Icotrokinra Shows Strong Efficacy and Safety in Plaque Psoriasis: Meta-Analysis
Libya: New research, published in the International Journal of Dermatology, has demonstrated high efficacy and good tolerability of oral icotrokinra in moderate-to-severe plaque psoriasis, with rapid and sustained improvements in PASI scores and quality of life. Its safety profile was comparable to placebo, supporting its potential as a promising oral treatment option, though longer-term and comparative studies are needed.
Plaque psoriasis, particularly in its moderate-to-severe form, often requires systemic therapy; however, currently available oral options are frequently limited by either suboptimal efficacy or safety concerns. In this context, researchers led by Alhasan Altayf from the Faculty of Medicine, Azzaytuna University, Tarhuna, Libya, conducted a systematic review and meta-analysis to evaluate the therapeutic potential of icotrokinra, a novel oral interleukin-23 receptor antagonist peptide.
The analysis was carried out in line with PRISMA 2020 guidelines and included five randomized controlled trials comprising a total of 1,951 participants. These studies compared a once-daily 200 mg dose of icotrokinra with placebo in patients with moderate-to-severe plaque psoriasis. The primary endpoint assessed was the proportion of patients achieving at least a 75% reduction in the Psoriasis Area and Severity Index (PASI 75) at Week 16.
Key findings were as follows:
- Icotrokinra showed significantly higher response rates compared to placebo, with improvements evident as early as Week 4.
- At Week 4, 15% of patients receiving icotrokinra achieved PASI 75, compared to 2% in the placebo group.
- By Week 16, PASI 75 response rates increased to 73% with icotrokinra versus 11% with placebo.
- Higher efficacy thresholds also favored icotrokinra, with many patients achieving PASI 90 and PASI 100 responses.
- The treatment demonstrated both rapid onset and substantial depth of clinical response, including near-complete or complete skin clearance.
- The incidence of adverse events, serious adverse events, and infections was similar between the icotrokinra and placebo groups.
- Overall safety findings indicate a favorable tolerability profile for icotrokinra compared to existing systemic therapies.
Trial sequential analysis further reinforced the robustness of the findings, indicating that the available evidence is sufficient to support the observed benefits. However, the researchers acknowledged certain limitations, including the relatively short follow-up duration of up to 16 weeks, which restricts conclusions regarding long-term efficacy, durability of response, and rare adverse events. Additionally, reliance on pooled data may mask variations across individual patient populations.
Overall, the study underscores icotrokinra as a promising oral therapeutic option that may help bridge the gap between traditional oral agents and biologic therapies. Future research focusing on long-term outcomes and head-to-head comparisons with existing treatments will be essential to better define its role in psoriasis management.
Reference:
Altayf, A., Lateiresh, M., Marwan, L., Alfeetouri, M. Y., Zouaoui, Y., & Elhadi, M. Efficacy and Safety of Oral Icotrokinra in Moderate-to-Severe Plaque Psoriasis: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis. International Journal of Dermatology. https://doi.org/10.1111/ijd.70380
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