INDIVIDUAL ARTICLE: Evidence-Based Synthesis of Deucravacitinib: Long Term Efficacy, Safety, and Practical Use in Moderate-to-Severe Psoriasis

February 2026 | Volume 25 | Issue 2 | 070210s3 | Copyright © February 2026


Published online January 31, 2026

Abigail Katz BAa, Charles Kircik b, Angela Lamb MDa, April Armstrong MD MPHc

aIcahn School of Medicine at Mount Sinai, The Kimberly and Eric J. Waldman Department of Dermatology at Mount Sinai, New York, NY
bGatton College of Business and Economics, Lexington, KY
cDavid Geffen School of Medicine at the University of California Los Angeles, Los Angeles, CAA

Abstract
Background: Deucravacitinib, a first-in-class, oral, selective TYK2 inhibitor, has redefined systemic therapy options for moderate-to-severe plaque psoriasis. This review synthesizes published data from the POETYK phase 3 and long-term extension (LTE) studies, together with current research and real-world clinical evidence, to provide clinicians a comprehensive perspective on the agent's long-term efficacy, safety, and clinical utility.
Objective: To synthesize long-term efficacy and safety data for deucravacitinib and provide practical insights for real-world use.
Discussion: We reviewed published, long-term data for 1,519 patients on deucravacitinib over 5,000 person-years of exposure. Sustained clinical response was observed in the efficacy cohort (n=513), with PASI 75/90/100 responses maintained at 67%, 46%, and 22% at week 256 (mNRI). Nearly half of patients achieved minimal disease impact on daily life (DLQI 0/1). Patient-reported outcomes confirmed durable improvement in symptoms, itch, and quality of life. Deucravacitinib demonstrated a consistent safety profile with no new signals in the available long-term data. Rates of adverse and serious adverse events declined over time; acne, when present, was mild and transient. The agent's selective TYK2 regulatory-domain inhibition distinguishes it mechanistically from broader JAK inhibitors, underpinning its favorable safety and tolerability.
Conclusions: Long-term evidence affirms deucravacitinib's durable disease control, stable safety, and patient-friendly convenience. With once-daily oral dosing, minimal laboratory monitoring, and efficacy across difficult-to-treat sites, deucravacitinib represents a practical and reliable long-term therapy with oral simplicity for patients with moderate-to-severe plaque psoriasis.


INTRODUCTION

Psoriasis is a chronic, immune-mediated inflammatory skin disease affecting more than 125 million individuals worldwide.1-3 At the cellular level, aberrant activation of inflammatory pathways triggers keratinocyte hyperproliferation, resulting in the formation of thick, scaly plaques.3,4 Two cytokines central to this process, interleukin (IL)-23 and type I interferons (IFNs), signal through the intracellular enzyme tyrosine kinase 2 (TYK2).1,5,6 As a member of the Janus kinase (JAK) family, TYK2 plays an essential role in mediating inflammatory signaling cascades, and overactivation of this pathway contributes to psoriasis pathogenesis.4 This pivotal role has made TYK2 an attractive therapeutic target.1,5,6

First- and second-generation TYK2 inhibitors developed for immune-mediated diseases, including psoriasis, act by blocking the adenosine triphosphate (ATP) binding site on the TYK2 catalytic domain.7,8 Deucravacitinib represents a paradigm shift as a next-generation, oral, selective, allosteric TYK2 inhibitor that binds the regulatory domain rather than the catalytic domain.7 This unique mechanism confers greater receptor specificity and minimizes off-target inhibition of other JAK pathways, reducing the potential side effect burden.8,9 Deucravacitinib is the first FDA-approved oral medication in its class for moderate-to-severe plaque psoriasis and is administered at a dose of 6 mg once daily.10


Keywords: Open Access, Supplement
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