Positive results showcase icotrokinra’s ‘unique’ mechanism of action in plaque psoriasis
Key takeaways:
- Late-breaking data supported the efficacy of icotrokinra, an interleukin-23 inhibitor, for plaque psoriasis.
- By week 24, 46% of icotrokinra-treated patients achieved IGA 0 and 40% reached PASI 100.
ORLANDO — Adults and adolescents treated with icotrokinra experienced improvements in their moderate to severe plaque psoriasis, according to a late-breaking presentation at the American Academy of Dermatology Annual Meeting.
Previously known as JNJ-2113, icotrokinra (Protagonist Therapeutics, Johnson & Johnson) has a very specific mechanism of action for the treatment of moderate to severe plaque psoriasis, according to Robert Bissonnette, MD, MSc, CEO and medical director of Innovaderm and presenter of these late-breaking data.
“Its mechanism of action is fairly unique in dermatology,” Bissonnette told Healio. “It is not a protein, it is a small peptide that can be given orally, and it blocks the interaction between interleukin-23 and its receptor.”
The data were derived from the phase 3 ICONIC-LEAD study, in which adults and adolescents aged 12 years and older with moderate to severe plaque psoriasis were randomly assigned to receive once-daily icotrokinra 200 mg (n = 456) or placebo (n = 228) for 16 weeks. At week 16, patients receiving placebo were switched to icotrokinra 200 mg and continued that dosage to week 24.
All patients treated with icotrokinra had plaque psoriasis for 26 weeks or more with a mean body surface area involvement of 24.6%, a PASI score of 19.4 and an IGA score of 3 or higher. These baseline characteristics were similar among placebo-treated patients.
According to the presentation, the co-primary endpoints were met with 65% of icotrokinra-treated patients reaching an IGA score of 0 or 1 with at least a 2-grade improvement from baseline and 50% reaching PASI 90 by week 16. In contrast, 8% and 4% of placebo-treated patients met these endpoints, respectively.
By week 24, 46% of icotrokinra-treated patients achieved IGA 0 and 40% reached PASI 100. Among those who were switched from placebo to icotrokinra, 23% achieved IGA 0 and 14% achieved PASI 100.
Both groups experienced equal rates of adverse events (49%) at week 16 with the most common being nasopharyngitis (7% in both groups) and upper respiratory tract infection (7% in both groups). According to the presentation, these adverse events were similarly observed through week 24.
“Overall, results are positive,” Bissonnette told Healio. “We've seen good efficacy with this oral drug in patients with moderate to severe plaque psoriasis. The safety profile so far looks good as well; however, there are many other trials that will be conducted with this study, and data beyond week 24 will eventually be presented so that we can have a better overall picture of safety and efficacy.”