Navigating Expanding Treatment Options for Plaque Psoriasis: A Conversation With Advanced Practice Providers - Episode 6

Positioning TYK2 Inhibitors in the Plaque Psoriasis Algorithm

Published on: 

Lauren Miller, MPAS, PA-C; and Jayme Heim, MSN, FNP-BC, share approaches to implementing the newly approved TYK2 inhibitor, deucravacitinib, into the treatment algorithm of plaque psoriasis.

Lauren Miller, MPAS, PA-C: So, where do you put TYK2 (Tyrosine kinase 2) inhibitors, where do you put that in your algorithm? Do you have specific patients that when they come in, maybe depending on disease, location, severity, how do you place that in your algorithm? And do you have a specific patient type that you think works well introducing a tick two inhibitor for them?

Jayme Heim, MSN, FNP-BC: You know, I really don't have an algorithm. I think that because of the years of doing this, it becomes an art. Yeah, you have an instinctive knowledge. That guides you a lot of the ways. I've I had a patient too, that before this medication was FDA approved, she had tried other biologic therapies, but her legs, she just kept having to have these recalcitrant areas on her legs and they just were not clearing for her. And it was so bothersome because she wanted to wear capris, she wanted to wear shorts, she wanted to wear a dress that wasn't down to her ankles. And so I talked to her about this medication and she went on this medication and she is the happiest woman in the world. She's completely clear. I mean, not only does she not have any redevelopment of the psoriasis on the rest of her body, but her legs are clear. The other thing too, are always those hard-to-treat areas. I think, you know, when we look at the 16 week data in for the poetic trials and 70% of those patients get clear to almost clear. I found it's been really great with patients, too, that have scalp psoriasis and it's definitely one of those medications that you need to look at. When you talk about as far as is it for everybody, of course, it’s for moderate to severe, it's for patients over 18 years, 18 years and older, you know, so you won't be using it on children yet. But I think that definitely if you have a patient, too, because you want to look to the comorbidities, we always look at that when we do our assessment to assess for those comorbidities. And if you do have a patient that does have a lot of problems with reoccur infections, then maybe you might want to reconsider. But even the data, they really is not so much far off them from placebo.

Lauren Miller, MPAS, PA-C: And perhaps I think I agree with everything that you said about the patients and where I would put that. You know, right now it does not have the indication for psoriatic arthritis. I would love for that to be coming and for that to happen. But really, it seems to be able to treat a wide range of patients as long as they're adults, like you said, and have moderate to severe disease.

Transcript is AI-generated and edited for clarity and readability.