Deucravacitinib for the treatment of cutaneous lupus erythematosus: a 9-patient case series

Our 9-patient case series explores the efficacy, safety, and tolerability of deucravacitinib 6 mg once daily for the treatment of various subtypes of cutaneous lupus erythematosus (CLE). Deucravacitinib was prescribed either off-label or for concomitant psoriasis.
Supplementary Table 1 summarises the clinical characteristics of our patients, including age, CLE subtype, association with systemic LE, serology, disease duration, previous topical and systemic therapies, areas involved at baseline, duration of therapy with deucravacitinib, CLASI (Cutaneous LE Disease Area and Severity Index) values at baseline, week 12, and week 24, as well as therapy-associated adverse events. Supplementary Figure 1 shows graphical representation of median CLASI-A, CLASI-D, and CLASI values at baseline, week 12, and week 24 (A) and individual CLASI-A values for each patient at the same timepoints (B).
Median CLASI-A decreased from 7.0 at baseline to 1.0 at week 12, settling to 0 at week 24, while median CLASI-D increased from 1.0 at baseline to 2.0 at week 12 and 2.5 at week 24. At week 12, 77.8% patients achieved CLASI-50, defined as a decrease of ≥50% from baseline CLASI-A. Furthermore, all 6 patients followed up to 24 weeks achieved CLASI-50.
Adverse events were mild and included headache (11.1%) and transient bilateral hand arthralgias (11.1%), which resolved without need for drug discontinuation.
These finding, although preliminary, suggest that deucravacitinib may represent a safe and effective therapeutic option for conventional treatment-refractory CLE, regardless of CLE subtype.