F rom topicals and light therapy to systemic medications, a variety of treatments are available to treat psoriasis. Because each option is unique, some will work better for you than others.
A medication that falls under a class of drugs called Janus kinase (JAK) inhibitors was approved by the U.S. Food and Drug Administration (FDA) to treat moderate to severe plaque psoriasis in people 18 and older. Even though this class of drugs has been used to treat other conditions for years, it’s new to the psoriasis treatment landscape.
How This JAK Inhibitor Works for Psoriasis
“The approved pill for psoriasis distinguishes itself from other JAK inhibitors by being classified in a separate category called ‘selective TYK2 inhibitors,’” says Jeffrey Sobell, MD, a dermatologist at Tufts Medical Center in Boston. “This is the first and only medication that currently carries this designation.”
6 Essential Facts About JAK Inhibitors for Psoriasis
1. Only one JAK inhibitor has been approved to treat plaque psoriasis.
Deucravacitinib (Sotyktu) was approved by the FDA in September 2022 for treating moderate-to-severe psoriasis. It is a type of JAK inhibitor known as a TYK2 inhibitor.
But more may be coming down the pike.
And while JAK inhibitors, as a drug class, are new to psoriasis, they have been used to treat autoimmune diseases for over a decade. The first JAK inhibitor was approved for treating rheumatoid arthritis in 2012, and many more have been approved to treat other conditions since.
2. JAK inhibitors for psoriatic arthritis may also help treat psoriasis.
Around 30 percent of people with psoriasis also have psoriatic arthritis, which causes inflammation, swelling, and pain in the joints. Two other JAK inhibitors — tofacitinib (Xeljanz) and upadacitinib (Rinvoq) — are approved to treat psoriatic arthritis.
Although they’re not approved to treat psoriasis, “If you’re given [one of these drugs] for psoriatic arthritis, it almost certainly is going to make your skin better, too,” notes Steven R. Feldman, MD, PhD, a professor of dermatology at Wake Forest University School of Medicine in Winston-Salem, North Carolina. Likewise, “If you’re given [deucravacitinib] for psoriasis, it’s very likely going to make your arthritis better,” even though this new drug is not specifically indicated for treating psoriatic arthritis.
3. You only have to take it once a day.
This JAK inhibitor only needs to be taken once per day. By contrast, the only other oral treatment for plaque psoriasis, a disease-modifying drug known as apremilast (Otezla), must be taken twice a day and at a higher dose.
Note, too, that biologics, which also treat psoriasis systemically, have to be injected or taken as an infusion.
4. JAK inhibitors are considered very effective.
Two trials (called POETYK PSO-1 and PEOTYK PSO-2) found that 6 milligrams (mg) of deucravacitinib once a day was more effective than 30 mg of apremilast twice daily. After taking the JAK inhibitor for 24 weeks, 7 out of 10 people achieved at least a 75 percent improvement in their psoriasis severity and surface area affected, notes Dr. Sobell, and maintained those results after a year of continuing to take the drug.
Similarly, other research has shown that another JAK inhibitor, tofacitinib (Xelkjanz), is effective for treating both psoriasis and psoriatic arthritis, even though it’s only approved for the latter.
5. Although considered safe, deucravacitinib is known to have several possible side effects.
A 2-year study that focused on the safety and effectiveness of deucravacitinib found the most common risks associated with it to be mild to moderate, such as upper respiratory infection or headache.
This is different from the JAK inhibitors that are approved for treating psoriatic arthritis. Both tofacitinib and upadacitinib come with a black box warning about an increased risk of cancer and serious heart-related problems, such as blood clots, heart attack, and stroke, for some people.
Because deucravacitinib works differently from these other JAK inhibitors, it poses fewer risks and doesn’t carry this black box warning, notes Saakshi Khattri, M.D., a board certified dermatologist and rheumatologist and assistant professor of dermatology at the Icahn School of Medicine at Mount Sinai Hospital, in New York City.
That said, some people who take deucravacitinib may experience a serious allergic reaction. The drug can impact your immune system, making you more susceptible to respiratory infections. It may also increase your risk of certain types of cancer, such as lymphoma, and can lead to serious muscle damage, known as rhabdomyolysis.
6. It can be pricey.
This psoriasis medication can be costly — over $6,000 a month.
But, if you and your doctor decide that trying a JAK inhibitor for psoriasis may be right for you, your insurance company should cover most of the cost. Even then, you may have some out-of-pocket expenses based on the details of your prescription benefits. In that case, you can reach out to the drug manufacturer directly to see if you qualify for their patient assistance programs, which help cover your out-of-pocket drug costs.
Is a JAK Inhibitor Right For You?
5 Questions Your Should Be Asking About JAK Inhibitors for Psoriasis
Next Steps: Making Psoriasis Treatment Decisions
You’ve learned a lot about JAK inhibitors for psoriasis. So, what’s next?
Take some extra time to absorb all of this information and decide if a JAK inhibitor is something you might want to consider.
Before your next appointment, think about your current treatment plan and how well it’s controlling your psoriatic arthritis.
- Have you tried other psoriasis treatments?
- Are you able to follow your treatment regimen exactly as prescribed?
- Has it improved your psoriasis symptoms as well as you had hoped?
- Are you downplaying any symptoms or side effects with your doctor?
- Are you looking to see if other treatments may help you better manage your condition?
If you’re curious about trying a JAK inhibitor for psoriasis, here are a few conversation starters for your next doctor’s appointment.
- Do you think it’s possible for me to gain better control of my psoriasis?
- Which medication(s) would you recommend, and why?
- Am I a good candidate for a JAK inhibitor?
- If so, what can I expect while taking one?
- How often should I monitor the progress of my treatment?