Oral Icotrokinra Shows Rapid Efficacy Across Skin and Scalp Psoriasis With Favorable Safety
Icotrokinra, an oral interleukin-23 receptor antagonist, demonstrated rapid and significant clinical efficacy across multiple endpoints in moderate-to-severe plaque psoriasis, including difficult-to-treat areas, according to a meta-analysis of randomized controlled trials. The findings support its potential as an oral alternative to injectable biologics.
Investigators analyzed five randomized trials including 1509 patients treated with icotrokinra and compared outcomes with placebo. Primary endpoints included Investigator’s Global Assessment (IGA) responses, Psoriasis Area and Severity Index (PASI) improvements, and scalp-specific outcomes, along with patient-reported symptom measures.
Clinical responses were observed early and increased over time. Icotrokinra significantly improved rates of IGA 0/1 as early as week 4 and continued through week 16. The authors reported that icotrokinra “significantly increased the likelihood of achieving an IGA score of 0 or 1” across all timepoints. High levels of clearance were also achieved, with strong effects seen for PASI 90 responses at weeks 4, 8, and 16.
Efficacy extended to high-impact sites. Patients treated with icotrokinra were significantly more likely to achieve scalp clearance, with improvements in scalp-specific IGA scores at both week 8 and week 16. Patient-reported outcomes also improved, with higher rates of complete symptom resolution.
Safety outcomes were comparable to placebo. Rates of serious adverse events and malignancy did not differ significantly between treatment groups. The authors noted that icotrokinra demonstrated “a favorable short-term efficacy and an acceptable safety profile,” supporting its use as an emerging oral option.
Reference
Cevallos-Cueva M, Onejeme C, Ghanem L, Fonseca LO, Tyring SK. A novel oral interleukin-23 receptor antagonist peptide, icotrokinra, for moderate-to- severe plaque psoriasis: a systematic review and meta-analysis of randomized controlled trials. Inflammopharmacology. Published online March 3, 2026. doi:10.1007/s10787-026-02149-x
