April Armstrong, MD, MPH, discussed important breakthroughs in psoriasis and psoriatic arthritis, specifically focusing on deucravacitinib, upadacitinib, and bimekizumab in her session, “Breakthroughs in Psoriasis and Psoriatic Arthritis: Deucravacitinib, Upadacitinib, and Bimekizumab,” at Fall Clinical 2022.

She started with deucravacitinib, a US Food and Drug Administration (FDA)-approved, once daily oral Tyk2 inhibitor. The results of deucravacitinib pivotal studies showed:

• Significantly greater proportions of patients in the deucravacitinib arm compared with the placebo and apremilast arms achieved static Physician's Global Assessment 0/1 at week 16 in both trials
• Deucravacitinib was also superior to apremilast at week 24 in both trials

Some of the additional safety profile data included:

• Well-tolerated
• Low discontinuation rates
• Low rates of zoster, acne/folliculitis

Dr Armstrong concluded the deucravacitinib discussion with the following points:

• FDA approved 6 mg once daily oral medication for moderate to severe plaque psoriasis in adults
• No tests required before initiation other than TB evaluation (unless patient has known or suspected disease)
• No known drug-drug interactions
• Can be taken with or without food

Next, Dr Armstrong pivoted to upadacitinib and its role in psoriatic arthritis. For psoriatic arthritis:

• Dosing: 15 mg daily
• JAK1 inhibitor
• It is indicated for those who have psoriatic arthritis who had inadequate response or intolerance to one or more TNF Inhibitors

According to one of the pivotal studies, “At week 56, 60% of the patients maintained ACR20, i.e., at least 20% improvement in their joint signs and symptoms.” Upadacitinib was also shown to delay radiographic progression.

Lastly, Dr Armstrong talked about bimekizumab’s unique mechanism of action:

• Dual specificity for IL-17A and IL-17F
• Targets 3 dimers with high pM affinity: IL-17A/A, IL-17F/F, and IL-17A/F
• Inhibits the activation of the IL-17RA/RC receptor complex and the subsequent inflammatory cascade

“Bimekizumab has a very high efficacy rate, with nearly 7 out of 10 patients achieving clear, and a fast onset,” Dr Armstrong concluded.

Reference
Armstrong A. Breakthroughs in psoriasis and psoriatic arthritis therapies: bimekizumab, upadacitinib and deucravacitinib. Presented at: Fall Clinical Dermatology Conference 2022; October 20–23, 2022; Las Vegas, NV.