Recent clinical trials have revealed significant advancements in the treatment of psoriasis, with the investigational drug icotrokinra showing superior efficacy compared to deucravacitinib. The findings come from the ICONIC-ADVANCE 1 and 2 trials, as discussed by a panel of experts, including Dr. Linda Stein Gold. Despite an expanding therapeutic landscape, many patients continue to express dissatisfaction with current treatment options, highlighting a critical need for improvement in psoriasis care.
The panel began by addressing the persistent gaps in psoriasis management, referencing data from the ENCOMPASS and Stein Gold 2025 surveys. These surveys revealed that patients overwhelmingly prefer oral treatments over injectable therapies, reflecting a significant trend in patient-reported preferences. Factors such as lifestyle, comorbidities, and psychosocial impacts play a crucial role in shared decision-making and treatment adherence.
New Insights into Psoriasis Treatment
A key topic of discussion was the International Psoriasis Council’s (IPC) recent definition of “topical failure.” The panel explored how this new definition could reduce “topical churn” and promote earlier initiation of systemic therapies for patients with psoriasis. The implications of this approach could lead to better outcomes and improved quality of life for individuals suffering from the condition.
The icotrokinra (ICO) clinical development program was highlighted as a potential solution to existing treatment gaps. Results from the ICONIC-ADVANCE 1 and 2 trials demonstrated that ICO outperformed deucravacitinib in terms of efficacy at both 16 and 24 weeks. Notably, the findings also indicated favorable safety and tolerability profiles. New data from the ICONIC-LEAD study at week 52 revealed sustained clearance of psoriasis symptoms and no new safety concerns in both adults and adolescents, emphasizing ICO’s potential as a groundbreaking treatment option.
The panel also discussed the potential impact of ICO on adolescent psoriasis, suggesting that early and aggressive oral interventions may help prevent progression to psoriatic arthritis (PsA). This represents a significant milestone in the advancement of oral IL-23–targeted therapies.
Advancements in Psoriatic Arthritis Management
Transitioning from psoriasis to psoriatic arthritis, the experts addressed new findings from the APEX phase 3b study. This study highlighted that guselkumab demonstrated the first clear evidence of IL-23–mediated inhibition of structural joint damage. The findings reinforce the rationale for early biologic treatment in high-risk patients, marking an important step forward in managing PsA.
Comparing APEX to previous IL-23 studies, the panel discussed the implications for therapy sequencing and the potential to enhance patient outcomes. They also noted other emerging data from the Fall Clinical 2025, including the SPECTREM and PSOLAR studies, which further contribute to the understanding of effective treatment strategies.
In conclusion, Dr. Stein Gold and her colleagues emphasized the importance of adopting a forward-looking approach to psoriasis treatment. They advocate for integrating personalized therapy selection, early detection of psoriatic arthritis, and cross-specialty collaboration to elevate the standards of care for patients with psoriasis and PsA. The ongoing research and recent findings provide a hopeful outlook for improved patient outcomes in the future.
