Panelists discuss how emerging oral therapies like TYK2 inhibitors, next-generation PDE4 inhibitors, and the novel oral IL-23 receptor blocker icotrokinra are achieving unprecedented efficacy levels in psoriasis treatment, with some oral agents now demonstrating complete skin clearance rates and superior performance in high-impact areas like scalp and genital psoriasis. The panelists emphasize the importance of shared decision-making, early intervention, and addressing treatment gaps through patient-centered care approaches.
Panelists discuss how plaque psoriasis affects 0.4% to 8% of the global population, with high-impact areas such as the scalp (up to 80% of patients) and nails (25% of patients) significantly impacting quality of life and warranting systemic therapy consideration.
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.
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 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 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 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 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 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 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 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 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 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 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.
