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Psoriasis — SCE Dermatology MCQ

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HardDermatopharmacologyPsoriasisSCE Dermatology

A 48-year-old man has psoriasis and is started on a new oral medication, Deucravacitinib. What is the novel mechanism of action?

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Correct answer: BTYK2 (tyrosine kinase 2) inhibitor

Deucravacitinib is a first-in-class selective TYK2 (tyrosine kinase 2) inhibitor — an allosteric inhibitor binding to the regulatory (pseudokinase) domain of TYK2 rather than the catalytic domain. TYK2 mediates signalling of IL-23, IL-12, and type I interferons — key cytokines in psoriasis pathogenesis. Selective TYK2 inhibition preserves JAK1/2/3 function, theoretically reducing the haematological, lipid, and infection risks associated with broader JAK inhibition. Deucravacitinib demonstrated superiority over Apremilast and comparable efficacy to some biologics in clinical trials. It does not require routine blood monitoring. NICE appraisal is ongoing.

Reference: NICE Appraisal; BAD 2020 Psoriasis Guidelines Update