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Risankizumab Compared to Icotrokinra in Adult Patients with Psoriasis
In this analysis presented at Maui Derm, indirect comparisons were made between risankizumab and icotrokinra in patients with psoriasis.
Recent findings suggest, as early as Week 4, patients with psoriasis on risankizumab may see greater response rates across all measures of skin clearance and psoriasis severity versus rates reported among patients on icotrokinra.1,2,3
These data were featured in a poster titled ‘Matching-Adjusted Indirect Comparison of Risankizumab Versus Icotrokinra in Adult Patients With Moderate-to-Severe Plaque Psoriasis,’ and was authored by such investigators as Jeff Crowley, MD, a board-certified dermatologist and pediatric dermatologist.
This study was presented at the 2026 Maui Derm Hawaii conference, and it was designed to compare the clinical efficacy of risankizumab with icotrokinra among adults with moderate-to-severe psoriasis. Because of the lack of direct comparative research between these medications, an indirect analytical approach was deemed necessary to assess relative performance and to support clinical decision-making.
Risankizumab is an approved interleukin (IL)-23 inhibitor administered as a 150-mg subcutaneous injection at baseline, Week 4, and every 12 weeks thereafter. It has consistently demonstrated robust skin clearance in individuals with moderate-to-severe psoriasis. Icotrokinra, an oral IL-23 receptor antagonist provided at a dose of 200 mg once-per-day, is under investigation for the same patient population. In light of the lack of head-to-head data, Crowley et al conducted a matching-adjusted indirect comparison (MAIC) to explore these drugs’ efficacy.
They included phase 3, randomized, double-blind, placebo-controlled clinical trials evaluating each medication in adults with moderate-to-severe psoriasis who were also deemed eligible for phototherapy and systemic agents. All of the trials were independently reviewed, with only those meeting predefined inclusion criteria being incorporated. The availability of individual patient-level data for risankizumab was noted from the UltiMMa-1, UltiMMa-2, and IMMhance trials. Published aggregate data were used for icotrokinra from the ICONIC-LEAD trial (adult population exclusively) and ICONIC-ADVANCE 1 and 2.
Crowley and colleagues ensured comparability across populations, with patient-level data from the risankizumab studies being statistically weighted to align with the pooled baseline characteristics reported in the icotrokinra research. Such characteristics included sex, age, race, baseline body mass index (BMI), body surface area involvement, Psoriasis Area and Severity Index (PASI) score, static Physician’s Global Assessment score, and prior phototherapy and biologic therapy exposure.
Efficacy outcomes were assessed by the investigative team via risk comparisons between risankizumab and icotrokinra for PASI 75, PASI 90, and PASI 100 responses, as well as Investigator’s Global Assessment (IGA) scores of 0 or 1 and 0 alone, at the 4, 8, 12, 16, and 24-week marks. In Crowley and coauthors’ findings, patients as early as the 4 and 8-week marks receiving risankizumab attained higher response rates across all measures of skin clearance and severity of psoriasis versus those treated with icotrokinra.
These differences persisted through the 16-week mark, with risankizumab continuing to demonstrate superior efficacy across all endpoints assessed by the investigators. Comparable advantages favoring risankizumab were also observed by the investigators in the unanchored analysis conducted at the 24-week mark.
References
Crowley J, Song E, Strober B, et al. Matching-Adjusted Indirect Comparison of Risankizumab Versus Icotrokinra in Adult Patients With Moderate-to-Severe Plaque Psoriasis. Presented at: Maui Derm Hawaii 2026; January 25-29, 2026; Maui, Hawaii.
Magnolo N, Lee L, Paller A, et al. Efficacy and Safety of Risankizumab in Pediatric Patients With Psoriasis in the OptIMMize-1 Phase 3 Study: Results Through 52 Weeks. Presented at: Maui Derm Hawaii 2026; January 25-29, 2026; Maui, Hawaii.
Armstrong A, et al. Comparative analysis of icotrokinra and approved advanced treatments for achievement of completely clear skin in patients with moderate-to-severe psoriasis: A systematic literature review and network meta-analysis. Presented at: Maui Derm Hawaii Conference 2026; January 25-29; Maui, Hawaii.
