What is Sotyktu?
Sotyktu is a once-daily pill we use for psoriatic arthritis — the joint disease that can come with psoriasis. Its generic name is deucravacitinib. It’s also approved for plaque psoriasis, so it can treat the skin and the joints at the same time.
Sotyktu is a TYK2 inhibitor. TYK2 (tyrosine kinase 2) is an enzyme inside your immune cells that relays the inflammatory signals driving psoriatic disease. By quieting that one signal, Sotyktu reduces joint pain, swelling, and skin plaques without broadly shutting down your immune system.
How to take it
- One 6 mg tablet once a day, with or without food.
- Take it at about the same time each day.
- Swallow the tablet whole — do not crush, split, or chew it.
What to expect when starting
Sotyktu works gradually. Many patients see their skin and joints improve over the first several weeks, with fuller benefit by around 16 weeks. Keep taking it even before you feel the full effect.
Most patients tolerate Sotyktu well. It does not require a slow dose build-up — you start at the full 6 mg dose.
How Sotyktu differs from JAK-inhibitor pills
The other oral pills for psoriatic arthritis — such as Xeljanz and Rinvoq — are JAK inhibitors, which carry an FDA boxed warning about heart events, blood clots, and certain cancers. Sotyktu works through a related but different target (TYK2 rather than JAK1/2/3), and it does not carry that boxed warning.
Sotyktu is a newer medication, so we still watch for infections and keep an eye on long-term safety. But for many patients, avoiding the boxed warning that comes with JAK-inhibitor pills is a meaningful advantage.
Before you start
We check a few things before your first dose:
- Tuberculosis (TB) test — to make sure you don’t have a hidden (latent) infection that treatment could reactivate.
- Baseline blood work and a review of your vaccination history.
- Update inactivated vaccines beforehand (flu, COVID, Shingrix). Live vaccines should be given before starting, not during.
Lab monitoring
Unlike the JAK-inhibitor pills, Sotyktu does not require a frequent, ongoing blood-test schedule. We check baseline labs before you start and then check periodically based on your situation. Mildly elevated liver enzymes, triglycerides, or a muscle enzyme called CPK can occur, which is one reason we keep a general eye on your labs.
Side effects to watch for
Most side effects are mild. Contact us if you experience:
- Fever, chills, or other signs of infection — Sotyktu can raise infection risk.
- Mouth sores (canker sores) — a fairly common and usually minor side effect.
- Acne or red, inflamed hair follicles (folliculitis), especially early on.
- Cold sores or shingles that flare up.
Things to avoid
- Live vaccines — such as the live shingles vaccine (Zostavax) or the live nasal flu spray. Inactivated vaccines (flu shot, COVID, Shingrix) are safe and encouraged.
- Starting Sotyktu during an active infection — let us know if you’re sick or on antibiotics before you begin.
- Combining it with a biologic or another targeted pill — Sotyktu isn’t used together with those.
- Pregnancy — there isn’t enough safety data to consider Sotyktu safe in pregnancy, so tell us early if you’re pregnant or planning to be, and we’ll plan around it.
Frequently asked questions
Is Sotyktu a JAK inhibitor? No. It’s a TYK2 inhibitor — a related but distinct class. That difference is why it does not carry the boxed warning that JAK-inhibitor pills do.
Is a pill as effective as an injection? For many patients with psoriatic arthritis, yes. Sotyktu treats both the joints and the skin, and being a once-daily pill makes it convenient for people who’d rather avoid injections.
Can I get vaccinated? Yes — inactivated vaccines (flu, COVID, Shingrix) are recommended. Avoid live vaccines, and talk to us before any new vaccination.
What if I miss a dose? Take it when you remember the same day. If it’s nearly time for the next dose, skip the missed one — don’t double up.
How long will I take it? Often long-term, as long as it’s controlling your joints and skin and you’re tolerating it well. We’ll reassess as part of your ongoing care.
This handout is provided for educational purposes and does not replace individualized medical advice. Always follow the specific instructions given by your rheumatologist.