Treating Adolescent Plaque Psoriasis: Tolerability and Adherence

This episode, titled ‘Treating Adolescent Plaque Psoriasis: Tolerability and Adherence,’ features panelists discussing therapy in younger patients.

Andrew Mastro, MS, PA-C, turns the conversation to a population clinicians often approach with extra caution, adolescents with plaque psoriasis, asking Alexa Hetzel, MS, PA-C, how icotrokinra's approval in this group and its once-daily dosing affect the treatment conversation. Hetzel answers both as a clinician and as a mother, noting that no parent wants to hear a child has a chronic disease that cannot be cured. She points out that the adolescent population in the icotrokinra studies actually responded better than adults, which she attributes to shorter disease duration and fewer accumulated comorbidities, reinforcing the value of controlling psoriasis earlier rather than letting it progress into adulthood.

Hetzel highlights the format itself as a meaningful adherence lever with younger patients. Many adolescents struggle to swallow pills, and because icotrokinra can be dispersed in water, parents can build it into an existing routine, similar to a daily vitamin or probiotic, without the added difficulty of an injection. She contrasts this with the anticipation and distress that can accompany injectable administration in younger patients, noting that the format alone can meaningfully change how a family experiences the start of systemic therapy.

Mastro then asks how icotrokinra's adolescent data compares with established injectable options such as ustekinumab and the IL-17 inhibitors, both of which lowered their age indications and changed practice when they became available. Hetzel says the efficacy signal is in line with expectations set by that injectable experience, but notes that administration remains a practical hurdle with biologics in this age group. Reconstituting a vial and drawing up a dose adds a layer of complexity beyond the injection itself, and the anticipatory distress some adolescents show around needles can complicate an already difficult conversation. An oral option, she says, preserves that established efficacy while removing a meaningful barrier to getting started.

In the next episode, ‘How Icotrokinra Fits Alongside Biologics in Plaque Psoriasis,’ the panelists unpack where icotrokinra's mechanism of action sits relative to established biologic classes.