Investigational Oral IL-23 Receptor Antagonist Improves Skin Clearance in Psoriasis: Daily Dose

_{©New Africa/AdobeStock}

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On August 11, 2025, we reported on findings from the ICONIC-LEAD clinical trial presented at the Dermatology Education Foundation (DERM) 2025 NP/PA CME Conference, July 23-26, 2025, in Las Vegas, Nevada.

The study

ICONIC-LEAD was a multicenter, randomized, double-blind, placebo-controlled phase 3 trial conducted at 170 sites worldwide. Researchers enrolled 684 participants aged 12 years or older with 10% or more body surface area (BSA) involvement, a Psoriasis Area and Severity Index (PASI) score of 12 or greater, and an Investigator’s Global Assessment (IGA) score 3 or greater.

The investigators randomized participants 2:1 to receive icotrokinra 200 mg once daily for 24 weeks (n=456) or placebo for 16 weeks followed by icotrokinra (n=228). The coprimary endpoints, assessed at week 16, were the proportion of participants achieving PASI 90 and the proportion achieving an IGA score of 0 or 1 (clear or almost clear) with at least a 2-grade improvement from baseline.

The findings

At the 16-week mark, significantly greater proportions of icotrokinra-treated participants achieved the study's endpoints compared to those receiving placebo:

• IGA 0/1: 65% vs 8%

• PASI 90: 50% vs 4%

• IGA 0: 33% vs 1%

• PASI 100: 27% vs <1%

(All comparisons multiplicity-adjusted P <.001)

Continued icotrokinra treatment through week 24 further increased response rates:

• IGA 0/1: 74%

• PASI 90: 65%

• IGA 0: 46%

• PASI 100: 40%

Click here for more details.