Deucravacitinib Disease Interactions

Deucravacitinib treatment has been associated with an increase in liver enzymes, in some cases greater than 3 times the upper normal limit (ULN). Liver enzymes should be evaluated at baseline and monitored thereafter in patients with known or suspected liver disease. If drug-induced liver injury is suspected, treatment should be interrupted until this diagnosis is excluded. Deucravacitinib is not recommended in patients with severe hepatic impairment.

Deucravacitinib increases the risk of infection and should be avoided in patients with active or serious infections. Clinical trials also reported cases of herpes virus reactivation. Patients should be screened for viral hepatitis and tuberculosis prior to initiating therapy with this drug, and should be monitored during treatment for infection reactivations or new infections. Any new infection should be promptly diagnosed and treated and the patient should be closely monitored. If a serious infection develops, discontinue treatment immediately until the infection is treated and resolved.

Malignancies including lymphomas were reported in clinical trials with deucravacitinib. Risks and benefits of each individual patient should be considered prior to treatment initiation, especially in patients with known malignancies (other than a successfully treated non-melanoma skin cancer).

A large, randomized, postmarketing safety trial of a JAK inhibitor in rheumatoid arthritis (RA) patients 50 years old and older with at least one cardiovascular risk factor, reported higher rates of all-cause mortality, including sudden cardiovascular death, major adverse cardiovascular events, overall thrombosis, deep venous thrombosis, pulmonary embolism, and malignancies (excluding non-melanoma skin cancer) in patients treated with the JAK inhibitor compared to patients receiving TNF blockers. Deucravacitinib is not approved for use in RA.