Acneiform Eruption with Deucravacitinib: Systematic Review and Meta-Analysis

Area of Science:

• Dermatology
• Pharmacology
• Immunology

Background:

• Deucravanitib is an oral selective tyrosine kinase 2 (TYK2) inhibitor used for chronic plaque psoriasis.
• Its application is expanding to other autoinflammatory conditions.
• Increased reporting of acneiform eruptions associated with deucravanitib use.

Purpose of the Study:

• Quantify the incidence of acneiform eruptions with deucravanitib.
• Compare the odds of these events versus placebo.
• Conduct exploratory analyses by deucravanitib dose and indication.

Main Methods:

• Systematic literature search of Medline, Embase, and CENTRAL for interventional and observational studies.
• Random-effects meta-analysis to pool proportions and odds ratios (OR).
• Primary outcome: incidence of acneiform eruption (acne, folliculitis, dermatitis acneiforme, rosacea).

Main Results:

• 14 studies included, with 8 controlled studies analyzed.
• Overall incidence of acneiform eruptions was 8.8% (467/5,280).
• Pooled incidence in controlled studies: 5.71% for deucravanitib vs. 0.84% for placebo (OR 4.56).
• Higher odds observed with greater daily doses and in psoriasis/inflammatory bowel disease indications.
• Discontinuations due to acneiform events were rare (0.21%).

Conclusions:

• Acneiform eruptions are a frequent cutaneous adverse event associated with deucravanitib.
• The incidence is significantly higher compared to placebo.
• Despite frequency, these events seldom necessitate treatment discontinuation.