In a new study comparing four oral small molecule drugs for psoriatic arthritis (PsA), deucravacitinib (Sotyktu) and upadacitinib (Rinvoq) showed the strongest performance across key measures. The other two drugs tested were apremilast (Otezla) and tofacitinib (Xeljanz).

Small molecule drugs work by targeting specific pathways in the immune system to reduce inflammation. Unlike biologic drugs, which require injections, small molecule drugs are taken as pills​.

For the study, researchers reviewed data from nine randomized controlled trials involving nearly 3,700 participants. Researchers found that all four drugs studied worked better than a placebo (inactive treatment).

Among the four treatments, researchers found that deucravacitinib and upadacitinib stood out in key areas:

• Joint symptom relief
• Skin improvement
• Physical function

They also found that upadacitinib showed borderline superiority to the biologic drug adalimumab (Humira) for skin clearance. This means it appeared slightly more effective in the study, but the difference was not strong enough to be considered definitive.

Deucravacitinib was the only drug to significantly improve physical function compared to apremilast​.

Injection-Free Alternatives to Biologics

While biologics require injections, small molecule drugs are taken orally, which may make them more appealing for some people.

Though these study findings suggest that deucravacitinib and upadacitinib may be the most effective oral treatments for PsA based on clinical trial data, it’s important to note that PsA affects everyone differently. A medication that works well for one person may not be the best choice for another.

When considering treatment options, it’s important to talk with your doctor about your specific symptoms, medical history, and treatment goals. Certain oral drugs may be more or less appropriate for you based on your personal health history. Together, you can weigh the benefits and risks of different medications to find the best approach for your PsA management.

Learn about eight types of treatments for psoriatic arthritis.

Find Your Team

MyPsoriasisTeam is the social network for people living with psoriatic arthritis and psoriasis. Members share experiences, offer support, and discuss treatment options.

Are you considering small molecule drugs for PsA? Have you tried any of these treatments? Share your experience in the comments below, start a conversation by posting to your Activities feed, or connect with like-minded members in Groups.