deucravacitinib: clinical use

Prescribing considerations

• Initiation should be supervised by a clinician experienced in diagnosing and treating psoriasis.
• Assess for clinically important infection and tuberculosis before treatment; treat latent tuberculosis before initiation.
• Review chronic or recurrent infection history and monitor clinically for infection.
• Consider completing age-appropriate immunisations before treatment and avoid live vaccines during therapy.
• Weigh benefits and risks in people with malignancy or substantial cardiovascular or venous thromboembolism risk; long-term TYK2 safety evaluation is ongoing.
• Use caution in very elderly patients because clinical experience is limited.
• Not recommended in severe hepatic impairment; safety and efficacy below 18 years have not been established.

Contraindications and cautions

• Hypersensitivity to deucravacitinib or any excipient.
• Clinically important active infection, including active tuberculosis.
• Rare hereditary galactose intolerance, total lactase deficiency or glucose-galactose malabsorption, because the tablet contains lactose.

Monitoring

• Check tuberculosis status and clinically assess infection risk before starting.
• Monitor for signs and symptoms of infection, including active tuberculosis.
• Review treatment response regularly.
• No routine laboratory-monitoring schedule is specified in the selected SmPC; raised creatine phosphokinase is a recognised adverse effect.
• Report suspected adverse reactions through the MHRA Yellow Card Scheme because the product is under additional monitoring.

Clinical pharmacology

Deucravacitinib is an allosteric inhibitor that binds the TYK2 regulatory domain rather than the catalytic domain. Oral absorption is near complete; metabolism involves several enzyme pathways, and elimination occurs through metabolic, renal and faecal routes.

Formulation and product differences

• The selected product is a pink, round, film-coated oral tablet marked “BMS 895”.
• It contains lactose and is essentially sodium-free.
• Calendar and non-calendar blister presentations are described; not all pack sizes may be marketed.

Tablet

Route: Oral

Strengths: 6 mg