Crohns and UC13 May 2023 11:40
From NIH May 2022
A member of the Janus kinase (JAK) family, Tyrosine Kinase 2 (TYK2), is crucial in mediating various cytokine-signaling pathways such as interleukin-23 (IL23), interleukin-12 (IL12) and type I Interferons (IFN) which contribute to autoimmune disorders (e.g., psoriasis, lupus, and inflammatory bowel disease) ( NOTE THE eg ie example here)
As a critical intracellular component of the IL12, IL23 and type I IFN cytokine cascades, TYK2 plays pivotal roles in autoimmune disorders including psoriasis (Ps), inflammatory bowel disease (IBD), systemic lupus erythematosus (SLE), lupus nephritis, multiple sclerosis (MS), etc. ( Note pivotal roles )
The TYK2 inhibitor, Deucravacitinib (BMS986165), is currently the compound most advanced clinically, which selectively binds to the JH2 regulatory domain of TYK2 and suppresses TYK2 associated cytokine pathways (22, 27, 52, 56–59). Deucravacitinib was demonstrated to be highly efficacious in phase 2 and 3 psoriasis trials with good safety profiles (58)
From Journal of Crohn's and Colitus Jan 22 ( Oxford Academic)
Pharmacodynamic data suggest insufficient inhibition of TYK2 pathways with DEUC 6 mg BID. Incidence of adverse events (AEs) was 70.1% in the DEUC arm and 47.6% with PBO; rates of serious AEs were 9.2% (n=8) and 4.8% (n=2), respectively. Rash, acne, and worsening of UC were the most common AEs in the DEUC arm. No meaningful changes from BL in mean values of laboratory parameters were observed with DEUC treatment.
Conclusion
This Phase 2 study of DEUC 6 mg BID in moderately-to-severely active UC did not meet its primary or secondary efficacy endpoints at Wk 12. In biologic-experienced pts, response rates were numerically higher with DEUC compared with PBO. The safety profile was consistent with DEUC trials in psoriasis and psoriatic arthritis. ( Note numerically higher but not significantly higher)
In this instance TyK 2 ( Deucravacitinib) failed in meeting its end point. BMS were looking at addressing this issue with higher dosages, I have no idea how far they have progressed this.
in addition Circa May 21.
Tofacitinib, a JAK1 inhibitor, is now licensed for use in the induction and maintenance of ulcerative colitis. ( jak 1 more efficacious in this instance than 100% allosteric TYK 2 here!)
You can draw your own conclusions from this.
Regards