Effectiveness and Safety of Deucravacitinib in Moderate-to-Severe Psoriasis: an Italian Multicenter Real-Life Study in the Lazio Region

INTRODUCTION: Psoriasis is a chronic, immune-mediated disease that significantly impacts patients' quality of life. Deucravacitinib, an oral selective TYK2 inhibitor, has shown promising efficacy and safety in phase 3 trials, but real-world evidence remains limited. OBJECTIVE: To evaluate the effectiveness and safety of deucravacitinib in moderate-to-severe psoriasis in an Italian real-life multicenter cohort. METHODS: A retrospective multicenter study was conducted across nine dermatology units in the Lazio region, including 49 adult patients treated with deucravacitinib. Clinical outcomes were assessed using the Psoriasis Area and Severity Index (PASI), Nail Psoriasis Severity Index (NAPSI), Disease Activity index for Psoriatic Arthritis (DAPSA), and Dermatology Life Quality Index (DLQI) at baseline, week 8, and week 16. RESULTS: Mean PASI scores significantly improved, from 11.4 at baseline to 4 at week 8 and to 1.7 at week 16. PASI 75 and PASI 90 responses were achieved by 31 and 13 patients, respectively. DLQI improved from 12 to 1 at week 16, indicating substantial quality-of-life gains. Clinical improvement was consistent in difficult-to-treat areas (scalp, nails, palmoplantar regions) and among patients with psoriatic arthritis. No significant difference emerged between biologic-naïve and biologic-experienced groups. Treatment was well tolerated, with only mild adverse events reported. CONCLUSION: This real-world study confirms deucravacitinib as an effective and safe oral treatment for moderate-to-severe psoriasis, providing rapid and sustained clinical improvement and enhanced patient quality of life.