Tolerability and Efficacy of Deucravacitinib in the Treatment of Refractory Psoriasis

Open Access

Abstract

Background: Psoriasis is a chronic, relapsing inflammatory disorder associated with significant physical and psychosocial burden. Despite multiple therapeutic options, a subset of patients remains refractory to conventional systemic therapies. Aim of the study: To evaluate the efficacy and tolerability of Deucravacitinib in patients with refractory moderate-to-severe psoriasis in a real-world clinical setting. Methods & Materials: This prospective observational study included 80 adult patients with refractory psoriasis treated with oral Deucravacitinib 6 mg once daily for 24 weeks. Clinical assessments were performed at baseline, week 4, week 12, and week 24 using PASI, BSA, sPGA, DLQI, and pruritus VAS scores. Safety evaluation included clinical monitoring and laboratory investigations. Data were analyzed using SPSS version 26.0, and statistical significance was set at p<0.05. Result: A progressive and significant improvement in all clinical parameters was observed over the treatment period. At week 24, PASI 75 and PASI 90 responses were achieved in a majority of patients, with a marked reduction in mean PASI score from 22.9 ± 6.7 to 6.3 ± 3.9. Significant improvements were also noted in BSA involvement, DLQI, and pruritus scores (p<0.001 for all). Overall, 73.75% of patients achieved a good to excellent response. The most common adverse events were mild upper respiratory infections and nasopharyngitis, with low rates of treatment discontinuation. Conclusion: Deucravacitinib demonstrated significant clinical efficacy and favorable tolerability in refractory psoriasis. It resulted in substantial disease control and improved quality of life with an acceptable safety profile. These findings support its role as a promising oral targeted therapy for difficult-to-treat psoriasis. Larger long-term studies are recommended to confirm durability and safety.