What’s New in Psoriasis? Biologic and Oral Advances You Need to Know

At the Masterclasses in Dermatology APP Institute, Alice Gottlieb, MD, PhD, delivered an evidence-driven and high-impact session titled “Psoriasis: Update in Oral and Biologic Therapy.” Her talk focused on the latest oral agents and biologics for plaque psoriasis, with a clear message: precision treatment is here and it is evolving fast.

Dr Gottlieb opened by reminding APPs that treatment decisions should reflect individual disease domains, comorbidities, and patient preferences. “Understand new developments in oral treatments for psoriasis,” she outlined as a key objective, setting the stage for a session rich in clinical data and therapeutic updates.

Among the emerging therapies discussed, icotrokinra (ICO), an IL-36 receptor inhibitor, stood out for its performance in both adults and adolescents. In the ICONIC studies, ICO showed meaningful improvements in Investigator’s Global Assessment (IGA) and Psoriasis Area and Severity Index scores:

“ICO demonstrated high rates of clear/almost clear skin in adolescents at weeks 16 and 24,” with up to 86.4% achieving IGA 0/1, compared to just 13.6% with placebo.

Next, Dr Gottlieb turned to deucravacitinib, the first-in-class TYK2 inhibitor. Long-term extension data from the POETYK PSO-LTE trial was especially compelling, with efficacy and safety sustained through 256 weeks.

“Adverse event rates declined over time, and serious infections, major adverse cardiac events, and malignancies remained low and stable,” she noted.

Dr Gottlieb also shared pearls on maintenance strategies, highlighting data from the GUIDE study that support guselkumab dosing every 16 weeks in patients who achieve clear skin by week 20. “Maintenance dosing of every 16 weeks was non-inferior to every 8 weeks,” she explained—an insight that could simplify care and improve patient adherence.

For managing older patients or those on Medicare, she reviewed intravenous and subcutaneous biologics that remain viable first- or second-line options, including infliximab, tildrakizumab, and certolizumab.

With dozens of biologics and advanced oral therapies now available, Dr Gottlieb emphasized the importance of tailoring treatment to patient-specific factors while staying informed on the data. Her session served as both an update and a roadmap for navigating the modern psoriasis toolbox.

Reference

Gottlieb A. Psoriasis: update in oral and biologic therapy. Presented at: Masterclasses in Dermatology APP Institute; October 11–12, 2025; Dallas, TX.