Jennifer Soung, MD

ICONIC-LEAD: 1 Year Icotrokinra Data Confirm Durable Psoriasis Clearance, PRO Improvements in Adults, Adolescents, With Jennifer Soung, MD

One-year data from the phase 3 ICONIC-LEAD trial confirm that icotrokinra (ICOTYDE) delivers durable skin clearance and meaningful patient-reported improvements across adults and adolescents with moderate-to-severe plaque psoriasis with no new safety signals through week 52.

Icotrokinra is the first and only targeted oral peptide blocking the IL-23 receptor after being approved by the United States Food and Drug Administration (FDA) on March 18, 2026 for moderate-to-severe plaque PsO in adults and adolescents 12 and older.

To discuss the findings presented at the 

2026 American Academy of Dermatology (AAD) Annual Meeting

 held in Denver, Colorado, from March 27-31, 

 spoke with Jennifer Soung, MD, Founder and Director of Clinical Research at Southern California Dermatology in Santa Ana, California, and ICONIC-LEAD investigator. ICONIC-LEAD enrolled 684 patients ≥12 years (adults, n = 618; adolescents, n = 66) with moderate-to-severe plaque PsO (BSA ≥10%, PASI ≥12, IGA ≥3). In the adult randomized-withdrawal analysis, of 341 week-24 responders re-randomized 1:1 to continue icotrokinra or withdraw to placebo, continuous icotrokinra produced superior maintenance of PASI 75 (89% vs. 30%; 

 <.001) at week 52, with median time to loss of response not reached in those continuing therapy versus 16.9 and 10.1 weeks for PASI 75 and PASI 90, respectively, among those re-randomized to placebo.

The adolescent data, presented across 2 companion posters at AAD, were particularly notable given the absence of approved advanced oral options for this population. Among adolescents randomized to icotrokinra (n = 44; mean age 15.0 years, mean PASI 19.8, 70% moderate/30% severe), 91% achieved IGA 0/1 and 86% achieved PASI 90 by week 52, with 89% of week-24 IGA 0/1 responders and 92% of week-24 PASI 90 responders maintaining those responses at week 52. Complete skin clearance rates were also substantial, with 64% achieving IGA 0 and 57% achieving PASI 100 during weeks 24–52. On patient-reported outcomes, more than 80% of icotrokinra-randomized adolescents reported clinically meaningful itch improvement (≥4-point PSSD improvement) through weeks 24–52, more than 50% reported complete symptom resolution (PSSD symptom score 0), approximately 40% reported complete sign resolution (PSSD sign score 0), and more than 80% reported psoriasis no longer impacted their health-related quality of life (CDLQI 0/1) — with improvements observed as early as week 2. Through week 52, no adolescent discontinued due to an adverse event, no serious infections occurred, and no malignancies were reported, with the overall safety profile consistent with the placebo-controlled period.

“This is the first time an advanced systemic has concurrently received approval for adults and adolescents at the same time, and that's a game changer, because our adolescent patients don’t really want an injection,” Soung said. “We also saw such amazing skin clearance rates in our adolescent patients. So I think that, again, making PsO treatment more accessible and easier for our patients means more of our patients will benefit from these treatments.”

Soung’s reported disclosures include AbbVie, Amgen, Arcutis, Aslan, Bristol Myers Squibb, Coval Biopharma, Dermavant, Eli Lilly, Johnson & Johnson, KoBio Labs, National Psoriasis Foundation, Novartis, Ortho Dermatologic, Oruka, Pfizer, Regeneron/Sanofi, and UCB.

Soung J, Lebwohl MG, Hebert A, et al. Durability of icotrokinra (targeted oral peptide) effects in adolescents with moderate-to-severe plaque psoriasis: one-year results from the ICONIC-LEAD study. Poster presented at: American Academy of Dermatology Annual Meeting; March 27–31, 2026; Denver, CO. Poster P73600.

Soung J, Lebwohl MG, Hebert A, et al. Early and durable improvements in patient-reported outcomes with the targeted oral peptide icotrokinra in adolescents with moderate-to-severe plaque psoriasis: one-year results from the ICONIC-LEAD study. Poster presented at: American Academy of Dermatology Annual Meeting; March 27–31, 2026; Denver, CO. Poster P73603.

Johnson & Johnson. FDA approval of ICOTYDE™ (icotrokinra) ushers in new era for first-line systemic treatment of plaque psoriasis with a targeted oral peptide. Press release. March 18, 2026. 

https://www.jnj.com/media-center/press-releases/fda-approval-of-icotyde-icotrokinra-ushers-in-new-era-for-first-line-systemic-treatment-of-plaque-psoriasis-with-a-targeted-oral-peptide

Videos

Soung discussed how new 52-week data support icotrokinra's recent FDA approval, marketed as Icotyde.

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.

Jennifer Soung, MD

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