Why do many doctors not recommend deuterated colexitinib/sondido?

Deucravacitinib As a representative of TYK2 selective inhibitors, it has shown unique advantages in the treatment of diseases such as plaque psoriasis. However, during clinical promotion, some doctors still remain cautious. There are many reasons behind this phenomenon.

The first is the uncertainty of security. As a new drug, long-term follow-up data are insufficient. Although mechanistically more selective than broad-spectrum JAK inhibitors, there is currently a lack of real-world evidence for more than a decade on the long-term effects on cardiovascular risk, malignancy incidence, and serious infections. Doctors tend to emphasize long-term efficacy and safety when dealing with patients with chronic diseases, which leads them to recommend biologics with more follow-up data.

The second is pharmacoeconomic factors. As an innovative oral targeted drug, deuterated colexitinib is priced relatively high and has not yet been included in medical insurance in some areas. For the average patient, the long-term burden is heavy, resulting in insufficient practical accessibility. In contrast, there are a variety of anti-IL-23 and IL-17 biologics that not only have clear efficacy, but have also been included in the medical insurance reimbursement list in some countries, which gives doctors more practical considerations when making choices.

In addition, some doctors believe that the drug still has limitations in efficacy. Although clinical trials have proven that it can significantly improve skin lesions, its skin lesion clearance rate is not necessarily better than some new-generation biological agents, and its efficacy is weak in some severe patients. This difference in efficacy, especially in the field of psoriasis, which requires higher treatment targets, has become an important reason for doctors to use caution.

Another point that cannot be ignored is the issue of patient compliance. Although oral medications are convenient, their efficacy can also be affected by patients voluntarily stopping the medication after symptoms improve. As a chronic relapsing disease, psoriasis requires long-term standardized management, so some doctors prefer to choose injectable biologics that are more controllable and have higher compliance.

Reference materials:https://go.drugbank.com/drugs/DB16650