Efficacy and safety of icotrokinra for plaque psoriasis: a systematic review and meta-analysis.
Sunaina Advani, Advait Raja, Tatiana Giraldo et al.
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In 30 seconds
This systematic review and meta-analysis assessed icotrokinra, an oral IL-23 receptor antagonist, in adolescents and adults with moderate-to-severe plaque psoriasis. It included five placebo-controlled randomised trials (one phase II and four phase III). At week 16, icotrokinra increased the likelihood of achieving an Investigator’s Global Assessment score of 0 or 1 versus placebo (risk ratio 7.27, 95% confidence interval 5.80-9.11). High-level skin clearance also improved, while treatment-emergent and serious adverse-event rates were comparable between groups. No new safety signals were identified during the 16-week trial period.
Key findings
- At week 16, Investigator’s Global Assessment scores of 0 or 1 were more likely with icotrokinra than placebo (risk ratio 7.27, 95% confidence interval 5.80-9.11; I2 = 0%).
- Achievement of ≥ 90% improvement in Psoriasis Area and Severity Index was higher with icotrokinra (risk ratio 13.8, 95% confidence interval 7.21-26.5).
- Treatment-emergent and serious adverse-event rates were comparable between icotrokinra and placebo, with no new safety signals over 16 weeks.
Why it matters
The findings suggest that an oral IL-23 receptor antagonist can deliver short-term skin-clearance benefits in moderate-to-severe plaque psoriasis, with adverse-event rates similar to placebo in the included trials. Oral administration may address practical concerns associated with parenteral therapies, although the evidence presented here covers only short-term outcomes.
What to keep in mind
The safety and efficacy findings are limited to the 16-week trial period; longer-term outcomes are not reported in the abstract.