New Daily Pill Matches Injectable Biologics for Plaque Psoriasis

What's new?

The FDA approved icotrokinra (brand name Icotyde) for adults and adolescents (ages 12 and older) with moderate-to-severe plaque psoriasis.

While it is taken as a once-daily tablet, icotrokinra is classified as a targeted peptide. It works using the exact same targeted precision as advanced injectable biologics, selectively blocking the IL-23 receptor, a key pathway driving psoriasis inflammation.

Why it matters for patients

1. No injections required. Offers biologic-level efficacy without needles, refrigerated storage, or self-injections.
2. High rates of skin clearance. In Phase 3 clinical trials (the ICONIC program), nearly 75% of patients achieved clear or almost clear skin (IGA 0/1) by 24 weeks.
3. Effective on hard-to-treat areas. Trials demonstrated high success rates for difficult areas like the scalp, palms, soles, and genital region.
4. Strong adolescent outcomes. Pediatric patients (ages 12+) responded exceptionally well, with over 86% reaching clear or almost clear skin at week 24.

Key takeaway

Patients no longer have to choose between the convenience of a pill and the high clearance rates of an injectable biologic. Icotrokinra brings targeted IL-23 therapy into a daily oral tablet.

References

• Bissonnette R, Soung J, Hebert AA, Pink AE, Pinter A, Moore AY, Shi Y, Wang WH, Toth DP, Miller-Kassamali M, Cafone J, Jiang J, Li S, DeKlotz CMC, Nunes F, Lebwohl MG. Oral Icotrokinra for Plaque Psoriasis in Adults and Adolescents. N Engl J Med. 2025 Nov 6;393(18):1784-1795. doi:10.1056/NEJMoa2504187. PMID: 41191940.
• Ferris L, et al. A Phase 2b, Long-term Extension, Dose-ranging Study of Oral JNJ-77242113 for the Treatment of Moderate-to-Severe Plaque Psoriasis: FRONTIER 2. Oral presentation (Abstract #S026) at the American Academy of Dermatology (AAD) 2024 Annual Meeting. March 2024.
• Gooderham M, Lain E, Bissonnette R, Huang YH, Lynde CW, Hoffmann M, Song EJ, Weirich O, Ceitlin RHG, Rubens JH, DeLozier AM, Ota T, Hsu MC, Li S, DeKlotz CMC, Nunes F, Warren RB. Targeted Oral Peptide Icotrokinra for Psoriasis Involving High-Impact Sites. NEJM Evid. 2025 Dec;4(12):EVIDoa2500155. doi:10.1056/EVIDoa2500155. Epub 2025 Nov 5. PMID: 41191932.
• Bissonnette R, et al. Targeted Oral Peptide IL-23 Receptor Antagonist JNJ-2113 for Psoriasis. The New England Journal of Medicine. 2024;390(6):512–521.
• Presented at the European Academy of Dermatology and Venereology (EADV) Congress and the American Academy of Dermatology (AAD) Annual Meeting (Late-Breaking Abstracts).

Disclosure

I have no financial interest or conflict of interest related to this medication or its manufacturer, and I received no payment for writing this post.