Short-Term Effectiveness and Safety of Deucravacitinib in Psoriasis: A Multicenter Real-World Study with Scalp-Specific Outcomes-IL PSO (Italian Landscape Psoriasis)

Introduction: Real-world evidence on deucravacitinib in moderate-to-severe psoriasis remains limited, especially regarding difficult-to-treat areas such as scalp involvement. We conducted a multicenter retrospective study to assess the short-term effectiveness and safety of deucravacitinib in routine clinical practice, with a specific focus on scalp outcomes. Methods: We enrolled 111 adult patients with moderate-to-severe psoriasis treated with deucravacitinib for at least 16 weeks across 19 different Italian dermatology units. Effectiveness was assessed in terms of PASI (Psoriasis Area and Severity Index) responses and scalp-specific Physician's Global Assessment (ss-PGA). Results: At week 16, PASI 75, PASI 90, and PASI 100 were achieved by 49.6%, 29.7%, and 18.9% of patients, respectively, with response rates further improving to 84.9%, 60.6%, and 45.5% at week 32. Among patients with baseline scalp involvement (n = 49), 89.8% reached ss-PGA 0/1 at week 16 and 100% at week 32, showing rapid and sustained scalp clearance. Notably, baseline scalp involvement did not negatively affect overall skin response. Deucravacitinib demonstrated a favorable safety profile. Adverse events (AEs) were reported by 8.1% of patients and were all mild in severity. Treatment was discontinued in 2.7% of patients, and no severe AEs were observed. Conclusion: Deucravacitinib demonstrated clinical effectiveness and a favorable safety profile in real-world practice, including excellent scalp clearance rates, confirming its therapeutic value even in patients with difficult-to-treat areas.