Linda Stein Gold, MD

This interview at the 2026 Maui Derm Hawaii meeting features a discussion of new and emerging therapies in psoriasis, including icotrokinra.

Final reflections from physicians Stein Gold, Soung, and Cotter, emphasizing multidisciplinary, patient-focused advances in psoriasis and PsA care.

Highlights from Fall Clinical 2025, including emerging IL-23 and real-world data shaping the next phase of psoriasis research.

Comparison of APEX findings to prior IL-23 trials such as KEEPSAKE-1 and their implications for clinical practice.

Summary of the phase 3b APEX study showing guselkumab’s efficacy and inhibition of structural joint damage.

The panel discusses the prevalence and risk factors for psoriasis progression to psoriatic arthritis.

Debate on whether early IL-23–targeted therapy like ICO could delay or prevent PsA onset.

Examination of unique challenges and the importance of early, effective therapy in younger patients.

Review of new week 52 results showing durable responses and strong efficacy in both adults and adolescents.

Discussion of nasopharyngitis and URTI as the most common AEs and how the safety profile compares to other oral agents.

Overview of the ADVANCE trials showing ICO’s superior efficacy to deucravacitinib and consistent safety across 24 weeks.

Jennifer Soung, MD, outlines ICO’s mechanism as an IL-23 receptor antagonist and its significance in oral systemic therapy.

The panel explores patient attitudes toward oral vs injectable treatments and practical limitations of current oral agents.

Review of the updated IPC framework defining topical failure, reducing “topical churn,” and guiding earlier systemic escalation.

The experts analyze new patient and clinician survey data, revealing gaps between treatment satisfaction and practice realities.

Discussion on how patient goals, treatment experiences, and preference for oral agents shape individualized therapy plans.

Panelists discuss how future oral therapy research should focus on studying younger pediatric populations, implementing early intervention strategies, and investigating whether newer oral agents can reduce the incidence of psoriatic arthritis development.

Dr. Stein Gold introduces the panel and outlines the discussion’s focus on emerging therapies and evolving clinical approaches in psoriasis and PsA management.

Linda Stein Gold, MD, introduces the panel and outlines the discussion’s focus on emerging therapies and evolving clinical approaches in psoriasis and PsA management.

Panelists discuss how including adolescent patients (12 years and older) from the outset of phase 3 studies provides immediate treatment options for younger patients and increases clinician confidence in prescribing to this population.

Panelists discuss how icotrokinra demonstrated significant efficacy in high-impact areas, achieving clear or almost clear scalp in 66% of patients and clear or almost clear genital psoriasis in 77% of patients at week 16.

Panelists discuss how the durability data through week 52 show nearly 90% of adult patients and over 90% of adolescent patients maintaining PASI 75 response, addressing patient concerns about long-term treatment effectiveness.

Panelists discuss how the ICONIC-LEAD placebo-controlled studies showed icotrokinra achieving clear or almost clear skin in about 75% of patients at week 24, representing unprecedented efficacy for an oral psoriasis therapy.

Panelists discuss how the head-to-head ICONIC-ADVANCE studies demonstrated icotrokinra’s superior efficacy vs deucravacitinib, with approximately double the complete clearance rates and a safety profile similar to placebo.

Panelists discuss how icotrokinra represents a novel oral peptide that selectively blocks the IL-23 receptor, offering the trusted safety profile of IL-23 inhibition in an oral formulation with high selectivity and no off-target effects.

Panelists discuss how second-generation PDE4 inhibitors, such as orismilast, aim to improve upon apremilast’s efficacy while maintaining safety, with phase 2 data showing PASI 75 rates up to 50%.

Panelists discuss how emerging TYK2 inhibitors such as brepocitinib and ESK001 target the JAK/STAT pathway to block IL-23 and IL-17 signaling, showing promising phase 2 results with PASI 100 rates around 33% and PASI 75 rates of 64%.

Panelists discuss how effective shared decision-making involves clinicians presenting 2 to 3 optimal treatment options based on patient-specific factors rather than overwhelming patients with all possibilities or making unilateral decisions, ultimately improving treatment adherence.

Panelists discuss how many eligible patients with psoriasis remain undertreated despite advanced therapy availability due to patient discontinuation from topical burden, injection anxiety, and the historical lack of effective oral options with good safety profiles.

Panelists discuss how modern topical treatments have evolved beyond traditional corticosteroids to include more effective nonsteroidal options, such as tapinarof and roflumilast, which provide better long-term control and can complement systemic therapies.