Icotrokinra Shows Superior Efficacy Over Advanced Oral Therapies in New Psoriasis Meta-Analysis

A new network meta-analysis presented at the 2026 Maui Derm Hawaii conference confirms that icotrokinra, Johnson and Johnson’s investigational targeted oral peptide, offers a highly effective option for patients with moderate to severe psoriasis (PsO).¹ In the poster, titled “Comparative Analysis of Icotrokinra and Approved Advanced Treatments for Achievement of Completely Clear Skin in Patients with Moderate-to-Severe Psoriasis: A Systematic Literature Review and Network Meta-Analysis,” the drug demonstrated superior efficacy compared with currently approved advanced oral treatments and comparable efficacy to several leading injectable biologics in achieving completely clear skin.

Study Methodology

The study, which compares icotrokinra against 13 other advanced therapies, provides crucial data in a treatment landscape where head-to-head clinical trials are limited. Complete skin clearance, defined as a 100% improvement in the Psoriasis Area and Severity Index (PASI 100) or an Investigator Global Assessment score of 0 (IGA 0), has become a realistic and highly sought-after goal, strongly associated with improvements in quality of life and symptom burden for patients with PsO.

The network meta-analysis utilized robust methods, conducting a systematic literature review through March 2025 and employing random-effects Bayesian models to ensure comparability and account for heterogeneity across studies. The consistency of the results across both key metrics of complete clearance (PASI 100 and IGA 0) reinforces the findings.

Results

Icotrokinra is unique as a targeted oral peptide that selectively inhibits the IL-23 pathway—the same mechanism targeted by highly effective injectable biologics like risankizumab and guselkumab. The analysis, which analyzed data from 66 randomized clinical trials, focused on comparing complete skin clearance rates at week 16. The results, assessed against a strict Bayesian framework, showed compelling efficacy for icotrokinra:

• Superior to current advanced orals: Icotrokinra demonstrated superior efficacy compared with apremilast (a PDE4 inhibitor) and deucravacitinib (a tyrosine kinase 2 inhibitor) for achieving both PASI 100 and IGA 0 clearance.
• Comparable to injectable biologics: Icotrokinra’s efficacy was deemed comparable to several major injectable biologics, including the IL-23 p19 inhibitors (guselkumab and risankizumab) and the IL-17 inhibitors (secukinumab and ixekizumab).
• Superior to other biologics: Icotrokinra also demonstrated superior clearance rates compared with ustekinumab (an IL-12/23 inhibitor) and adalimumab (a tumor necrosis factor inhibitor).

Addressing Patient Preferences

The findings are particularly relevant given confirmed patient and provider preferences. Recent surveys indicate that skin symptoms remain the primary source of burden for patients with PsO, and there is a shared preference for oral treatment options over topical or injectable alternatives.²

According to the study authors, this comparative analysis “indicates that icotrokinra may provide [patients with] PsO with a treatment option that delivers high rates of completely clear skin via their preferred once-daily pill.”¹

The researchers noted that although 2 highly potent IL-17 inhibitors—bimekizumab and brodalumab—were “favored” over icotrokinra in achieving complete clearance, the overall positioning of icotrokinra as an oral agent comparable to several high-efficacy injectable biologics marks a critical development.

Overall, this new research positions icotrokinra to potentially fill a significant gap in the PsO treatment paradigm, offering biologic-level efficacy through the convenience of an oral tablet. Future research, including long-term data analyses, is anticipated to further contextualize the therapy’s role in clinical practice.

References

1. Armstrong A, Hashim M, Feghelm L, Yang YW, Disher T. Comparative analysis of icotrokinra and approved advanced treatments for achievement of completely clear skin in patients with moderate-to-severe psoriasis: a systematic literature review and network meta-analysis. Presented at: 2026 Maui Derm Hawaii Conference; January 25-29, 2026; Maui, HI.

2. Gold LS, Soung J, Trenkler N, Duenas A, Conklin L, et al. Impact and insights of psoriasis on quality of life and shared decision-making among US adolescents and adults. J of Skin. 2025;9(6):s643. doi:10.25251/hhxytc82