Oral Icotrokinra Shows Strong Short-Term Efficacy in Plaque Psoriasis, Meta-Analysis Finds
Oral icotrokinra, a selective interleukin-23 (IL-23) receptor antagonist, demonstrated significant improvements in skin clearance and patient-reported outcomes in moderate-to-severe plaque psoriasis, according to a systematic review and meta-analysis of randomized controlled trials. The findings highlight the potential of an oral alternative to injectable biologics.
Investigators analyzed5 randomized controlled trials including 1951 patients treated with icotrokinra 200 mg once daily or placebo. At week 16, icotrokinra significantly improved Investigator’s Global Assessment (IGA) 0/1 responses (risk ratio [RR], 7.27) and Psoriasis Area and Severity Index (PASI) 75 responses (RR, 6.70), both compared with placebo. Higher levels of clearance were also observed, including PASI 90 (RR, 13.82) and PASI 100 (RR, 31.65).
Efficacy extended to difficult-to-treat areas. Scalp-specific outcomes improved significantly (ss-IGA RR, 4.27), and patient-reported measures showed marked benefit. Complete symptom resolution on the Psoriasis Symptom Scale Diary was significantly more likely with icotrokinra (RR, 9.76).
Safety outcomes were comparable to placebo, with no significant differences in adverse event rates across trials. Heterogeneity was minimal, supporting consistency of results across studies.
The authors concluded that “oral icotrokinra demonstrates potential efficacy across multiple clinical and patient-reported endpoints with a safety profile comparable to placebo.” However, they cautioned that “current evidence remains insufficient to draw definitive conclusions,” as trial sequential analysis indicated that the required information size has not yet been reached.
Reference
AlJuma RS, Hashim S, Alshamali MA, Alkhatlan S, Hammadi DJ, Alharran AM. Safety and efficacy of oral icotrokinra for moderate-to-severe plaque psoriasis: a systematic review and meta-analysis of randomized controlled trials. Front Immunol. 2026;17:1768292. doi:10.3389/fimmu.2026.1768292
