Explore why therapeutic inertia keeps plaque psoriasis patients cycling through topicals instead of escalating to systemic therapy.

Trace how oral plaque psoriasis therapy has evolved over time, from PDE4 and TYK2 inhibition to once-daily oral peptides.

Andrew Mastro, MS, PA-C, asks Alexa Hetzel, MS, PA-C, to place icotrokinra alongside the oral agents clinicians have relied on to date, apremilast and deucravacitinib.

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.

The discussion turns to mechanism of action as Andrew Mastro, MS, PA-C, asks Alexa Hetzel, MS, PA-C, where icotrokinra sits conceptually relative to the biologic classes that have anchored psoriasis treatment.

Andrew Mastro, MS, PA-C, asks Alexa Hetzel, MS, PA-C, to describe the patient profile she has in mind when reaching for icotrokinra.

Andrew Mastro, MS, PA-C, widens the lens and asks Alexa Hetzel, MS, PA-C, where icotrokinra sits within the broader plaque psoriasis landscape, including whether route of administration itself shapes patient preference.

Andrew Mastro, MS, PA-C, closes out this stretch of the conversation by asking Alexa Hetzel, MS, PA-C, to look three to five years ahead and describe how she expects the plaque psoriasis treatment paradigm to evolve.

Returning after a break in filming, Andrew Mastro, MS, PA-C, asks Alexa Hetzel, MS, PA-C, whether a persistent gap remains in plaque psoriasis care despite the expanding menu of oral and injectable options, whether tied to a specific patient population or to access itself.

Andrew Mastro, MS, PA-C, asks Alexa Hetzel, MS, PA-C, whether efficacy and durability drive first-time systemic treatment decisions or whether route of administration and patient comfort carry more weight in practice.