Icotrokinra Shows Sustained Skin Clearance Through 52 Weeks in Psoriasis

New 52-week data presented at the American Academy of Dermatology (AAD) 2026 Annual Meeting highlight the sustained efficacy and safety of icotrokinra (ICOTYDE; Johnson & Johnson), a first-in-class oral peptide targeting the IL-23 receptor, in patients with moderate-to-severe plaque psoriasis.

Across the Phase 3 ICONIC-ADVANCE 1 and 2 trials, icotrokinra demonstrated increasing rates of complete skin clearance over time. PASI 100 responses rose from 41% to 49% and from 33% to 48% between Weeks 24 and 52 in the two studies, respectively. Patients who crossed over from placebo at Week 16 achieved similar clearance rates by Week 52, reaching up to 50%. Safety findings remained consistent through one year, with no new signals identified.

In adolescents enrolled in the ICONIC-LEAD study, efficacy outcomes were similarly robust. At Week 52, 57% of patients achieved PASI 100 and 61% achieved Investigator’s Global Assessment (IGA) 0. High levels of response were sustained, with 86% achieving PASI 90 and 92% maintaining that response from Week 24 to Week 52.

Study investigator Linda Stein Gold, MD, emphasized the significance of durable response over time in a chronic disease.

“We want to see these drugs used over the course of years, not just weeks or months, because psoriasis is a chronic disease,” Dr. Stein Gold told Practical Dermatology. “What I can tell you is I am seeing consistent results over time. I am seeing patients get their skin under control and keep it under control.” 

Icotrokinra represents a novel therapeutic class as an oral peptide designed to selectively block IL-23 signaling.

“This drug is different from what we have seen in the past for systemic therapy in that it is an oral peptide and it is once daily,” Dr. Stein Gold noted.

Additional analyses showed that patients transitioning from deucravacitinib to icotrokinra experienced enhanced efficacy.

“More than double the patients developed clear skin on icotrokinra than they did on deucravacitinib,” Dr. Stein Gold said. 

The availability of an oral option with high efficacy may also influence treatment patterns.

“We have not had an oral drug that offers us the efficacy, the safety, and the tolerability that we have seen with biologic agents,” she said.