Deucravacitinib 6 mg Effective in Patients with Psoriasis Over 2 Years

Two-year findings from a real-world Japanese patient cohort indicate deucravacitinib provides durable disease control in moderate-to-severe psoriasis, although responses differ over time based on age and body mass index (BMI) of patients.1

These findings were authored by such researchers as Teppei Hagino, MD, PhD, of Nippon Medical School Chiba Hokusoh Hospital. In the background of their analysis, Hagino and colleagues noted prior data suggesting those with a BMI of ≥ 25 kg/m2 had slightly diminished responses to this drug than patients with a BMI < 25 kg/m2 following 52 weeks of use.2

Despite positive findings on deucravacitinib’s efficacy among those with psoriasis, the investigative team highlighted the lack of real-world data on its long-term use and the prior lack of awareness about BMI and/or age’s impact on such results.

“The aim of this study was to evaluate the 104 week…effectiveness of deucravacitinib 6 mg daily in patients with psoriasis, stratified by BMI (< 25 versus ≥ 25 kg/m2) or age (< 65 versus ≥ 65 years),” Hagino and coauthors wrote.1

Study Design and Background

In the period between December 2022 - August 2025, the investigators carried out their prospective, single-center investigation in Japan. They involved patients in the age range of 15 years or older who also lived with moderate-to-severe psoriasis. All participants given once-per-day, oral deucravacitinib therapy at a dose of 6 mg for a maximum duration of 104 weeks. Some of the team’s subjects had previously been given apremilast or biologics prior to their using deucravacitinib.

After detailed consultations took place their treating clinicians, those involved in the analysis elected to begin deucravacitinib from among the available options for systemic agents. Hagino et al noted a portion of the data from this 104-week cohort, drawn from Weeks 16 - 52, had been published previously under the same study protocol. Additional participants were newly and prospectively involved for this more recent analysis.

Those included as participants were patients with moderate-to-severe psoriasis, psoriatic arthritis (PsA), or erythrodermic psoriasis. Individuals shifting directly from other systemic agents to deucravacitinib did so without a required washout period. For these patients, their PASI and sPGA scores recorded at the time of treatment switch were defined as baseline values at Week 0. At the time of their entry, the participants’ demographic and clinical variables were documented by the investigative team.

These would include BMI, age, sex, duration of disease, and the existence or absence of arthritis. Comorbid condition information, with conditions including smoking status, diabetes, heart disease, and prior exposure to systemic drugs including apremilast or biologics, was gathered by the team. At baseline, they looked at disease severity via patients’ Psoriasis Area and Severity Index (PASI) and static Physician’s Global Assessment (sPGA) scores.

There were 127 total participants with psoriasis who were provided dail oral deucravacitinib 6 mg. Across the entire cohort, Hagino and colleagues noted their PASI scores indicated sustained disease improvements over the full 104-week treatment period. When stratified by age or by BMI, there was no statistically significant distinction observed in participants’ mean percentage PASI reduction between the cohorts at any time point.

The team highlighted data showing, between the 16 and 68-week marks, PASI score reductions and the proportions of subjects attaining PASI 75, PASI 90, or an absolute PASI score of 2 or below showed a tendency to be slightly greater in those with a BMI below 25.1 This was compared with subjects showing a BMI of 25 or higher, though Hagino and coauthors noted the reversal of this pattern reversed at later points in their analysis.

Throughout the 104-week follow-up, the investigators noted higher rates of complete or near-complete clearance, defined as PASI 100 or an absolute PASI score of 1 or less, consistently seen among those with BMI below 25.1 By the 104-week mark, PASI 100 and absolute PASI ≤1 were attained by 16.7% and 54.2% of individuals showing a BMI of <25, respectively. This was compared to rates of 0% and 40.0% among individuals with a BMI of ≥25.

In an analysis which was age-based, Hagino et al found the percentages of PASI reductions and the PASI 75 and PASI 90 rates were slightly higher in those aged 65 years or older versus younger subjects, after which this trend would reverse.1 By the 104-week mark, they found PASI 100 and absolute PASI ≤1 were seen among 28.6% and 57.1% of individuals below 65 years, respectively. Conversely, rates noted in participants aged 65 years or older were 0% and 46.7%, respectively.

“In conclusion, once daily deucravacitinib 6 mg showed sustained effectiveness for Japanese patients with psoriasis throughout 104 weeks in real-world analyses stratified by BMI or age,” the team concluded.1 “Early differences between age groups should be interpreted with caution because older patients had lower baseline PASI and the subgroup analyses were not adjusted for baseline severity.”

References

1. Okabe Y, Hagino T, Kanda N. Two-Year Real-World Effectiveness of Deucravacitinib 6 mg in Psoriasis: A Single-Center Analysis Stratified by Body Mass Index or Age in a Japanese Cohort. J Dermatol. 2026 Jan 5. doi: 10.1111/1346-8138.70137. Epub ahead of print. PMID: 41489211.

2. Hagino T, Onda M, Kanda N, et al. Real-world 52-week effectiveness of deucravacitinib in psoriasis: A stratified analysis by age and body mass index. J Dermatol. 2025 Apr;52(4):663-671. doi: 10.1111/1346-8138.17617. Epub 2025 Jan 28. PMID: 39873274.