Icotyde clears tough-to-treat psoriasis sites through two years

New phase 3 data from the ICONIC-TOTAL study, presented at the 2026 European Academy of Dermatology and Venereology Congress, showed that Icotyde (icotrokinra) was associated with sustained improvements through 112 weeks in adults and adolescents with plaque psoriasis and at least moderate involvement of the scalp, genitals, hands, or feet.

Among patients treated with the once-daily oral therapy, rates of clear or almost clear skin increased from 57% at week 16 to 70% at week 112.

At two years, complete site-specific clearance was reported in 60% of patients with scalp psoriasis, 89% with genital psoriasis, and 63% with hand and/or foot psoriasis. Nail disease also continued to improve, with mean improvement in nail psoriasis severity rising from 33% at week 16 to 71% at week 112.

The findings suggest that Icotyde may offer durable disease control where topical therapies often fall short. Richard B. Warren, MD, PhD, professor of dermatology at the University of Manchester, said, "People with plaque psoriasis that affect high-impact sites deal with severe functional disability and intense daily pain. Even when these affected areas cover a small percentage of the body, they often do not respond to topical creams, limit activity, and degrade mental health due to unrelenting symptoms."

Although Johnson & Johnson positions Icotyde as a first-line systemic therapy, patients initially assigned to placebo switched to Icotyde at week 16 and the two-year analysis included no active comparator, so the findings do not establish how Icotyde compares with established biologics or newer oral therapies. As with other long-term extension analyses, outcomes may also be influenced by patient retention over time.

Safety through week 112 was consistent with the established profile, with no new safety signals reported. Common adverse reactions include headache, nausea, fungal infection, fatigue[WH3] , and cough. Clinicians may consider tuberculosis screening before starting treatment and should avoid administering live vaccines during therapy.

Icotyde, the first and only targeted oral peptide that blocks the interleukin-23 receptor, is approved for moderate-to-severe plaque psoriasis in adults and children 12 years or older who weigh at least 40 kg and are candidates for systemic therapy or phototherapy. Trials are underway in psoriatic arthritis, ulcerative colitis, and Crohn's disease, along with plaque psoriasis studies comparing the drug with deucravacitinib and ustekinumab.

Source: Johnson & Johnson. (2026 Oct 2). Johnson & Johnson announces new Icotyde (icotrokinra) data in difficult-to-treat plaque psoriasis with proven durability through 2-years, affirming its use as a powerful first line systemic therapy