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Deucravacitnib Improves Quality of Life in Patients With Scalp Psoriasis
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Two posters presented at the 2025 American Academy of Dermatology Annual Meeting highlighted the importance of improving quality of life in patients with moderate to severe scalp psoriasis.
At the 2025 American Academy of Dermatology Annual Meeting, 2 posters highlighted the burden of moderate to severe scalp psoriasis on a patient’s quality of life (QOL), and the potential of deucravacitinib in reducing this burden.
The first poster was based on findings from the PSORIATYK SCALP (NCT05478499) study, an ongoing, randomized, double-blind, placebo-controlled, phase 3b/4 trial, which assessed the efficacy and safety of deucravacitinib in patients with moderate to severe scalp psoriasis.1 Deucravacitinib is an oral, selective, allosteric tyrosine kinase 2 inhibitor approved for the treatment of adults with moderate to severe plaque psoriasis who are candidates for systemic therapy.
The study included patients aged 18 years and older with moderate to severe scalp psoriasis and a body surface area (BSA) of 3% and greater. The primary patient-reported outcomes were included from the Dermatology Life Quality Index (DLQI): numeric rating scales (NRSs; 0-10 scale) for scalp-specific itch, pain, and flaking, and whole-body itch, and Scalpdex, a scalp dermatitis–specific QOL instrument.
Among a cohort of 154 patients, disease burden was evident across both BSA subgroups (3% to 10% and greater than 10%). The overall mean (SD) DLQI score of 11.0 (6.1) highlighted a severe impact on quality of life. Scalp-related symptoms were substantial, with mean NRS scores indicating moderate to severe itch (6.4 [2.1]), pain (4.1 [2.9]), and flaking (6.9 [2.3]).
Mean whole-body itch severity was also notable, averaging 5.8 (2.7), with a numerically higher mean score in the BSA greater than 10% group (7.0 [2.4] vs 5.3 [2.6] in the BSA 3% to 10% group). Interestingly, while overall scalp symptoms were comparable between subgroups, the total Scalpdex score was numerically worse in the BSA 3% to 10% group (57.5 [21.1] vs 49.7 [22.2]), suggesting variability in perceived scalp-related burden.
These findings underscore the significant symptom burden and QOL impact across disease severity.
The second poster was also based on findings from PSORIATYK SCALP and aimed to evaluate the efficacy and safety of deucravacitinib.2
Patients were randomized in a 1:2 ratio to receive either placebo or deucravacitinib. The primary analysis evaluated changes in DLQI scores from baseline, with treatment group and randomization stratification factors included as fixed effects and baseline DLQI as a covariate. Response rates for achieving a DLQI score of 0 or 1 (DLQI 0/1), indicating no or minimal impact on quality of life, were analyzed. Additionally, subgroup analyses assessed the proportion of patients achieving the minimum clinically important difference (MCID), defined as a reduction of 4 points or greater in DLQI within BSA subgroups of 3% to 10% and 10% and greater.
At baseline, mean DLQI scores were similar between the placebo (10.2 [5.6]) and deucravacitinib (11.3 [6.3]) groups. By week 16, patients receiving deucravacitinib experienced significantly greater improvement in DLQI scores compared with placebo, with a mean change from baseline of −6.4 (95% CI, −7.5 to 5.3) vs −1.5 (95% CI, −3.0 to 0.0; P < .0001), respectively. The proportion of patients achieving DLQI 0/1, indicating no or minimal impact on quality of life, was also significantly higher with deucravacitinib (32.3%; 95% CI, 23.3-42.5) compared with placebo (10.0%; 95% CI, 3.3-21.8; P = .0028).
Furthermore, DLQI MCID response rates were consistently greater in the deucravacitinib group compared with both BSA subgroups: 66.1% (95% CI, 53.0-77.7) vs 33.3% (95% CI, 18.6-51.0; P = .0017) for BSA 3% to 10% and 75.8% (95% CI, 57.7-88.9) vs 18.2% (95% CI, 2.3-51.8; P = .0007) for BSA 10% and greater.
These findings highlight the significant impact of deucravacitinib in improving QOL compared with placebo.
References
1. Feldman SR, Duval-Modeste A, Foulkes A, et al. Moderate to severe scalp psoriasis is associated with severe impact on quality of life: an analysis of patient-reported outcomes in PSORIATYK SCALP, a scalp-specific phase 3b/4 trial with deucravacitinib. Poster presented at: 2025 AAD Annual Meeting; Orlando, FL; March 7-11, 2025.
2. Feldman SR, Hoffman M, Bagel J. Deucravacitinib is associated with improvements in Dermatology Life Quality Index in patients with moderate to severe scalp psoriasis: an analysis of PSORIATYK SCALP, a randomized, double-blind, placebo-controlled, phase 3b/4 trial. Poster presented at: 2025 AAD Annual Meeting; Orlando, FL; March 7-11, 2025.
