Oral Therapies and Injectables in the Psoriasis Pipeline, With Lisa Swanson, MD

During the 2025 Fall Clinical Dermatology Conference in Las Vegas, following the session, ‘Where Oral Therapies Fit in an Injectable Landscape for Psoriasis Management,’ HCPLive spoke with Lisa A. Swanson, MD.1

Swanson is known for her role as a dual-board-certified dermatologist and pediatric dermatologist at Ada West Dermatology. In light of Swanson’s session, during which she highlighted injectable and oral options for patients with psoriasis, the HCPLive editorial team asked her about the topics covered in this talk.

“At Fall Clinical 25 I got the chance to participate in a wonderful session with Dr. Tiffany Mayo and Dr Linda Stein Gold, where we talked about IL-23 inhibition for the treatment of plaque psoriasis,” Swanson explained. “And you might say, ‘That's old news, Lisa, because we have three IL-23 inhibitors that are injectables, and we've had them for years.’ But we talked about an oral peptide that works to inhibit IL-23, and yes, you heard me right. This is an oral peptide that inhibits IL-23. They said we could never experience biologic mechanism of action in a pill, because the molecules were simply too big.”

The US Food and Drug Administration (FDA) received a New Drug Application (NDA) for icotrokinra, specifically aiming for an indication for adults and pediatric patients 12 years of age and older with moderate-to-severe psoriasis.2 As Swanson highlighted, this medication is designed to selectively block the interleukin (IL)-23 receptor, a key inflammation driver in psoriasis.

“The science is wonderful and amazing, and now we will hopefully soon have this FDA-approved oral option called icotrakinra,” Swanson said. “We talked about how it was studied in patients as young as 12 years old. I love that. As a pediatric dermatologist, the efficacy endpoints are remarkable. The first time I saw them, I was truly surprised at how efficacious it was. We know what to expect from our injectables. I think the pill medications that we've had have always skewed a little bit lower on the efficacy totem pole. This pill packs a punch.”

Swanson noted that she hopes icotrokinra, following an approval, can help younger and older patients with psoriasis who are needle-phobic or simply dislike injectables. If approved, icotrokinra could place clinicians in a position where an oral therapy could deliver the same potential efficacy as a shot, but in a once-a-day pill form.

“I was also recently introduced to the idea that I had a teenager who was then heading off to college, and that teenager was on an injectable,” Swanson said. “But once they got to college, they found it too difficult to manage the refrigeration, because in the dorm, it's a small fridge. There's other stuff they need to put in there, and so it was for that reason that that patient chose to switch to a pill.”

For any additional information on the topics covered in Swanson’s interview, view her full interview segment posted above.

In this summary, the quotes included were edited for clarity.

Swanson previously disclosed serving as a consultant for AbbVie, Alphyn, Arcutis, Boehringer Ingelheim, Castle, Dermavant, Galderma, Incyte, Janssen, Leo, Lilly, Novan, Pfizer, Sanofi-Regeneron, and Verrica.

References

1. Mayo T, Stein Gold L, Swanson E. CME Satellite Symposium: Where Oral Therapies Fit in an Injectable Landscape for Psoriasis Management. Session presentation at the 2025 Fall Clinical Dermatology Conference, Las Vegas, Nevada, Oct 23-26, 2025.

2. Smith T. Johnson & Johnson Submits NDA for Icotrokinra in Adolescents, Adults with Psoriasis. HCPLive. July 21, 2025. Accessed October 30, 2025. https://www.hcplive.com/view/fda-receives-new-drug-application-icotrokinra-adolescents-adults-psoriasis.