 David Cotter, MD, PhD

Positive Results Identified for Risankizumab and Other Psoriasis Drugs, With David Cotter, MD, PhD

, David Cotter, MD, PhD, assistant clinical professor at the University of Nevada, shared his perspective on new data and recent developments in psoriasis management highlighted during the 

2026 American Academy of Dermatology (AAD) Annual Meeting

 on the floor of the 2026 AAD meeting, Cotter offered an enthusiastic and candid tour of what he sees as the most clinically meaningful developments in psoriasis currently, from new site-specific data on established biologics to a landmark oral treatment approval he anticipates could change prescribing habits significantly.

“We have a number of new molecules that are going to be entering soon, and we have some updated data from some of our old favorite molecules, some things that are particularly exciting and have dedicated studies looking at high impact sites,” Cotter expressed.

Among the findings that stood out most to Cotter, new data on risankizumab (Skyrizi) aimed specifically at high-impact sites, including scalp and genital psoriasis, were spotlighted. The availability of dedicated endpoints for these notoriously difficult areas has already shifted his practice, Cotter noted, pointing out that his own initiation of risankizumab more frequently for patients with genital involvement as the new results emerged.

Additionally, Cotter highlighted a recent label update for guselkumab (Tremfya) supporting its ability to inhibit radiographic progression in psoriatic arthritis (PsA), a development he believes shifts the calculation when selecting a first-line agent for patients managing both skin and joint disease.

On the question of head-to-head comparative data, Cotter pointed to 5 head-to-head trials on risankizumab against different mechanisms of action, including such drugs as apremilast and deucravacitinib. These data have resulted in risankizumab being his default biologic for plaque psoriasis.

In the PsA space, Cotter flagged bimekizumab as potentially the strongest option overall, citing topline data from the BE BOLD trial demonstrating superiority over risankizumab in attainment of rapid joint disease control. Turning to oral therapies, Cotter also noted the approval of icotrokinra (Icotyde) for moderate to severe plaque psoriasis down to age 12 as significant. He called it a game changer both therapeutically and regulatorily, noting its launch-day pediatric approval signals a great deal about the drug's safety profile and the rigor with which it was studied.

Disclosures: Cotter has previously reported serving as a consultant, speaker, and/or investigator for AbbVie, Alumis, Arcutis, Boehringer Ingelheim, Bristol Myers Squibb, Castle, Dermavant/Organon, DermTech, Eli Lilly, Galderma, Johnson and Johnson, Journey, KOWA, Pfizer, Regeneron, and Sanofi, UCB.

Magnolo N, Soung J, Sivamani RK, et al. Risankizumab vs deucravacitinib in adults with moderate plaque psoriasis: week 16 subgroup results from the IMMpactful study. Poster presented at: 2026 American Academy of Dermatology Annual Meeting; March 27–31, 2026; Denver, CO. Poster DV-017716.

Johnson and Johnson. FDA approves ICOTYDE (icotrokinra), the first and only targeted oral peptide IL-23 receptor antagonist, for the treatment of moderate-to-severe plaque psoriasis. Press release. Published March 18, 2026. Accessed March 18, 2026. 

https://www.jnj.com/media-center/press-releases

Videos

This interview with David Cotter, MD, PhD, highlights recent findings and new data in the psoriasis treatment space highlighted at AAD 2026.

AAD Updates on Risankizumab and More for Psoriasis, With David Cotter, MD, PhD

Final reflections from physicians Stein Gold, Soung, and Cotter, emphasizing multidisciplinary, patient-focused advances in psoriasis and PsA care.

Closing Thoughts on the Impact of IL-23s in Psoriasis and Psoriatic Arthritis

, despite the expanding therapeutic landscape. Linda Stein Gold, MD, and her colleagues analyze patient- and provider-reported data from the 

 surveys, revealing that many patients remain dissatisfied with current therapies and that oral agents are overwhelmingly preferred over injectables. The experts discuss how patient lifestyle, comorbidities, and psychosocial burden influence shared decision-making and treatment adherence. They also interpret the 

International Psoriasis Council’s (IPC)

 and explore its implications for reducing “topical churn” and advancing systemic therapy earlier in the disease course.

 and its potential to close current gaps in care. The panel provides an in-depth review of the 

 clinical development program, summarizing the 

 trials, which demonstrated superior efficacy versus deucravacitinib at both 16 and 24 weeks, with favorable safety and tolerability. They also discuss new 

 showing sustained clearance and no new safety signals in adults and adolescents. The faculty reflect on ICO’s implications for adolescent psoriasis and how early, aggressive oral intervention may help prevent progression to psoriatic arthritis, marking a significant milestone in the evolution of oral IL-23–targeted therapy.

The final portion of the series shifts focus to 

managing active psoriatic arthritis (PsA)

. The experts discuss new findings from the 

 demonstrated the first clear evidence of IL-23–mediated inhibition of structural joint damage, reinforcing the rationale for early biologic use in high-risk patients. They compare APEX to prior IL-23 studies, discuss implications for therapy sequencing, and highlight other emerging data from 

 studies. In closing, Stein Gold and colleagues emphasize a forward-looking approach that integrates personalized therapy selection, early detection of PsA, and cross-specialty collaboration to elevate standards of psoriasis care

Highlights from Fall Clinical 2025, including emerging IL-23 and real-world data shaping the next phase of psoriasis research.

APEX Trial Results: Radiographic Prevention Among Patients With Psoriatic Arthritis

Comparison of APEX findings to prior IL-23 trials such as KEEPSAKE-1 and their implications for clinical practice.

David Cotter, MD, PhD

Articles