Icotrokinra demonstrates high rates of clearance in scalp, genital psoriasis

Key takeaways:

• Icotrokinra showed rapid efficacy among adults and adolescents with at least moderate psoriasis.
• Most participants with scalp psoriasis treated with icotrokinra achieved the study’s primary endpoint.

Icotrokinra demonstrated high rates of clearance in scalp and genital psoriasis after 16 weeks of treatment, according to data presented at the 2025 Society for Investigative Dermatology Annual Meeting.

Icotrokinra is the first investigational, oral peptide designed to selectively block interleukin-23 receptors in people with moderate to severe plaque psoriasis, ulcerative colitis and other inflammatory diseases.

According to Melinda J. Gooderham, MSc, MD, medical director of the SKiN Center for Dermatology, investigator with Probity Medical Research and assistant professor at Queen’s University, Peterborough, Ontario, Canada, icotrokinra’s unique mechanism of action makes it an ideal treatment for psoriasis.

“Most small molecules, like a Janus kinase inhibitor for example, are absorbed and block signaling pathways inside the cell, which takes away a bit of its specificity because it might block other pathways and cause potential adverse effects,” Gooderham told Healio. “Icotrokinra is a peptide, so it blocks [pathways] outside of the cell. Icotrokinra’s ability to block the IL-23 pathway through an oral route, which we know is the safest and most effective pathways to block, is what is causing all the buzz in dermatology.”

New data from the phase 3 ICONIC-TOTAL study showcased icotrokinra’s rapid efficacy among adults and adolescents aged 12 years and older with at least moderate psoriasis covering as little as 1% body surface area in high-impact areas.

Results showed that 57% of participants, overall, treated with once-daily icotrokinra (n = 208) achieved the study’s primary endpoint of an IGA 0 or 1 score and a two-grade or higher improvement from baseline by week 16. In contrast, only 6% of participants in the placebo group (n = 103) achieved the same (P < .001).

Among those with scalp psoriasis, 66% treated with icotrokinra achieved the primary endpoint vs. 11% receiving placebo. Similarly, 77% treated with icotrokinra for genital psoriasis reached a static PGA score of 0 or 1 vs. 21% in the placebo group (P < .001).

Icotrokinra’s safety profile was favorable, yielding no new safety signals. Half of participants treated with icotrokinra and 42% receiving placebo experienced adverse events, 0.5% and 1.9% of which were serious, respectively.

“Right now, a lot of our oral therapies have baggage,” Gooderham said. “Whereas this oral peptide has basically the same safety profile as a biologic, but taken as an oral, so you get the oral option without a compromise.”

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For more information:

Melinda J. Gooderham, MSc, MD, can be reached at dermatology@healio.com.