Oral Interleukin-23 Inhibitor, Icotrokinra, to Manage Moderate to Severe Plaque Psoriasis
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Reviewed by Dat Tien Nguyen, B.A, ScM.
Translated by Nhi Phuong Quynh Le, B.A |
Posted on December 1st, 2025
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Plaque psoriasis is an inflammatory skin condition driven by an overactive immune response. Treatments that target pro-inflammatory pathways-such as interleukin-12 (IL-12), IL-17, IL-23, and TNFα-have been effective, but most require injectable administration. The need for regular clinic visits can reduce adherence, while existing oral treatments tend to be less effective. To address this gap, a Johnson & Johnson–funded study evaluated the oral agent icotrokinra for the treatment of plaque psoriasis.
The phase 3 trial enrolled 684 participants with moderate to severe plaque psoriasis, involving an average of 25.5% of total body surface area. Their mean Psoriasis Area and Severity Index (PASI) score was 19.9. Using the Investigator’s Global Assessment (IGA), 75% of patients were classified as having moderate disease (score of 3), and the remaining 25% had severe disease (score of 4). Most patients (72%) had previously received treatment, including 34% who had used injectable cytokine inhibitors and 30% who had undergone phototherapy.
Participants were randomly assigned to receive either placebo or oral icotrokinra at a daily dose of 200 mg. Icotrokinra works by blocking IL-23 receptor signaling. After 16 weeks, 69% of patients treated with icotrokinra achieved at least a 75% improvement from baseline PASI, compared with only 11% in the placebo group. Likewise, 65% of treated participants reached an IGA score of 0 or 1, versus 8% in the control group. Safety outcomes showed no meaningful increase in adverse events associated with icotrokinra. Future comparative trials will help determine how this oral therapy measures up against current standard treatments and whether its ease of use can improve long-term accessibility and adherence.
The phase 3 trial enrolled 684 participants with moderate to severe plaque psoriasis, involving an average of 25.5% of total body surface area. Their mean Psoriasis Area and Severity Index (PASI) score was 19.9. Using the Investigator’s Global Assessment (IGA), 75% of patients were classified as having moderate disease (score of 3), and the remaining 25% had severe disease (score of 4). Most patients (72%) had previously received treatment, including 34% who had used injectable cytokine inhibitors and 30% who had undergone phototherapy.
Participants were randomly assigned to receive either placebo or oral icotrokinra at a daily dose of 200 mg. Icotrokinra works by blocking IL-23 receptor signaling. After 16 weeks, 69% of patients treated with icotrokinra achieved at least a 75% improvement from baseline PASI, compared with only 11% in the placebo group. Likewise, 65% of treated participants reached an IGA score of 0 or 1, versus 8% in the control group. Safety outcomes showed no meaningful increase in adverse events associated with icotrokinra. Future comparative trials will help determine how this oral therapy measures up against current standard treatments and whether its ease of use can improve long-term accessibility and adherence.