Durability of response to icotrokinra in adults with moderate-to-severe plaque psoriasis

BACKGROUNDIcotrokinra, a targeted oral peptide, precisely blocks the interleukin-23 receptor. In two phase III moderate-to--severe plaque psoriasis trials, ICONIC-ADVANCE 1 (NCT06143878) and ICONIC-ADVANCE 2 (NCT06220604), icotrokinra provided significantly higher skin clearance rates vs. placebo at week 16 and deucravacitinib at weeks 16 and 24.

OBJECTIVESTo evaluate the clinician- and patient-reported outcomes (PROs) for participants who received icotrokinra in the ICONIC-ADVANCE 1 and ADVANCE 2 phase III clinical trials.

METHODSICONIC-ADVANCE 1 and 2 randomized (2 : 1 : 2 and 4 : 1 : 4, respectively) adults with moderate-to-severe plaque psoriasis to icotrokinra 200 mg, placebo (transition to icotrokinra at week 16) or deucravacitinib 6 mg once daily (transition to icotrokinra at week 24). Outcomes assessed through week 52 included proportions of participants achieving Investigator Global Assessment (IGA) 0/1 (with ≥ 2-grade improvement from baseline), Psoriasis Area and Severity Index (PASI) 90, IGA 0, PASI 100, scalp-specific IGA (ss-IGA) 0/1, several well-established PROs, and adverse events (AEs).

RESULTSICONIC-ADVANCE 1 and 2 randomized 1505 participants (774 and 731, respectively). Skin clearance rates among participants randomized to icotrokinra increased through week 24 and were durable through week 52, with approximately 70-75% exhibiting clear/almost clear skin (IGA 0/1, PASI 90) and approximately 50% demonstrating completely clear skin (IGA 0, PASI 100) during weeks 24-52. Among participants achieving clear/almost clear skin at week 16, around 85-90% maintained response at week 52. Response rates for ss-IGA 0/1 and PROs were also durable through week 52. Participants who transitioned from placebo or deucravacitinib to icotrokinra exhibited increasing response rates that were comparable to participants randomized to icotrokinra through week 52. The AE profile was similar to placebo through week 16 and showed lower AE rates than deucravacitinib through week 24; no safety signals were observed through week 52.

CONCLUSIONSOnce-daily icotrokinra provided robust, durable skin clearance and symptom improvement, with no safety signals, through week 52 in adults with moderate-to-severe plaque psoriasis. Participants transitioning from placebo or deucravacitinib to icotrokinra achieved similar increased response rates to participants who were randomized to icotrokinra through week 52. Our findings support icotrokinra as a systemic therapy with long-term robust disease control and a favourable safety profile.

Abstract from PubMed