Deucravacitinib

SOTYKTU

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Pronunciation: dyoo-krav-a-SYE-ti-nib (soe-TIK-too)

Deucravacitinib ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Deucravacitinib ballicule

Deucravacitinib SOTYKTU mascot mnemonic cartoon — Visual mnemonic: Deucravacitinib mascot
**“Soto ticks too”**
baseball player Juan Soto

What it isAllosteric TYK2 inhibitor acting at the regulatory domain; plaque psoriasis.

Why this oneIts TYK2 selectivity avoids broad JAK inhibition and the class boxed warning carried by JAK inhibitors.

What limits itInfections, herpes reactivation, and liver-enzyme elevations require attention; long-term safety is still accruing.

Deucravacitinib molecular structure (skeletal formula) — Molecular structure: Deucravacitinib

FDA label

Read the full label on DailyMed ↗

FDA dosing	Population	Start	Target	Max
Plaque psoriasis (moderate-to-severe, candidates for systemic therapy or phototherapy)	Adults	6 mg QD	6 mg QD	6 mg QD
Psoriatic arthritis (active)	Adults	6 mg QD	6 mg QD	6 mg QD

Renal No adjustment needed (mild, moderate, severe, or ESRD on dialysis)

Hepatic Mild-moderate (Child-Pugh A/B): no adjustment. Severe (Child-Pugh C): not recommended

Instructions

With or without food; do not crush, cut, or chew tablets
Evaluate for active and latent TB before initiation; do not give with active TB; treat latent TB first
Complete all immunizations per current guidelines before starting; avoid live vaccines during treatment

Available strengths

tab 6 mg

Cautions

Hypersensitivity reactions incl. angioedema — discontinue if clinically significant
Infections (serious, incl. pneumonia, COVID-19; herpes virus reactivation): avoid with active/serious infection; interrupt until resolved
Tuberculosis: evaluate before treatment
Malignancies incl. lymphomas observed — weigh benefit/risk with prior malignancy
Rhabdomyolysis/elevated CPK — discontinue if markedly elevated CPK or myopathy
Laboratory abnormalities: periodic triglycerides; liver enzymes with known/suspected liver disease
Avoid live vaccines
Potential class risks of JAK inhibition (mortality, MACE, thrombosis, malignancy observed with a JAK inhibitor vs TNF blockers in RA; hypoglycemia in diabetics) — TYK2 relationship unknown

Adverse reactions

>=1%: upper respiratory infections, increased blood CPK, herpes simplex, mouth ulcers, folliculitis, acne

Pregnancy Insufficient human data; no embryo-fetal effects in rats/rabbits at exposures at least 72x MRHD

Lactation No human data; present in rat milk (likely present in human milk) — weigh benefits of breastfeeding against maternal need and infant risk

Cost

Deucravacitinib (SOTYKTU)

Strength		#/mo	generic $/mo	CostPlus
6 mg	tab	30 qd		not offered

NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Deucravacitinib is dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.

NO BOXED WARNINGS

Principal riskLong-term safety still accruing

Classes and tags

Clinical profile

Therapeutic safety burden2 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk2 / 4

Legacy pregnancy categoryN/A (post-2015 labeling)

Defining liabilitySerious infections and muscle injury requiring surveillance

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