Bristol Myers Squibb Presents Late-Breaking Data from Pivotal Phase 3 POETYK PsA-1 Trial Demonstrating Superiority of Sotyktu (deucravacitinib) Compared with Placebo in Adults with Psoriatic Arthritis
Significantly more patients treated with Sotyktu achieved improvements in joint and skin symptoms, measures of disease activity and quality of life at Week 16 in POETYK PsA-1
New data from POETYK PsA-2 trial demonstrated that meaningful clinical responses continued to improve and outcomes were maintained through Week 52
Sotyktu demonstrated safety consistent with the established clinical profile and was well tolerated in both studies, with no new safety signals
The data for POETYK PsA-1 are being presented as a late-breaking abstract (#LB0001) at the
“Psoriatic arthritis can be a complex, multifaceted and heterogeneous disease, underscoring the significant need to equip healthcare providers with new safe and effective oral treatment options,” said
Patients treated with Sotyktu saw improvements across a wide range of clinical measures of disease activity, patient-reported outcomes and extra-articular manifestations of PsA at Week 16. Importantly, several key secondary endpoints were met, including Psoriasis Area and Severity Index (PASI) 75 response, Health Assessment Questionnaire-Disability Index (HAQ-DI) score, 36-
PsA-1 efficacy endpoints at Week 16 |
||||
Category |
Endpoint |
Sotyktu 6 mg once daily n=336 |
Placebo n=334 |
P value |
Clinical efficacy |
ACR20 response, % |
54.2 |
34.1 |
<0.0001* |
ACR50 response, % |
24.7 |
13.5 |
0.0002** |
|
ACR70 response, % |
11.6 |
5.4 |
0.0039** |
|
PASI 75 response,a % |
51.9 |
7.1 |
<0.0001* |
|
MDA response, % |
19.0 |
10.2 |
0.0012* |
|
DAS28-CRP score, mean CfB |
-1.33 |
-0.83 |
<0.0001** |
|
Patient-reported outcomes |
HAQ-DI score, mean CfB |
-0.39 |
-0.22 |
<0.0001* |
SF-36 PCS score, mean CfB |
6.06 |
3.71 |
<0.0001* |
|
FACIT-Fatigue score, mean CfB |
4.6 |
2.0 |
<0.0001** |
|
Extra-articular manifestations of PsA (pooled POETYK PsA-1 and POETYK PsA-2 analyses) |
LEI enthesitis resolution,b % |
50.3 |
45.1 |
0.1781 |
SPARCC enthesitis resolution,c % |
47.1 |
36.1 |
0.0018** |
|
Dactylitis resolution,d % |
57.6 |
44.1 |
0.0100** |
*Statistically significant. |
**Nominally significant. |
ACR20, |
aAssessed in all randomized patients with ≥3% BSA and a sPGA score of ≥2 at baseline (placebo, n=170; Sotyktu,n=162); bAssessed in pooled patients from POETYK PsA-1 and POETYK PsA-2 in patients with an LEI score ≥1 at baseline (placebo, n=317; Sotyktu, n=318); cAssessed in pooled patients from POETYK PsA-1 and POETYK PsA-2 in patients with SPARCC score ≥1 at baseline (placebo, n=407; Sotyktu, n=393); dAssessed in pooled patients from POETYK PsA-1 and POETYK PsA-2 in patients with an tender dactylitis count of ≥1 at baseline (placebo, n=188; Sotyktu, n=210). |
In addition, inhibition of radiographic progression was observed with Sotyktu at Week 16 in post hoc analyses. While the prespecified analysis did not show a statistically significant difference between Sotyktu and placebo in mean change from baseline (CfB) in the modified Sharp-
No new safety signals were identified in the POETYK PsA-1 trial. The most frequent adverse event (AE) in both the Sotyktu and placebo arms was upper respiratory tract infection (5.1% versus 3.0%, respectively). Serious AEs (1.8% versus 2.4%, respectively) and AEs that led to discontinuation (2.4% versus 1.8%, respectively) were infrequent though Week 16.
“These positive Phase 3 data build on the strong results from our POETYK Phase 3 PsA-2 trial and underscore the potential of Sotyktu as an oral, first-in-class TYK2 inhibitor for people living with psoriatic arthritis,” said
Continued improvement of clinical responses and maintenance of outcomes through Week 52 in POETYK PsA-2
Additionally, new data from the pivotal Phase 3 POETYK PsA-2 trial (abstract #OP0095), which evaluated patients with active PsA who were bDMARD naïve or had previously received TNFα inhibitor treatment, is also being presented at the meeting. Results showed superior efficacy of Sotyktu compared with placebo at Week 16. Additionally, through Week 52, clinical responses continued to improve for those who remained on or switched to Sotyktu treatment, and outcomes were maintained for those receiving continuous Sotyktu treatment.
At Week 16, 54.2% of Sotyktu-treated patients achieved ACR20 response versus 39.4% of those receiving placebo (p=0.0002). At Week 52, 62.2% of patients receiving continuous Sotyktu treatment and 67.3% of patients who switched from placebo to Sotyktu after Week 16 achieved ACR20 response. Similar trends were observed for ACR50 and ACR70. Additionally, key secondary endpoints continued to be maintained with Sotyktu treatment compared with placebo at Week 52, including PASI 75 response, MDA response, HAQ-DI score and SF-36 PCS score. Sotyktu was well tolerated through Week 52, demonstrating a safety profile consistent with previous results of Sotyktu in PsA and PsO.
Sotyktu is approved in numerous countries around the world for the treatment of adults with moderate-to-severe plaque PsO.
About the Sotyktu Phase 3 Psoriatic Arthritis Trial Program
The Phase 3 Sotyktu psoriatic arthritis (PsA) program includes two Phase 3, multicenter, randomized, double-blind, placebo-controlled trials evaluating the efficacy and safety in adults 18 years of age and older with active PsA: POETYK PsA-1 (IM011-054; NCT04908202) and POETYK PsA-2 (IM011-055; NCT04908189).
POETYK PsA-1 enrolled approximately 670 patients with active PsA who were not previously treated with a biologic disease-modifying antirheumatic drug (bDMARD naïve). POETYK PsA-2 enrolled approximately 730 patients with active PsA who were bDMARD naïve or had previously received TNFα inhibitor treatment. Both trials include a 52-week treatment period comprised of a placebo-controlled treatment period through Week 16, followed by a reallocation and continued active treatment period from Week 16 to Week 52. POETYK PsA-2 also included an apremilast safety reference arm.
The primary endpoint of both trials was the proportion of participants achieving an ACR20 response at Week 16. Important secondary endpoints were also assessed at Week 16 across measures of PsA disease activity. POETYK PsA-1 also evaluated inhibition of progression of structural joint damage at Week 16 as a key secondary endpoint.
Patients in both trials completing 52 weeks of treatment are potentially eligible to enroll in open-label extensions.
About Psoriatic Arthritis
Psoriatic arthritis (PsA) is a chronic, immune-mediated, heterogenous disease with multiple musculoskeletal and skin manifestations, including inflammatory arthritis, enthesitis (inflammation where tendon or ligament attaches to the bone), dactylitis (swelling of finger and toe joints) and psoriatic skin and nail lesions. Up to 30 percent of patients with psoriasis will develop PsA. In addition to the loss of physical function, pain and fatigue caused by PsA, the disease can significantly impact the mental and emotional well-being of patients. Patients with PsA are also at increased risk of serious comorbidities, including cardiovascular disease, metabolic syndrome, depression and anxiety.
About Sotyktu (deucravacitinib)
Sotyktu (deucravacitinib) is an oral, selective tyrosine kinase 2 (TYK2) inhibitor with a unique mechanism of action, representing a new class of small molecules. It is the first selective TYK2 inhibitor in clinical studies across multiple immune-mediated diseases.
Sotyktu is approved in numerous countries around the world for the treatment of adults with moderate-to-severe plaque psoriasis.
SOTYKTU
SOTYKTU® (deucravacitinib) is indicated for the treatment of moderate-to-severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy.
Limitations of Use:
SOTYKTU is not recommended for use in combination with other potent immunosuppressants.
IMPORTANT SAFETY INFORMATION
CONTRAINDICATIONS
SOTYKTU is contraindicated in patients with a history of hypersensitivity reaction to deucravacitinib or to any of the excipients in SOTYKTU.
WARNINGS AND PRECAUTIONS
Hypersensitivity: Hypersensitivity reactions such as angioedema have been reported. If a clinically significant hypersensitivity reaction occurs, institute appropriate therapy and discontinue SOTYKTU.
Infections: SOTYKTU may increase the risk of infections. Serious infections have been reported in patients with psoriasis who received SOTYKTU. The most common serious infections reported with SOTYKTU included pneumonia and COVID-19. Avoid use of SOTYKTU in patients with an active or serious infection. Consider the risks and benefits of treatment prior to initiating SOTYKTU in patients:
- with chronic or recurrent infection
- who have been exposed to tuberculosis
- with a history of a serious or an opportunistic infection
- with underlying conditions that may predispose them to infection.
Closely monitor patients for the development of signs and symptoms of infection during and after treatment. A patient who develops a new infection during treatment should undergo prompt and complete diagnostic testing, have appropriate antimicrobial therapy initiated and be closely monitored. Interrupt SOTYKTU if a patient develops a serious infection. Do not resume SOTYKTU until the infection resolves or is adequately treated.
Viral Reactivation
Herpes virus reactivation (e.g., herpes zoster, herpes simplex) was reported in clinical trials with SOTYKTU. Through Week 16, herpes simplex infections were reported in 17 patients (6.8 per 100 patient-years) treated with SOTYKTU, and 1 patient (0.8 per 100 patient-years) treated with placebo. Multidermatomal herpes zoster was reported in an immunocompetent patient. During PSO-1, PSO-2, and the open-label extension trial, the majority of patients who reported events of herpes zoster while receiving SOTYKTU were under 50 years of age. The impact of SOTYKTU on chronic viral hepatitis reactivation is unknown. Consider viral hepatitis screening and monitoring for reactivation in accordance with clinical guidelines before starting and during therapy with SOTYKTU. If signs of reactivation occur, consult a hepatitis specialist. SOTYKTU is not recommended for use in patients with active hepatitis B or hepatitis C.
Tuberculosis (TB): In clinical trials, of 4 patients with latent TB who were treated with SOTYKTU and received appropriate TB prophylaxis, no patients developed active TB (during the mean follow-up of 34 weeks). One patient, who did not have latent TB, developed active TB after receiving 54 weeks of SOTYKTU. Evaluate patients for latent and active TB infection prior to initiating treatment with SOTYKTU. Do not administer SOTYKTU to patients with active TB. Initiate treatment of latent TB prior to administering SOTYKTU. Consider anti-TB therapy prior to initiation of SOTYKTU in patients with a past history of latent or active TB in whom an adequate course of treatment cannot be confirmed. Monitor patients for signs and symptoms of active TB during treatment.
Malignancy including Lymphomas: Malignancies, including lymphomas, were observed in clinical trials with SOTYKTU. Consider the benefits and risks for the individual patient prior to initiating or continuing therapy with SOTYKTU, particularly in patients with a known malignancy (other than a successfully treated non-melanoma skin cancer) and patients who develop a malignancy when on treatment with SOTYKTU.
Rhabdomyolysis and Elevated CPK: Treatment with SOTYKTU was associated with an increased incidence of asymptomatic creatine phosphokinase (CPK) elevation and rhabdomyolysis compared to placebo.
Discontinue SOTYKTU if markedly elevated CPK levels occur or myopathy is diagnosed or suspected. Instruct patients to promptly report unexplained muscle pain, tenderness or weakness, particularly if accompanied by malaise or fever.
Laboratory Abnormalities: Treatment with SOTYKTU was associated with increases in triglyceride levels. Periodically evaluate serum triglycerides according to clinical guidelines during treatment. SOTYKTU treatment was associated with an increase in the incidence of liver enzyme elevation compared to placebo. Evaluate liver enzymes at baseline and thereafter in patients with known or suspected liver disease according to routine management. If treatment-related increases in liver enzymes occur and drug-induced liver injury is suspected, interrupt SOTYKTU until a diagnosis of liver injury is excluded.
Immunizations: Prior to initiating therapy with SOTYKTU, consider completion of all age-appropriate immunizations according to current immunization guidelines including prophylactic herpes zoster vaccination. Avoid use of live vaccines in patients treated with SOTYKTU. The response to live or non-live vaccines has not been evaluated.
Potential Risks Related to JAK Inhibition: It is not known whether tyrosine kinase 2 (TYK2) inhibition may be associated with the observed or potential adverse reactions of Janus Kinase (JAK) inhibition. In a large, randomized, postmarketing safety trial of a JAK inhibitor in rheumatoid arthritis (RA), patients 50 years of age and older with at least one cardiovascular risk factor, 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) were observed in patients treated with the JAK inhibitor compared to those treated with TNF blockers. SOTYKTU is not approved for use in RA.
ADVERSE REACTIONS
Most common adverse reactions (≥1% of patients on SOTYKTU and more frequently than with placebo) include upper respiratory infections, blood creatine phosphokinase increased, herpes simplex, mouth ulcers, folliculitis and acne.
SPECIFIC POPULATIONS
Pregnancy: Available data from case reports on SOTYKTU use during pregnancy are insufficient to evaluate a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. Report pregnancies to the Bristol Myers Squibb Company’s Adverse Event reporting line at 1-800-721-5072.
Lactation: There are no data on the presence of SOTYKTU in human milk, the effects on the breastfed infant, or the effects on milk production. SOTYKTU is present in rat milk. When a drug is present in animal milk, it is likely that the drug will be present in human milk. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for SOTYKTU and any potential adverse effects on the breastfed infant from SOTYKTU or from the underlying maternal condition.
Hepatic Impairment: SOTYKTU is not recommended for use in patients with severe hepatic impairment.
SOTYKTU is available in 6 mg tablets.
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This press release contains “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995 regarding, among other things, the research, development and commercialization of pharmaceutical products. All statements that are not statements of historical facts are, or may be deemed to be, forward-looking statements. Such forward-looking statements are based on current expectations and projections about our future financial results, goals, plans and objectives and involve inherent risks, assumptions and uncertainties, including internal or external factors that could delay, divert or change any of them in the next several years, that are difficult to predict, may be beyond our control and could cause our future financial results, goals, plans and objectives to differ materially from those expressed in, or implied by, the statements. These risks, assumptions, uncertainties and other factors include, among others, that future study results may not be consistent with the results to date, that Sotyktu (deucravacitinib) may not receive regulatory approval for the additional indication described in this release in the currently anticipated timeline or at all, any marketing approvals, if granted, may have significant limitations on their use, and, if approved, whether Sotyktu for such additional indication will be commercially successful. No forward-looking statement can be guaranteed. Forward-looking statements in this press release should be evaluated together with the many risks and uncertainties that affect Bristol Myers Squibb’s business and market, particularly those identified in the cautionary statement and risk factors discussion in Bristol Myers Squibb’s Annual Report on Form 10-K for the year ended
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