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. 2025 Aug;15(8):2281-2293.
doi: 10.1007/s13555-025-01428-9. Epub 2025 May 30.

Deucravacitinib in Patients with Plaque Psoriasis Who Screened Positive for Psoriatic Arthritis: Improvements in Joint Pain and the Impact of Musculoskeletal Symptoms

Joseph F Merola  1 , Philip J Mease  2 , April W Armstrong  3 , Vibeke Strand  4 , Thomas Lehman  5 , Stefan Varga  5 , Jiyoon C Choi  5 , Brandon Becker  5 , Yichen Zhong  5 , Matthew J Colombo  5 , Diamant Thaçi  6 , Androniki Bili  5 , Alice B Gottlieb  7
Affiliations

Deucravacitinib in Patients with Plaque Psoriasis Who Screened Positive for Psoriatic Arthritis: Improvements in Joint Pain and the Impact of Musculoskeletal Symptoms

Joseph F Merola et al. Dermatol Ther (Heidelb). 2025 Aug.

Abstract

Introduction: For patients with psoriasis, psoriatic arthritis can be a painful comorbid condition that is often undiagnosed. It is therefore essential that more research is done to understand which treatments for psoriasis relieve both dermatologic and joint symptoms. This analysis aimed to compare the effects of deucravacitinib vs. placebo or apremilast on joint pain and the impact of musculoskeletal symptoms at weeks 16 and 24 in patients from the POETYK psoriasis (PSO-1; NCT03624127) and POETYK PSO second (PSO-2; NCT03611751) trials who self-reported joint symptoms.

Methods: During screening in each trial, patients with psoriasis who reported musculoskeletal complaints completed the self-administered Psoriatic Arthritis Screening and Evaluation (PASE) questionnaire. Scores of ≥ 47 constituted positive screens (PASE positive). Joint pain and the impact of musculoskeletal symptoms were measured using a visual analog scale (VAS), with higher scores denoting worse disease burden.

Results: This pooled analysis included 185 patients who screened as PASE-positive in the combined POETYK PSO-1 and PSO-2 trials. Improvement from baseline was greater in patients treated with deucravacitinib vs. placebo at week 16 for joint pain VAS (- 15.2 vs. - 3.2) and joint disease VAS (- 17.4 vs. - 3.8). Improvements from baseline were also greater for patients treated with deucravacitinib vs. apremilast for joint pain VAS (- 22.8 vs. - 8.6) and joint disease VAS (- 19.6 vs. - 8.8) scores at week 24. Greater proportions of deucravacitinib-treated patients also achieved 30%, 50%, and 70% improvements in joint pain and musculoskeletal symptoms and impact VAS scores at weeks 16 and 24 than those who received placebo or apremilast.

Conclusion: Findings from this pooled analysis suggest that deucravacitinib may be used in patients with psoriasis to effectively treat both dermatologic and joint symptoms. Graphical abstract available for this article.

Keywords: Arthralgia; Arthropathy; Disease burden; Self-report; Therapeutics.

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Conflict of interest statement

Declarations. Conflict of Interest: Joseph F. Merola is a consultant and/or investigator for AbbVie, Amgen, Biogen, Bristol Myers Squibb, Dermavant, Janssen, Leo Pharma, Lilly, Novartis, Pfizer, Regeneron, Sanofi, Sun Pharma, and UCB. Philip J. Mease has received research grants and consulting and/or speaker fees from AbbVie, Acelyrin, Amgen, Bristol Myers Squibb, Century, CorEvitas, Cullinan, Janssen, Lilly, MoonLake Immunotherapeutics, Novartis, Pfizer, Sana, and UCB. April W. Armstrong is an investigator, scientific advisor, and/or speaker for AbbVie, Almirall, Arcutis, Aslan Pharmaceuticals, Beiersdorf, Boehringer Ingelheim, Bristol Myers Squibb, Dermavant, Dermira, EPI Health, Incyte, Janssen, Leo Pharma, Lilly, Mindera Health, Nimbus, Novartis, Ortho Dermatologics, Pfizer, Regeneron, Sanofi, Sun Pharma, and UCB. Vibeke Strand is a consultant for AbbVie, Alpine Immune Sciences, Alumis, Amgen, Aria, AstraZeneca, Atom Bioscience, Bayer, Bioventus, Blackrock, Bristol Myers Squibb, Boehringer Ingelheim, Celltrion, Endo, Equillium, Ermium, Fortress Biotech, Genentech/Roche, Gilead, GSK, Horizon, Inmedix, Janssen, Kiniksa, Lilly, Merck, MiMedx, Novartis, Omeros, Pfizer, Priovant, Regeneron, R-Pharm, Samsung, Sandoz, Sanofi, Scipher, Setpoint, Sorrento, Spherix, and Tonix. Thomas Lehman, Stefan Varga, Brandon Becker, Yichen Zhong, and Matthew J. Colombo are employees of and shareholders in Bristol Myers Squibb. Jiyoon C. Choi is an employee of Bristol Myers Squibb and is a shareholder in Bristol Myers Squibb and Johnson and Johnson. Diamant Thaçi is an investigator, consultant, lecturer, and/or serves on scientific advisory boards for AbbVie, Almirall, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Galderma, Janssen-Cilag, Leo Pharma, Lilly, Novartis, Pfizer, Regeneron, Roche-Posay, Sanofi, Target RWE, and UCB. Androniki Bili was an employee of Bristol Myers Squibb at the time of this study. Alice B. Gottlieb has received research and/or educational grants (all paid to Mount Sinai School of Medicine) from Bristol Myers Squibb, Highlights Therapeutics, Janssen, and UCB; has served as a remunerated advisory board member and/or consultant for Amgen, AnaptysBio, Avotres Therapeutics, Boehringer Ingelheim, Bristol Myers Squibb, Dice Therapeutics, Highlights Therapeutics, Janssen, Lilly, Novartis, Sanofi, UCB, and XBiotech (stock options). Ethical Approval: The POETYK PSO-1 and PSO-2 trials were conducted in accordance with Good Clinical Practice, as defined by the International Council for Harmonization and the Declaration of Helsinki, with independent IRB approval obtained at each study site. All patients in POETYK PSO-1 and PSO-2 also provided written informed consent before trial participation. Permission to use the PASE questionnaire was obtained under the Creative Commons Attribution License.

Figures

Fig. 1
Fig. 1
Study designs for A POETYK PSO-1 and for B POETYK PSO-2. aApremilast was titrated in a blinded fashion from 10 mg QD to 30 mg BID over the first 5 days of dosing. bPatients in the apremilast group who did not achieve ≥ 50% improvement from baseline PASI at week 24 were switched in a blinded fashion to deucravacitinib. BID twice daily, PASI Psoriasis Area and Severity Index, PSO psoriasis, QD once daily. The study design figure for POETYK PSO-1 is reprinted from Armstrong et al. [23], and the study design figure for POETYK PSO-2 is reprinted from Strober et al. [24]. ©2022 by the American Academy of Dermatology, Inc. Published by Elsevier Inc. under the open-access CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
Fig. 2
Fig. 2
Improvement from baseline in joint pain VAS scorea. aIn patients with VAS scores of ≥ 30. bPOETYK PSO-1 and PSO-2 pooled data. cAt week 16 in each trial, patients receiving placebo crossed over to deucravacitinib; these patients are not represented in the week 24 analysis. dOnly patients in POETYK PSO-1. eThe p value indicates whether improvements from baseline between treatment groups (i.e., deucravacitinib vs. placebo or deucravacitinib vs. apremilast) were statistically significant. MCID defined based upon recommendations by Dworkin et al. [29]. CI confidence interval, MCID minimal clinically important difference, VAS visual analog scale
Fig. 3
Fig. 3
Proportion of patients achieving 20%, 30%, 50%, and 70% improvement in joint pain VAS scoresa. aIn patients with VAS scores of ≥ 30. bAt week 16 in each trial, patients receiving placebo crossed over to deucravacitinib; these patients are not represented in the week 24 analysis. CI confidence interval, VAS visual analog scale
Fig. 4
Fig. 4
Improvement from baseline in joint disease activity VAS scorea. aIn patients with VAS scores of ≥ 30. bPOETYK PSO-1 and PSO-2 pooled data. cAt week 16 in each trial, patients receiving placebo crossed over to deucravacitinib; these patients are not represented in the week 24 analysis. dOnly patients in POETYK PSO-1. eThe p value indicates whether improvements from baseline between treatment groups (i.e., deucravacitinib vs. placebo or deucravacitinib vs. apremilast) were statistically significant. CI confidence interval, VAS visual analog scale
Fig. 5
Fig. 5
Proportion of patients achieving 20%, 30%, 50%, and 70% improvement in joint disease activity VAS scoresa. aIn patients with scores of ≥ 30. bAt week 16 in each trial, patients receiving placebo crossed over to deucravacitinib; these patients are not represented in the week 24 analysis. CI confidence interval, VAS visual analog scale
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