Sotyktu and Otezla are both oral prescription medicines used to treat moderate-to-severe plaque psoriasis, but they work in different ways. Sotyktu blocks a protein called TYK2 (tyrosine kinase 2) to help lower inflammation and improve the severity and number of psoriasis lesions. Otezla works by blocking the phosphodiesterase type 4 (PDE4) enzyme to lower inflammation.

What are they approved for?

In September 2022, the FDA approved Bristol Myers Squibb’s Sotyktu (deucravacitinib) for adults to treat:

• moderate-to-severe plaque psoriasis in patients who are candidates for systemic therapy (injections or pills) or phototherapy (a specialized type of ultraviolet [UV] light).

Otezla (apremilast), made by Amgen, was first approved in March 2014 and is used to treat adults with:

• plaque psoriasis (in patients who are candidates for phototherapy or systemic therapy)
• psoriatic arthritis
• oral ulcers associated with Behçet’s Disease.

How are Sotyktu and Otezla taken?

Both drugs are taken orally as a tablet. Sotyktu is taken once per day and Otezla is twice per day.

Sotyktu is given as 6 mg orally once daily.

• It can be taken with or without food. Do not crush, cut, or chew the tablets.
• It comes as a 6 mg oral tablet.
• If you have severe liver disease you may not be able to use Sotyktu.

Otezla is given as 30 mg twice daily after a titration of slowly raising your dose over a period of 6 days.

• Slowly increasing your dose will help you to avoid stomach problems. Your doctor will tell you how to slowly increase your dose.
• It can be taken with or without food. Do not crush, cut, or chew the tablets.
• Otezla comes as a 10 mg, 20 mg, and 30 mg tablet.
• If you have problems with your kidney, your dose of Otezla may need to be lowered for both the slow titration and the final maintenance dose.

Which is more effective - Sotyktu or Otezla?

The effectiveness of Sotyktu was compared to Otezla in the head-to-head study called POETYK PSO.

In the pivotal, head-to-head, phase 3 POETYK PSO clinical trials with 1,684 adult patients, Sotyktu, given at a dose of 6 mg orally once daily was more effective in improving skin clearance when compared to an inactive placebo pill and to oral Otezla (apremilast), given at a dose of 30 mg orally twice daily.

The superior effectiveness of Sotyktu compared to placebo and Otezla was seen at both 16 and 24 weeks, and responses from Sotyktu lasted throughout one year (52 weeks).

• When compared to Otezla in two groups, 32% and 42% of people taking Sotyktu saw 90% clearer skin compared to 20% and 22%, of patients taking Otezla after 24 weeks.
• When compared to a placebo, 53% of people taking Sotyktu saw 75% clearer skin compared to 9% in the placebo group.
• The effectiveness of Sotyktu compared to placebo and Otezla was seen at both 16 and 24 weeks in studies, respectively, and responses from Sotyktu lasted throughout one year in POETYK PSO.

In addition, the POETYK PSO long-term extension (LTE) trial showed that effectiveness lasted throughout two years (112 weeks) of treatment in adult patients with moderate to severe plaque psoriasis.

• In the LTE study, reachers looked at the Psoriasis Area and Severity Index (PASI) 75 or PASI 90 scores used by doctors to determine the effectiveness of psoriasis treatments. Patients receiving Sotyktu showed 82% for PASI 75 and 55% for the PASI 90.
• A PASI 75 score and a PASI 90 score indicate a 75% reduction or 90% reduction, respectively, in disease severity and a significant improvement in psoriasis, such as how much skin is effected, as well as discoloration, thickness, and scaling of the areas.
• In addition, over the 112 weeks, the static Physician's Global Assessment (sPGA) 0/1 was determined to be 67% of patients, meaning the average of all skin lesions were clear (0) or almost clear (1).

Sotyktu has also led to greater clearing of scalp psoriasis in 16 weeks when compared to a placebo or Otezla.

• In two 16-week clinical studies, 60% to 70% of people in the Sotyktu groups had a clear or almost clear scalp compared to 37% to 39% of those in the Otezla group and 17% taking a placebo.

Learn more: How long can I take Sotyktu for?

How do common side effects compare between Sotyktu and Otezla?

It’s important to remember rates of side effects cannot be compared outside of direct comparative clinical studies as patient populations, doses and study designs may differ.

A side effect that has been commonly reported with both Sotyktu and Otezla includes upper respiratory tract infections.

Common side effects with Sotyktu are:

• upper respiratory tract infections (19.2%)
• increased blood creatine phosphokinase (2.7%)
• cold sores (2%)
• canker sores (1.9%)
• inflamed hair pores (1.7%)
• acne (1.4%)

Learn more: Warnings and precautions for Sotyktu

Common side effects with Otezla include:

• in psoriatic arthritis (≥ 5%): diarrhea, nausea, and headache
• in plaque psoriasis (≥ 5%): diarrhea, nausea, upper respiratory tract infection, and headache, including tension headache
• in Behçet’s Disease (≥ 10%): diarrhea, nausea, and headache.

Learn more: Warnings and precautions for Otezla

Which is more expensive - Sotyktu or Otezla?

At this time, Sotyktu is more expensvie than Otezla, but both are costly medicines used to treat plaque psoriasis. Your insurance may pay for either product, but you may have to pay a deductible, copay, or co-insurance.

There are no generic alternatives for either product at this time, which could help you save money. The lower-cost generic option for Otezla called apremilast was approved by the FDA in February 2021, but it is not yet on the U.S. market, possibly due to patent protection challenges.

Your cost can vary based on your pharmacy and location, any coupons or discounts you may have, or if you have insurance or a patient assistance program through the manufacturer.

Check with your insurance company. If you are not able to afford the medicine, call the manufacturer who may be able to offer a copay card or other financial assistance.

What is the price for Sotyktu?

The dose for Sotyktu is 6 mg orally once daily. The cash price for a 30-day supply of Sotyktu 6 mg is around $6,501 (30 tablets), but most people do not pay this price.

Bristol-Myers Squibb, the manufacturer of Sotyktu, offers the Sotyktu 360 Support Copay Assistance Program. If you qualify and have commercial based insurance (not Medicare or Medicaid), you may be eligible to get Sotyktu for $0 per month. For additional information contact the Copay Assistance Program at 888-768-9588 (1-888-SOTYKTU).

To learn more about payment options, visit the Sotyktu Pricing Guide

What is the price for Otezla?

The maintenance dose for Otezla for psoriasis is 30 mg twice a day. The cost of brand name Otezla if you are paying cash is around $4854 for a month’s supply of medication (60 tablets); however, most people do not pay this price.

Amgen, the manufacturer of Otezla, offers a $0 co-pay program for eligible patients. If you use Medicare or Medicaid, or are paying cash, you are not eligible for the Otezla co-pay program, but may be eligible through the Patient Assistance Program (PAP) if you cannot afford your medication.

Call Amgen’s SupportPlus at 1-844-4OTEZLA (1-844-468-3952), 8 AM to 8 PM Monday through Friday for more information about coverage for Otezla.

To learn more about payment options, visit the Otezla Pricing Guide.

Note: The above price guides are based on using the Drugs.com discount card which is accepted at most U.S. pharmacies.

This is not all the information you need to know about these medicines for safe and effective use and does not take the place of your doctor’s directions. Review the full patient medication guide and discuss this information and any questions you have with your doctor or other health care provider.