One mechanic navigates life with moderate to severe plaque psoriasis

Sponsored by and provided by Bristol Myers Squibb

Working on fast cars has been Rogelio "Al" Castro's lifelong passion. Now, in retirement, he loves to take his grandkids to the speedway and tell them what it was like when he worked in the pit - the concrete vibrating underfoot; the adrenaline rush of jumping over the wall and changing tires in seconds; the pride he felt in troubleshooting and fixing an engine in record time.

A self-described problem-solver, Al was highly regarded by his clients for quickly diagnosing a vehicle's problem and getting it back on the road. But when it came to his personal life, there was one speed bump that took him years to navigate - the moderate to severe plaque psoriasis that he tried to hide during the day but kept him up scratching at night.

"Ever since I was a kid, I've loved taking things apart, seeing how they work and trying to put them back together better and stronger," says Al. "But my psoriasis was something I struggled to figure out. As a mechanic, it was incredibly frustrating to deal with a condition that I couldn't fix myself."

Al is not alone in living with plaque psoriasis. Around two million Americans have moderate to severe plaque psoriasis,[i] an autoimmune condition that causes dry, itchy, scaly patches (or plaques) to form across the skin.[ii] For many, in addition to physical discomfort, there is also the emotional burden of living with a chronic condition that may impact everyday choices and experiences due to embarrassment and fear of stigma.[i]

Covering Up to Cope

When Al was in his 30s, his psoriasis dramatically worsened, spreading to his elbows, knees and legs. To cope, he started covering up.

"It became a life-changing ordeal. No matter how hot and humid it was, I always wore long sleeves and pants because I didn't want to scare people," he remembers. "When I was working inside a car, I always made sure I was covered so I wouldn't leave any flakes behind. I don't think people knew the steps I was taking to keep my disease hidden. Looking back, it was a lot to carry."

For Al, hiding his psoriasis was a way to avoid difficult conversations and misinformed comments. While covering up may have helped Al to cope, his psoriasis impacted his relationships and other aspects of his life, and he realized he needed to find a treatment that worked for him.

After years of trying different topical therapies, Al reached a turning point after he experienced issues with his hip that required surgery. At the time, he had a large patch of plaque psoriasis on his hip and doctors couldn't operate until it was resolved. That led Al to search for something to help clear his skin.

The Turning Point: Finding A Treatment

There are different types of treatments for people with moderate to severe plaque psoriasis, including oral medicines, injectables and topicals (creams or ointments).[ii]

While psoriasis appears on the skin's surface, it starts inside the body in the immune system - the collection of organs, cells and proteins that help protect the body from infections and illnesses. In psoriasis, the immune system becomes overactive and sends too many inflammatory signals, including a molecule known as tyrosine kinase 2 (TYK2), which plays a key role in passing on signals in psoriasis.[iii]

Al's dermatologist introduced him to an oral medicine called Sotyktu™, a once-daily pill, that was approved by the U.S. Food and Drug Administration in 2022. [iv] Sotyktu is a prescription medicine used to treat adults with moderate to severe plaque psoriasis who may benefit from taking injections or pills (systemic therapy) or treatment using ultraviolet or UV light (phototherapy).[iv] [v]  It is not known if Sotyktu is safe and effective in children under 18 years of age. Sotyktu is the only FDA-approved once-daily pill that selectively targets and blocks TYK2 signals. It is not currently known how blocking TYK2 signals works to reduce psoriasis symptoms.[iv]

Sotyktu can provide appropriate patients with the chance of clearer skin. In two studies of people with moderate to severe plaque psoriasis including 1,684 adults, 841 people received Sotyktu, 422 received another medicine called Otezla® (apremilast), and 421 received placebo. Patients were assessed at 16, 24 and 52 weeks.[iv]

The co-primary endpoints of both studies measured the percentage of patients who achieved 75% improvement in the Psoriasis Area and Severity Index, also known as PASI 75, and the percentage of patients who achieved a static Physician's Global Assessment score (sPGA) of 0 or 1 at Week 16 versus placebo. Key secondary endpoints included the percentage of patients who achieved PASI 75 and PASI 90 compared to apremilast at Week 16 and Week 24.[iv]

In one study, 50% of people taking Sotyktu saw clear or almost clear skin vs. 9% taking placebo at week 16 and 53% of people taking Sotyktu saw 75% clearer skin vs. 9% taking placebo at week 16.[iv] At 24 weeks, 32% of people taking Sotyktu saw 90% clearer skin vs. 20% taking apremilast. Sotyktu may cause certain side effects.[iv] The most common side effects of this treatment include common cold, sore throat and sinus infection, cold sores, canker sores on inner lips, gums, tongue or roof of the mouth, inflamed hair pores and acne. Please see below for full Important Safety Information for Sotyktu.[iv]

Sotyktu helped more people have a clearer scalp compared to apremilast, with 70% of people having a clear or almost clear scalp at 16 weeks vs. 39% of people taking apremilast.[iv] In a second study, 60% of people taking Sotyktu vs. 37% of people taking apremilast saw a clear or almost clear scalp at 16 weeks.[iv]

In studies, more adults on Sotyktu (8% vs. 1% for placebo) reported relief of bothersome symptoms, such as pain, burning, skin tightness, stinging or itching, at 16 weeks compared to placebo.[iv] There was no significant difference in complete relief from bothersome symptoms vs. apremilast at 16 weeks.[iv] To learn more, visit Sotyktu.com.

Living Life with Clearer Skin

Since he started taking Sotyktu, Al says he has found a once-daily treatment that fits his lifestyle, his plaques have significantly improved and he is happy to leave his long sleeves behind. "My skin is so much clearer now. I no longer worry about my grandkids wondering what's wrong with grandpa. I can go to the beach and wear a bathing suit and play with them in the water. I'm grateful for these little things that let me enjoy life to the fullest." Now he wants other people living with moderate to severe plaque psoriasis to find a treatment that works for them. His advice is to be proactive in seeking treatment options.

"When you're fixing a car, sometimes you have to do more research, talk to other mechanics. You may not know what you're missing. I found it was the same with psoriasis. If it's not controlled, talk to your doctor, your dermatologist. Do the research, ask about Sotyktu. Don't give up until you find something that works for you."

To hear more stories from people like Al, visit Clear-Understanding.com.

*Rogelio "Al" is a Bristol Myers Squibb Patient Ambassador who takes Sotyktu for his moderate to severe plaque psoriasis. 

IMPORTANT SAFETY INFORMATION

INDICATION

SOTYKTU™ (deucravacitinib) is a prescription medicine used to treat adults with moderate-to-severe plaque psoriasis who may benefit from taking injections or pills (systemic therapy) or treatment using ultraviolet or UV light (phototherapy).

It is not known if SOTYKTU is safe and effective in children under 18 years of age.

IMPORTANT SAFETY INFORMATION ABOUT SOTYKTU (deucravacitinib)

SOTYKTU may cause serious side effects, including:

Serious allergic reactions. Stop taking SOTYKTU and get emergency medical help right away if you develop any of the following symptoms of a serious allergic reaction:

• feel faint
• swelling of your face, eyelids, lips, mouth, tongue, or throat
• trouble breathing or throat tightness
• chest tightness
• skin rash, hives

Infections. SOTYKTU is a medicine that affects your immune system. SOTYKTU can lower the ability of your immune system to fight infections and can increase your risk of infections. Some people have had serious infections while taking SOTYKTU, such as infections of the lungs, including pneumonia and tuberculosis (TB), and COVID-19.

• Your healthcare provider should check you for infections and TB before starting treatment with SOTYKTU and watch you closely for signs and symptoms of TB during SOTYKTU treatment.
• You may be treated for TB before you begin SOTYKTU treatment if you have a history of TB or have active TB.
• If you get a serious infection, your healthcare provider may tell you to stop taking SOTYKTU until your infection is controlled.

SOTYKTU should not be used in people with an active, serious infection, including localized infections. You should not start taking SOTYKTU if you have any kind of infection unless your healthcare provider tells you it is okay.

You may be at a higher risk of developing shingles (herpes zoster).

Before starting SOTYKTU, tell your healthcare provider if you:

• are being treated for an infection, or have had an infection that does not go away or keeps coming back
• have TB or have been in close contact with someone with TB
• have or have had hepatitis B or C
• think you have an infection or have symptoms of an infection such as:
• fever, sweats, or chills
• muscle aches
• weight loss
• cough
• shortness of breath
• blood in your phlegm (mucus)
• warm, red, or painful skin or sores on your body different from your psoriasis
• diarrhea or stomach pain
• burning when you urinate or urinating more often than normal
• feeling very tired

After you start taking SOTYKTU, call your healthcare provider right away if you have an infection or have symptoms of an infection.

SOTYKTU can make you more likely to get infections or make any infections you have worse.

Cancer. Certain kinds of cancer including lymphoma have been reported in people taking SOTYKTU. Tell your healthcare provider if you have ever had any type of cancer.

Muscle problems (rhabdomyolysis). SOTYKTU can cause muscle problems that can be severe. Treatment with SOTYKTU may increase the level of an enzyme in your blood called creatine phosphokinase (CPK) and can be a sign of muscle damage. Increased CPK is common in people taking SOTYKTU. Your healthcare provider may tell you to stop taking SOTYKTU if the amount of CPK in your blood gets too high or if you have signs and symptoms of severe muscle problems. Tell your healthcare provider right away if you have any of these signs or symptoms of severe muscle problems: unexplained muscle pain, tenderness, or weakness, feeling very tired, fever, or dark-colored urine.

Do not take SOTYKTU if you are allergic to deucravacitinib or any of the ingredients in SOTYKTU.

Before taking SOTYKTU, tell your healthcare provider about all of your medical conditions, including if you: have liver problems or kidney problems, have high levels of fat in your blood (triglycerides), or have recently received or are scheduled to receive an immunization (vaccine), as you should avoid receiving live vaccines during treatment with SOTYKTU.

Tell your healthcare provider if you are pregnant, plan to become pregnant, or if you are breastfeeding or plan to breastfeed. It is not known if SOTYKTU can harm your unborn baby or if SOTYKTU passes into your breast milk.

• Report pregnancies to the Bristol-Myers Squibb Company's Adverse Event reporting line at 1-800-721-5072

Tell your healthcare provider about all the medicines you take, including prescription medicines, over-the-counter medicines, vitamins, and herbal supplements. Keep a list of them to show your healthcare provider and pharmacist when you get a new medicine.

Take SOTYKTU exactly as your healthcare provider tells you to take it. Take SOTYKTU 1 time every day, with or without food. Do not crush, cut, or chew the SOTYKTU tablets.

SOTYKTU may cause serious side effects, including:

• Changes in certain laboratory test results. Changes in laboratory tests have happened in some people taking SOTYKTU. Your healthcare provider may do blood tests before you start taking SOTYKTU and during treatment with SOTYKTU to check for the following:
• Increased triglycerides. Too much fat in your blood can cause problems with your heart.
• Increased liver enzymes. If your liver enzymes increase too much, your healthcare provider may need to do additional tests on your liver and may tell you to stop taking SOTYKTU if they think that SOTYKTU is harming your liver.
• Potential risks from Janus kinase (JAK) inhibition. SOTYKTU is a tyrosine kinase 2 (TYK2) inhibitor. TYK2 is in the JAK family. It is not known whether taking SOTYKTU has the same risks as taking JAK inhibitors. Increased risk of death (all causes) has happened in people who were 50 years of age and older with at least 1 heart disease (cardiovascular) risk factor who were taking a JAK inhibitor used to treat rheumatoid arthritis (RA) compared to people taking another medicine in a class of medicines called TNF blockers. SOTYKTU is not for use in people with RA.

The most common side effects of SOTYKTU include: common cold, sore throat and sinus infection (upper respiratory infections), cold sores (herpes simplex), sores on inner lips, gums, tongue, or roof of the mouth (canker sores), inflamed hair pores (folliculitis) and acne.

These are not all of the possible side effects of SOTYKTU.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Please see the U.S. Full Prescribing Information and Medication Guide for SOTYKTU.

Sotyktu is a trademark of Bristol-Myers Squibb Company © 2024 Bristol-Myers Squibb Company. 1787-US-2400083  1/24

Otezla is a registered trademark of Amgen, Inc.

[i] Armstrong AW, Mehta MD, Schupp CW, Gondo GC, Bell SJ, Griffiths. Psoriasis Prevalence in Adults in the United States CEM10.1001/jamadermatol.2021.2007

[ii] Plaque psoriasis - treatment, causes, symptoms. Mount Sinai Health System. (n.d.). https://www.mountsinai.org/care/dermatology/services/psoriasis/plaque 

[iii] https://www.bms.com/life-and-science/science/the-innovation-behind-tyk2-inhibition.html

[iv] SOTYKTU Prescribing Information. SOTYKTU U.S. Product Information. September 2022. Princeton, N.J.: Bristol-Myers Squibb Company.

[v] Chimalakonda A, Burke J, Cheng L, et al. Selectivity profile of the tyrosine kinase 2 inhibitor deucravacitinib compared with janus kinase 1/2/3 inhibitors. Dermatol Ther (Heidelb) 2021;11(5):1763–1776. doi: 10.1007/s13555-021-00596-8.