Two-Year Data: Psoriasis Pill Kept Skin 90% Clearer in 72% of Patients

By Daniel Okafor

At least 72 percent of patients taking ICOTYDE (icotrokinra) kept skin that was at least 90 percent clearer between weeks 64 and 112. At least 44 percent had completely clear skin over the same period. Dermatology Times reported the results, presented at the 2026 Fall Clinical Dermatology Conference in Las Vegas.

The data come from the phase 3 ICONIC-LEAD trial of the once-daily pill, approved by the FDA in March. The trial enrolled 684 people ages 12 and older with moderate-to-severe plaque psoriasis, including 66 adolescents. Of those, 456 took ICOTYDE and 228 took a placebo.

Doctors rated at least 70 percent of patients clear or almost clear. 78 percent kept a meaningful improvement in itch.

What happens when patients stop taking it?

The researchers tracked withdrawal and retreatment. Some patients reached 90 percent clearer skin, then stopped ICOTYDE at week 24. When they restarted, 85 percent returned to that level within 24 weeks. No new safety concerns emerged through week 112.

Durability drove the trial design. "As plaque psoriasis is a chronic lifelong disease, durable results are essential in therapy selection," said Mark Lebwohl, MD, professor and chair emeritus of the Department of Dermatology at the Icahn School of Medicine at Mount Sinai and a trial investigator.

Did the scalp, hands and nails respond?

Yes. A separate trial, ICONIC-TOTAL, covered the hardest-to-treat, most visible areas, with two-year data presented at EADV 2026.

By week 112:

• 70 percent of patients with psoriasis in these areas were clear or almost clear, up from 57 percent at week 16.
• 60 percent of scalp patients cleared completely.
• 63 percent with involvement on hands or feet cleared completely.
• 89 percent with genital-area psoriasis cleared completely.

Nail psoriasis improved too. Average improvement rose from 33 percent at week 16 to 71 percent at week 112.

How does the pill work?

ICOTYDE blocks the IL-23 receptor (a protein on immune cells in the inflammatory pathway driving psoriasis). Many leading injectables target the same pathway. The dose is one 200-mg tablet per day.

The FDA approved it for people 12 and older with moderate-to-severe plaque psoriasis who weigh at least 40 kilograms (about 88 pounds) and are candidates for systemic therapy or phototherapy. Regulators in Europe, Japan and China have also approved it.

What does this change for patients?

Routine matters. Patients take the tablet right after waking, with water on an empty stomach, at least 30 minutes before eating. Those who have trouble swallowing pills can disperse the tablet in water. The prescribing information lists headache, nausea, cough, fungal infection and fatigue as the most common side effects.

More comparison data is coming. Earlier head-to-head trials showed ICOTYDE outperformed deucravacitinib, another oral psoriasis drug. A trial against the injectable ustekinumab is underway. Until then, fit still depends on each patient's skin and health history — results worth raising, along with any planned cosmetic treatments, at the next dermatology appointment.