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BMS-986165 + fluvoxamine is a combination of deucravacitinib (BMS-986165), a selective, oral tyrosine kinase 2 (TYK2) inhibitor developed primarily for immune-mediated diseases like psoriasis, psoriatic arthritis, and ulcerative colitis, with fluvoxamine, a selective serotonin reuptake inhibitor (SSRI) used primarily for major depressive disorder and obsessive-compulsive disorder. Deucravacitinib acts as a highly selective allosteric inhibitor of the TYK2 pseudokinase domain, thereby blocking IL-12, IL-23, and type I interferon signaling pathways, modulating immune responses. Fluvoxamine inhibits the serotonin transporter, increasing serotonin levels in the synaptic cleft, and is metabolized via hepatic pathways (notably CYP1A2, CYP2D6, CYP2C19), with potential for significant drug-drug interactions. This combination has been studied for potential pharmacokinetic interactions, where fluvoxamine acts as a strong CYP1A2 inhibitor and can alter the metabolism of co-administered drugs such as BMS-986165[7][9][3][5].
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