Robert Bissonnette, MD: Late-Breaking Data on Icotrokinra Shows Promising Efficacy and Safety in Psoriasis

At the recent American Academy of Dermatology (AAD) Annual Meeting, Robert Bissonnette, MD, presented late-breaking data from the ICONIC-LEAD (NCT06095115) study evaluating icotrokinra, an oral IL-23 receptor antagonist, for patients with moderate-to-severe plaque psoriasis.^1,2 The phase 3 study demonstrated significant efficacy at week 16, with further improvements observed through week 24. In an interview with Dermatology Times, Bissonnette, lead investigator and chairman at Innovaderm Research, Montreal, Canada, shared his insights on the data and what the results might mean for clinicians and patients down the road.

The study’s co-primary endpoints included the proportion of patients achieving an Investigator’s Global Assessment (IGA) score of 0/1 and a Psoriasis Area and Severity Index (PASI) 90 response at week 16, Bissonnette said. The data demonstrated 65% of patients on icotrokinra achieved IGA 0/1, compared to 8% on placebo, while PASI 90 was reached by 50% of patients versus 4% in the placebo group. Notably, efficacy continued to improve over time, with 46% of patients achieving IGA 0 at week 24.

“What was really interesting was that was that the efficacy continued to increase over time," Bissonnette told Dermatology Times. “And when you look at the curve, it was still going up.”

Looking at existing psoriasis treatments were also a key discussion point, as investigators look at how icotrokinra performs compared with other agents. “Comparison with deucravacitinib is interesting because it’s one of the newer oral agents that dermatologists are using to treat psoriasis,” Bissonnette told Dermatology Times. Unlike other oral therapies, icotrokinra specifically targets IL-23, offering a more precise mechanism of action compared to methotrexate, cyclosporine, or TYK2 inhibitors. If approved, icotrokinra would provide an oral alternative to IL-23 inhibitors currently available as injectable biologics.

Safety data from phase 3 remained consistent with previous findings, with no new safety concerns emerging. “When you look at the proportion of patients who had treatment-emergent adverse events, it was identical in both groups,” Bissonnette he said. No increased risk of infections or active tuberculosis was observed. Two malignancies were diagnosed early in the trial; both patients had preexisting lab abnormalities or symptoms prior to treatment initiation.

Ongoing studies are exploring icotrokinra’s efficacy in patients with scalp, genital, and palmoplantar psoriasis, as well as psoriatic arthritis. With additional data expected in the coming months, Bissonnette encouraged dermatologists to stay tuned for further insights into this promising oral therapy.

“I invite you to be attentive in the coming months and years,” he told Dermatology Times. “More data will be shown at many upcoming meetings.”

References

1. Bissonnette R. Icotrokinra, a Targeted Oral Peptide That Selectively Blocks the Interleukin-23–Receptor, for the Treatment of Moderate-to-Severe Plaque Psoriasis: Results Through Week 24 of the Phase 3, Randomized Double-blind, Placebo-Controlled ICONIC-LEAD Trial. Presented at the 2025 AAD Annual Meeting; March 7-11; Orlando, Florida.

2. Andrus E. Icotrokinra Demonstrates Promise in Phase 3 ICONIC-LEAD and ICONIC-ADVANCE for Plaque Psoriasis. Dermatology Times. March 11, 2025. Accessed March 12, 2025. https://www.dermatologytimes.com/view/icotrokinra-demonstrates-promise-in-phase-3-iconic-lead-and-iconic-advance-for-plaque-psoriasis