Deucravacitinib

• You must see your rheumatologist regularly to make sure the treatment is working and check for possible side effects.
• You should have regular blood tests as suggested by your rheumatologist.
• It is important to tell your rheumatologist if you have a new serious illness such as a serious infection, cancer, heart failure or stroke, so that your arthritis treatment can be reviewed.
• If you are worried about any side effects, you should contact your rheumatologist as soon as possible.
• If you stop deucravacitinib for any reason, you must contact your rheumatologist. Failure to do so may mean that your treatment may no longer be funded.
• If you are taking baricitinib and plan to become pregnant, you must discuss the timing with your rheumatologist.
   

• You may notice some relief of joint swelling, pain and stiffness within the first 2 to 4 weeks of treatment, though it can take up to 3 months to improve. 
• The benefits of continuing deucravacitinib will be reviewed at each clinic appointment and it is important you advise your treating rheumatologist of any new medical conditions at each visit. 

• If you stop or delay your deucravacitinib treatment, your disease may get worse. Keep taking your treatment, unless advised by your rheumatologist to stop or unless serious side effects occur (see Side effects).
• If you stop deucravacitinib for any reason you must contact your rheumatologist. 

• Deucravacitinib will only be given if your disease is active and if standard treatments have not worked.
• Blood tests are needed during your treatment to monitor for side effects and to assess if the treatment is working. 
• How often you have blood tests will depend on what other medicines you are taking and what other illnesses you have. Your rheumatologist will advise on this.
   

Deucravacitinib is taken by mouth in tablet form. The tablet should be swallowed whole do not crush, break or chew the tablet. 

• Take this medicine with a full glass of water at the same time each day. It can be taken with or without food. 

• If you miss a dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.

The usual dose for adults with plaque psoriasis is 6mg taken once a day.

This medicine may be used alone or with other arthritis medicines including:

• Other disease modifying anti rheumatic drugs (DMARDs) such as methotrexate.
• Steroid medicines such as prednisolone or cortisone injections into the joint. 
• Anti-inflammatory medicines (NSAIDs) such as naproxen (Naprosyn®) or ibuprofen (Brufen®, Nurofen®).
• Simple pain medicines such as paracetamol.
• There may be some instances where these medicines may not be right for you, always check with your doctor prior to taking any of these medicines.

Deucravacitinib cannot be used with other biologic DMARDs or targeted synthetic DMARDS (such as upadacitinib, tofacitinib, etanercept and adalimumab).  
 

You might experience side effects with your treatment. Tell your doctor if you notice side effects that you think are caused by this medicine. Many side effects disappear when deucravacitinib treatment is stopped.

Most common side effects

• The most common side effects reported are mild upper respiratory tract infections (common cold, sinus infections), and rash. Infections may need treatment and deucravacitinib may need to be stopped for a while if you develop infection, so it is important to contact your doctor for advice.  

Less common or rare side effects

• Serious infections such as tuberculosis (TB) are seen rarely, and screening for TB is needed before treatment begins.
• Increases in triglyceride levels occur in some patients when taking deucravacitinib. This will be monitored using blood tests.
• Changes in liver function can occur, it is recommended to have regular liver function tests to monitor this. 
• Deucravacitinib may increase the risk of getting shingles. If you get a painful skin rash with blisters inform your doctor immediately. Vaccination for shingles should be discussed with your rheumatologist before starting treatment.
• People with psoriatic arthritis may have increased risk of lymphoma and some other cancers. Medicines that change your immune system like deucravacitinib may increase this risk. 
• Skin cancers have been reported in people taking deucravacitinib and yearly skin checks are recommended.
• It is recommended that patients remain up to date with their age recommended cancer screens such as mammogram and bowel cancer screening.
• If you experience any side effects, please inform your doctor or pharmacist promptly.

Infections  
If you have an active infection of any kind, treatment with deucravacitinib will not be started until the infection is treated successfully.
You should have screening for some infections such as TB and hepatitis, before commencing treatment with deucravacitinib.

Use with other medications 

Deucravacitinib can interact with other medicines. You should tell your doctor (including your GP, rheumatologist and others) about all medicines you are taking or plan to take. This includes over-the-counter or herbal/naturopathic medicines. You should also mention your treatment when you see other health professionals.

Use with alcohol

You may drink alcohol while taking deucravacitinib. However, if you are also taking methotrexate you should be cautious about how much alcohol you drink. 

Vaccines

If you are taking deucravacitinib you should not be immunised with ‘live’ vaccines such as:
•    MMR (measles, mumps and rubella)
•    Varicella (chicken pox/shingles) 
•    OPV (oral polio virus)
•    BCG (bacillus calmette guerin) 
•    Japanese Encephalitis or Yellow Fever

Talk with your rheumatologist before receiving any vaccines.
Pneumococcal vaccines and the yearly seasonal flu vaccinations are encouraged.

For more information on vaccination including the COVID-19 vaccination click here.  

Surgery

If you require surgery for any reason, treatment with deucravacitinib should be stopped one week before surgery. It will be restarted again after the operation at a time agreed by your surgeon and rheumatologist.

Use in pregnancy and when breastfeeding  

• It is important to inform your doctor if you are planning a pregnancy while on deucravacitinib.
• Deucravacitinib should not be used during pregnancy. Women of childbearing potential should use effective birth control both during treatment and for at least 1 week after the final dose of deucravacitinib.
• Do not breastfeed if you are taking deucravacitinib as it is uncertain how much of the medicine might be excreted in breastmilk. 
• More detailed information is available at https://rheumatology.org.au/For-Patients/Pregnancy-Information

More detailed information is available here
 

• Store deucravacitinib in a cool, dry place, away from direct heat and light (for e.g. not in the bathroom). 
• Keep all medicines out of reach of children.