TYK2 in SLE

Team: TykTARC Influencers

Base article: Morand E, Pike M, Merrill JT, van Vollenhoven R, Werth VP, Hobar C, Delev N, Shah V, Sharkey B, Wegman T, Catlett I, Banerjee S, Singhal S. Deucravacitinib, a Tyrosine Kinase 2 Inhibitor, in Systemic Lupus Erythematosus: A Phase II, Randomized, Double-Blind, Placebo-Controlled Trial. Arthritis Rheumatol. 2023 Feb;75(2):242-252. doi: 10.1002/art.42391. Epub 2022 Nov 11. PMID: 36369798; PMCID: PMC10100399.

Authors: UNC Rheumatology Fellows

  1. Griffin Sonaty, MD, first-year rheumatology fellow, University of North Carolina
  2. Saloni Patolia, MD, first-year rheumatology fellow, University of North Carolina
  3. Aaron Smith, MD, first-year rheumatology fellow, University of North Carolina
  4. Michael Cunningham, MD, assistant professor of rheumatology, University of North Carolina

Team Overview: 

Are cytokines interferon’ with your patient’s SLEDAI score? Is their BILAG beating belimumab? Are they too SLICC to respond to saphnelo? Is their skin too CLASI for chloroquine? Do you envy the casual charm and elegance of the orally bioavailable JAK inhibitors, but would like your treatments to be supported by more evidence of efficacy against lupus and less evidence of increased risk of thromboembolic disease? Step right up, step right up, we’ve got a med for you!

Say sayonara syringes! Orally bioavailable deucravacitinib targets Tyk2, a key kinase in interferon 1, IL-10, IL-12, and IL-23 signaling. A recent double-blinded placebo controlled randomized clinical trial with 363 patients showed that 48-weeks of treatment with oral twice daily deucravacitinib led to significant improvements in frequencies of SRI-4 response (34.1%57.1%), LLDAS (13.3%36.3%), CLASI-50 (16.769.6), and BICLA (25.647.3). No other lupus treatment has ever been shown to be clinically efficacious against such a broad spectrum of lupus clinical trial endpoints! Commonly trended lupus disease markers such as complements and dsDNA also significantly improved. Absolutely no major cardiovascular or thromboembolic events occurred!

In short, deucravacitinib slam dunks over SLEDAI, boxes out BILAG, stuffs SRI-4, levels LLDAS, crosses CLASI and does it all per os! Where other medications take a time out, deucravacitinib sinks from downtown!

*Treatment with deucravicitinib may be associated with increased risk of acneiform rash, upper respiratory infection, or urinary tract infection.

Related content on theMednet.org:

What is your experience with using oral deucravicitinib for conditions such as recalcitrant facial discoid lupus or recalcitrant lichen planus?

 

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