 586 (34.8) No prior systemic therapy 173 (41.1) 369 (43.8) 173 (41.0) 715 (42.4) PASI score, mean (SD) 20.9 (8.6) 21.1 (8.0) 21.6 (8.6) 21.2 (8.3) ≤20, n (%) 254 (60.3) 475 (56.3) 241 (57.1) 970 (57.5) >20, n (%) 167 (39.7) 368 (43.7) 181 (42.9) 716 (42.5) sPGA score, n (%) 3 (moderate) 345 (81.9) 665 (78.9) 335 (79.4) 1345 (79.8) 4 (severe) 75 (17.8) 178 (21.1) 87 (20.6) 340 (20.2) BSA involvement, mean (SD), % 25.3 (16.1) 26.4 (15.8) 27.6 (16.4) 26.4 (16.0) BSA ≤20%, n (%) 226 (53.7) 421 (49.9) 200 (47.4) 847 (50.2) BSA >20%, n (%) 195 (46.3) 422 (50.1) 222 (52.6) 839 (49.8) BSA, body surface area; PASI, Psoriasis Area and Severity Index; SD, standard deviation; sPGA, static Physician’s Global Assessment. Efficacy • Analyses of pooled data from POETYK PSO-1 and PSO-2 using PASI 75 (Figure 3; Figure 4), PASI 90 (Figure 5; Figure 6), and sPGA 0/1 (Figure 7; Figure 8) demonstrated a consistent treatment benefit of deucravacitinib (n = 843) vs apremilast (n = 422) across multiple baseline patient demographics and disease characteristics at Week 24 — Deucravacitinib also demonstrated a consistent treatment benefit vs placebo and apremilast across these characteristics at Week 167,8 Figure 3. PASI 75 outcomes by baseline demographics (Week 24; pooled POETYK PSO-1 + PSO-2) -20 -10 0 10 20 30 40 50 60 70 Body weight 10th decile (heaviest) Body weight 9th decile Body weight 8th decile Body weight 7th decile Body weight 6th decile Body weight 5th decile Body weight 4th decile Body weight 3rd decile Body weight 2nd decile Body weight 1st decile (lightest) Weight ≥90 kg Weight <90 kg Age ≥65 y Age 40-65 y Age <40 y Difference (95% CI) Patients, n/N (%) Deucravacitinib Apremilast Difference vs apremilast (95% CI) Asian White Female Male BMI ≥35 kg/m2 BMI 30-<35 kg/m2 BMI 25-<30 kg/m2 BMI <25 kg/m2 19.0 (1.0, 37.0) 15.1 (-2.9, 33.1) 11.9 (-6.8, 30.6) 28.4 (12.0, 44.8) 44.3 (27.0, 61.6) 26.6 (8.9, 44.3) 32.0 (14.2, 49.7) 19.3 (2.1, 36.4) 27.2 (8.9, 45.5) 24.7 (7.1, 42.2) 23.8 (15.8, 31.9) 26.0 (18.1, 33.8) 2.9 (-15.8, 21.6) 20.3 (12.6, 27.9) 38.6 (29.4, 47.8) 37.3 (19.8, 54.8) 24.2 (18.1, 30.2) 25.3 (15.8, 34.8) 25.6 (18.6, 32.5) 12.3 (0.0, 24.7) 28.7 (17.6, 39.8) 29.9 (20.0, 39.9) 28.0 (15.8, 40.1) 14/40 (35.0) 13/42 (31.0) 15/39 (38.5) 13/49 (26.5) 13/41 (31.7) 15/43 (34.9) 13/39 (33.3) 25/51 (49.0) 17/40 (42.5) 22/38 (57.9) 64/203 (31.5) 96/219 (43.8) 23/38 (60.5) 93/236 (39.4) 44/148 (29.7) 12/40 (30.0) 143/368 (38.9) 70/155 (45.2) 90/267 (33.7) 39/97 (40.2) 31/102 (30.4) 46/131 (35.1) 43/91 (47.3) 48/86 (55.8) 38/82 (46.3) 43/86 (50.0) 45/82 (54.9) 58/78 (74.4) 51/83 (61.4) 59/90 (65.6) 54/79 (68.4) 54/78 (69.2) 76/92 (82.6) 221/399 (55.4) 305/437 (69.8) 50/77 (64.9) 292/490 (59.6) 184/269 (68.4) 56/83 (67.5) 462/734 (62.9) 193/274 (70.4) 333/562 (59.3) 92/174 (52.9) 128/217 (59.0) 178/275 (65.1) 127/169 (75.1) Apremilast better Deucravacitinib better BMI, body mass index; CI, confidence interval; PASI 75, ≥75% reduction from baseline in Psoriasis Area and Severity Index. Figure 4. PASI 75 outcomes by baseline disease characteristics (Week 24; pooled POETYK PSO-1 + PSO-2) Apremilast better Deucravacitinib better -20 -10 0 10 20 30 40 50 60 70 Difference vs apremilast (95% CI) BSA >20% BSA 10-20% sPGA score, 4 (severe) sPGA score, 3 (moderate) PASI >20 PASI ≤20 23.2 (15.3, 31.2) 26.7 (18.6, 34.9) 23.6 (11.3, 36.0) 25.2 (18.8, 31.6) 27.3 (18.7, 35.9) 23.2 (15.6, 30.7) 86/222 (38.7) 74/200 (37.0) 30/87 (34.5) 130/335 (38.8) 67/181 (37.0) 93/241 (38.6) 260/417 (62.4) 266/419 (63.5) 105/177 (59.3) 421/659 (63.9) 236/365 (64.7) 290/471 (61.6) Difference (95% CI) Patients, n/N (%) Deucravacitinib Apremilast BSA, body surface area; CI, confidence interval; PASI, Psoriasis Area and Severity Index; PASI 75, ≥75% reduction from baseline in PASI; sPGA, static Physician’s Global Assessment. Figure 5. PASI 90 outcomes by baseline demographics (Week 24; pooled POETYK PSO-1 + PSO-2) -20 -10 0 10 20 30 40 50 Body weight 10th decile (heaviest) Body weight 9th decile Body weight 8th decile Body weight 7th decile Body weight 6th decile Body weight 5th decile Body weight 4th decile Body weight 3rd decile Body weight 2nd decile Body weight 1st decile (lightest) Weight ≥90 kg Weight <90 kg Age ≥65 y Age 40-65 y Age <40 y Difference (95% CI) Patients, n/N (%) Deucravacitinib Apremilast Difference vs apremilast (95% CI) Asian White Female Male BMI ≥35 kg/m2 BMI 30-<35 kg/m2 BMI 25-<30 kg/m2 BMI <25 kg/m2 9.9 (-4.5, 24.2) 7.5 (-7.3, 22.2) 4.3 (-11.7, 20.2) 13.9 (0.1, 27.6) 28.6 (13.3, 43.9) 12.7 (-2.7, 28.0) 21.1 (5.8, 36.3) 23.0 (7.0, 39.1) 12.6 (-5.7, 30.8) 21.9 (3.5, 40.2) 12.5 (5.9, 19.1) 18.6 (11.2, 26.0) 14.8 (-3.4, 32.9) 9.9 (3.1, 16.7) 26.1 (17.8, 34.3) 30.5 (14.2, 46.8) 14.4 (9.0, 19.9) 15.9 (6.6, 25.1) 16.5 (10.7, 22.3) 2.6 (-7.9, 13.2) 20.2 (11.2, 29.1) 18.3 (9.5, 27.1) 22.2 (10.2, 34.1) 23/86 (26.7) 20/82 (24.4) 21/86 (24.4) 23/82 (28.0) 32/78 (41.0) 26/83 (31.3) 33/90 (36.7) 37/79 (46.8) 35/78 (44.9) 54/92 (58.7) 111/399 (27.8) 193/437 (44.2) 32/77 (41.6) 160/490 (32.7) 112/269 (41.6) 42/83 (50.6) 259/734 (35.3) 123/274 (44.9) 181/562 (32.2) 44/174 (25.3) 71/217 (32.7) 103/275 (37.5) 86/169 (50.9) 6/40 (15.0) 7/42 (16.7) 8/39 (20.5) 7/49 (14.3) 6/41 (14.6) 8/43 (18.6) 6/39 (15.4) 12/51 (23.5) 13/40 (32.5) 14/38 (36.8) 31/203 (15.3) 56/219 (25.6) 10/38 (26.3) 54/236 (22.9) 23/148 (15.5) 8/40 (20.0) 77/368 (20.9) 45/155 (29.0) 42/267 (15.7) 22/97 (22.7) 13/102 (12.7) 25/131 (19.1) 26/91 (28.6) Apremilast better Deucravacitinib better BMI, body mass index; CI, confidence interval; PASI 90, ≥90% reduction from baseline in Psoriasis Area and Severity Index. Figure 6. PASI 90 outcomes by baseline disease characteristics (Week 24; pooled POETYK PSO-1 + PSO-2) Apremilast better Deucravacitinib better -20 -10 0 10 20 30 40 50 Difference vs apremilast (95% CI) BSA >20% BSA 10-20% sPGA score, 4 (severe) sPGA score, 3 (moderate) PASI >20 PASI ≤20 18.2 (11.1, 25.4) 13.2 (6.0, 20.3) 17.5 (6.5 , 28.5) 15.0 (9.4 , 20.7) 22.0 (14.1, 29.8) 10.8 (4.3, 17.4) 47/222 (21.2) 40/200 (20.0) 17/87 (19.5) 70/335 (20.9) 38/181 (21.0) 49/241 (20.3) 166/417 (39.8) 138/419 (32.9) 68/177 (38.4) 236/659 (35.8) 158/365 (43.3) 146/471 (31.0) Difference (95% CI) Patients, n/N (%) Deucravacitinib Apremilast BSA, body surface area; CI, confidence interval; PASI, Psoriasis Area and Severity Index; PASI 90, ≥90% reduction from baseline in PASI; sPGA, static Physician’s Global Assessment. Figure 7. sPGA 0/1 outcomes by baseline demographics (Week 24; pooled POETYK PSO-1 + PSO-2) -20 -10 0 10 20 30 40 6050 Body weight 10th decile (heaviest) Body weight 9th decile Body weight 8th decile Body weight 7th decile Body weight 6th decile Body weight 5th decile Body weight 4th decile Body weight 3rd decile Body weight 2nd decile Body weight 1st decile (lightest) Weight ≥90 kg Weight <90 kg Age ≥65 y Age 40-65 y Age <40 y Difference (95% CI) Patients, n/N (%) Deucravacitinib Apremilast Difference vs apremilast (95% CI) Asian White Female Male BMI ≥35 kg/m2 BMI 30-<35 kg/m2 BMI 25-<30 kg/m2 BMI <25 kg/m2 42/86 (48.8) 35/82 (42.7) 33/86 (38.4) 36/82 (43.9) 48/78 (61.5) 44/83 (53.0) 51/90 (56.7) 47/79 (59.5) 42/78 (53.8) 68/92 (73.9) 183/399 (45.9) 263/437 (60.2) 42/77 (54.5) 248/490 (50.6) 156/269 (58.0) 49/83 (59.0) 391/734 (53.3) 167/274 (60.9) 279/562 (49.6) 79/174 (45.4) 108/217 (49.8) 152/275 (55.3) 107/169 (63.3) 9/40 (22.5) 11/42 (26.2) 12/39 (30.8) 12/49 (24.5) 13/41 (31.7) 11/43 (25.6) 10/39 (25.6) 19/51 (37.3) 14/40 (35.0) 16/38 (42.1) 52/203 (25.6) 75/219 (34.2) 15/38 (39.5) 79/236 (33.5) 33/148 (22.3) 12/40 (30.0) 111/368 (30.2) 61/155 (39.4) 66/267 (24.7) 31/97 (32.0) 27/102 (26.5) 38/131 (29.0) 31/91 (34.1) 24.7 (8.1, 41.3) 16.4 (-0.8, 33.5) 7.3 (-10.6, 25.3) 19.5 (3.5, 35.6) 31.5 (3.5, 49.6) 27.6 (10.7, 44.5) 31.1 (13.8, 48.3) 22.4 (5.3, 39.6) 19.3 (1.0, 37.7) 31.8 (13.6, 50.0) 20.2 (12.5, 27.9) 25.9 (18.2, 33.7) 14.5 (-4.8, 33.8) 17.2 (9.7, 24.7) 35.6 (26.8, 44.5) 28.8 (11.3, 46.4) 23.2 (17.3, 29.1) 21.6 (12.0, 31.2) 24.9 (18.3, 31.6) 13.1 (1.2, 25.0) 23.5 (12.7, 34.2) 26.3 (16.5, 36.0) 29.3 (17.1, 41.5) Apremilast better Deucravacitinib better BMI, body mass index; CI, confidence interval; sPGA 0/1, static Physician’s Global Assessment score of 0 (clear) or 1 (almost clear) with a ≥2-point improvement from baseline. Figure 8. sPGA 0/1 outcomes by baseline disease characteristics (Week 24; pooled POETYK PSO-1 + PSO-2) Apremilast better Deucravacitinib better -20 -10 0 10 20 30 40 6050 Difference vs apremilast (95% CI) BSA >20% BSA 10-20% sPGA score, 4 (severe) sPGA score, 3 (moderate) PASI >20 PASI ≤20 25.3 (17.7, 32.9) 21.0 (13.0, 29.1) 24.7 (13.2, 36.3) 22.8 (16.6, 29.1) 25.7 (17.4, 34.0) 21.3 (13.8, 28.7) 63/222 (28.4) 64/200 (32.0) 20/87 (23.0) 107/335 (31.9) 49/181 (27.1) 78/241 (32.4) 225/417 (54.0) 221/419 (52.7) 86/177 (48.6) 360/659 (54.6) 194/365 (53.2) 252/471 (53.5) Difference (95% CI) Patients, n/N (%) Deucravacitinib Apremilast BSA, body surface area; CI, confidence interval; PASI, Psoriasis Area and Severity Index; sPGA, static Physician’s Global Assessment; sPGA 0/1, sPGA score of 0 (clear) or 1 (almost clear) with a ≥2-point improvement from baseline. • Efficacy was observed through Week 52 in patients who received continuous deucravacitinib treatment in POETYK PSO-1 (n = 332), regardless of baseline patient demographics or disease severity (Table 2; Table 3) Table 2. Week 52 outcomes by baseline demographics (POETYK PSO-1) PASI 75 PASI 90 sPGA 0/1 Parameter Deucravacitinib, n/N (%) (n = 332) Deucravacitinib, n/N (%) (n = 332) Deucravacitinib, n/N (%) (n = 332) Age, y <40 71/109 (65.1) 44/109 (40.4) 59/109 (54.1) 40-65 125/197 (63.5) 88/197 (44.7) 101/197 (51.3) ≥65 20/26 (76.9) 14/26 (53.8) 15/26 (57.7) Weight, kg <90 146/200 (73.0) 103/200 (51.5) 121/200 (60.5) ≥90 70/132 (53.0) 43/132 (32.6) 54/132 (40.9) Body weight categories, decile 1st decile (lightest) 29/39 (74.4) 26/39 (66.7) 28/39 (71.8) 2nd decile 31/41 (75.6) 25/41 (61.0) 23/41 (56.1) 3rd decile 28/38 (73.7) 19/38 (50.0) 24/38 (63.2) 4th decile 31/41 (75.6) 19/41 (46.3) 22/41 (53.7) 5th decile 21/34 (61.8) 10/34 (29.4) 19/34 (55.9) 6th decile 20/25 (80.0) 14/25 (56.0) 19/25 (76.0) 7th decile 14/24 (58.3) 8/24 (33.3) 12/24 (50.0) 8th decile 14/32 (43.8) 10/32 (31.3) 9/32 (28.1) 9th decile 12/27 (44.4) 6/27 (22.2) 6/27 (22.2) 10th decile (heaviest) 16/31 (51.6) 9/31 (29.0) 13/31 (41.9) BMI, kg/m2 <25 55/78 (70.5) 45/78 (57.7) 46/78 (59.0) 25-<30 89/123 (72.4) 56/123 (45.5) 74/123 (60.2) 30-<35 40/69 (58.0) 25/69 (36.2) 31/69 (44.9) ≥35 32/62 (51.6) 20/62 (32.3) 24/62 (38.7) Sex Male 139/230 (60.4) 82/230 (35.7) 105/230 (45.7) Female 77/102 (75.5) 64/102 (62.7) 70/102 (68.6) Race White 168/267 (62.9) 115/267 (43.1) 141/267 (52.8) Asian 45/59 (76.3) 31/59 (52.5) 33/59 (55.9) BMI, body mass index; PASI 75/90, ≥75%/≥90% reduction from baseline in Psoriasis Area and Severity Index; sPGA 0/1, static Physician’s Global Assessment score of 0 (clear) or 1 (almost clear) with a ≥2-point improvement from baseline. Table 3. Week 52 outcomes by baseline disease characteristics (POETYK PSO-1) PASI 75 PASI 90 sPGA 0/1 Parameter Deucravacitinib, n/N (%) (n = 332) Deucravacitinib, n/N (%) (n = 332) Deucravacitinib, n/N (%) (n = 332) PASI score ≤20 109/177 (61.6) 69/177 (39.0) 85/177 (48.0) >20 107/155 (69.0) 77/155 (49.7) 90/155 (58.1) sPGA score 3 (moderate) 166/257 (64.6) 107/257 (41.6) 137/257 (53.3) 4 (severe) 50/75 (66.7) 39/75 (52.0) 38/75 (50.7) BSA involvement, % 10-20% 102/162 (63.0) 61/162 (37.7) 82/162 (50.6) >20% 114/170 (67.1) 85/170 (50.0) 93/170 (54.7) BSA, body surface area; PASI, Psoriasis Area and Severity Index; PASI 75/90, ≥75%/≥90% reduction from baseline in PASI; sPGA, static Physician’s Global Assessment; sPGA 0/1, sPGA score of 0 (clear) or 1 (almost clear) with a ≥2-point improvement from baseline. Conclusions • Deucravacitinib is efficacious in adults with moderate to severe plaque psoriasis, regardless of baseline patient demographics and disease characteristics — Deucravacitinib was more efficacious than apremilast across baseline subgroups at Week 24 in the pooled analysis of POETYK PSO-1 and PSO-2 — Continuous deucravacitinib treatment was efficacious across baseline subgroups at Week 52 in POETYK PSO-1 • These findings further support deucravacitinib, a once-daily oral drug, as an efficacious therapeutic option for adults with moderate to severe plaque psoriasis regardless of baseline patient demographics or disease characteristics References 1. SOTYKTU™ (deucravacitinib) [package insert]. Princeton, NJ; Bristol-Myers Squibb Company; September 2022. 2. SOTYKTU (deucravacitinib) [summary of product characteristics]. Dublin, Ireland: Bristol-Myers Squibb Pharma EEIG; March 2023. 3. Burke JR, et al. Sci Transl Med. 2019;11:eaaw1736. 4. Wrobleski ST, et al. J Med Chem. 2019;62:8973-8995. 5. Armstrong AW, et al. J Am Acad Dermatol. 2023;88:29-39. 6. Strober B, et al. J Am Acad Dermatol. 2023;88:40-51. 7. Gooderham M, et al. Presented at 30th EADV Congress; September 29–October 2, 2021. 8. Merola JF, et al. Presented at 30th EADV Congress; September 29–October 2, 2021. Acknowledgments • This study was sponsored by Bristol Myers Squibb • Writing and editorial assistance was provided by Jieming Fang, MD, of Peloton Advantage, LLC, an OPEN Health company, Parsippany, NJ, USA, funded by Bristol Myers Squibb Disclosures • 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 • LS: Consultant, paid investigator, and/or speaker: AbbVie, Amgen, Anacor, Ascend, Astellas, AstraZeneca, Blaze Bioscience, Boehringer Ingelheim, Botanix, Bristol Myers Squibb, Celgene, Dermira, Eli Lilly, Galderma, Genentech, GlaxoSmithKline, Hexima, Janssen, Leo Pharma, Mayne Pharma, MedImmune, Merck, Merck-Serono, Novartis, Otsuka, Pfizer, Phosphagenics, Photon MD, Regeneron, Roche, Samumed, Sanofi Genzyme, SHR Pharmacy, Sun Pharma ANZ, Trius, UCB, and Zai Lab • 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), Boehringer Ingelheim, Bristol Myers Squibb, Daiichi Sankyo, Eli Lilly, GlaxoSmithKline, Novartis, and UCB • MR: Nothing to disclose • JFM: Consultant and/or investigator: AbbVie, Amgen, Biogen, Bristol Myers Squibb, Dermavant, Eli Lilly, Janssen, Leo Pharma, Novartis, Pfizer, Regeneron, Sanofi, Sun Pharma, and UCB • 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 Kirin, and UCB, outside the submitted work • EC, SB, and TS: Employees and shareholders: Bristol Myers Squibb • AB: Speaker (with honoraria): AbbVie, Arcutis, Bristol Myers Squibb, Eli Lilly, Pfizer, Regeneron, Sanofi, and UCB; Scientific adviser (with honoraria): AbbVie, Abcentra, Affibody, Aligos, Almirall, Alumis, Amgen, AnaptysBio, Arcutis, Arena, ASLAN, Athenex, Bluefin Biomedicine, Boehringer Ingelheim, Bristol Myers Squibb, Cara Therapeutics, Dermavant, EcoR1, Eli Lilly, Escient, Evelo, Evommune, Forte, Galderma, HighlightII Pharma, Incyte, InnoventBio, Janssen, Landos, Leo Pharma, Merck, Novartis, Pfizer, Rapt, Regeneron, Sanofi Genzyme, Spherix Global Insights, Sun Pharma, TLL Pharmaceutical, TrialSpark, UCB, Vibliome, and Xencor; Clinical study investigator (institution has received clinical study funds): AbbVie, Acelyrin, Almirall, Amgen, Arcutis, Athenex, Boehringer Ingelheim, Bristol Myers Squibb, Concert, Dermavant, Eli Lilly, Evelo, Evommune, Galderma, Incyte, Janssen, Leo Pharma, Merck, Novartis, Pfizer, Regeneron, Sun Pharma, and UCB Presented at the Fall Clinical Dermatology Conference for PAs & NPs®; June 9-11, 2023; Orlando, FL This is an encore of the 2023 AAD poster Email: mgooderham@centrefordermatology.com Copies of this poster are for personal use only and may not be reproduced without written permission of the authors. Figure 1. Mechanism of action of deucravacitinib Deucravacitinib (allosteric inhibitor class) Unique TYK2 regulatory domain Catalytic domain (highly conserved across JAK family) ATP-binding active site (approved JAK inhibitor class) TYK2 Selectivity in cells3,4: • ≥100-fold greater selectivity for TYK2 vs JAK1 and JAK3 • ≥2000-fold greater selectivity for TYK2 vs JAK2 ATP, adenosine 5′-triphosphate; JAK, Janus kinase; TYK2, tyrosine kinase 2. https://creativecommons.org/licenses/by-nc-nd/4.0/ https://creativecommons.org/licenses/by-nc-nd/4.0/ https://creativecommons.org/licenses/by-nc-nd/4.0/ https://creativecommons.org/licenses/by-nc-nd/4.0/ mailto:mgooderham@centrefordermatology.com 23-1156C FCPANP - Eff by BC DS [23TYK2130] 23-1156C FCPANP - Eff by BC DS [23TYK2130]_BRK