ICONIC-TOTAL: Icotrokinra Shows Skin Clearance in Difficult-to-Treat PsO at 1 Year
Key Takeaways
Icotrokinra achieved high rates of skin clearance in challenging plaque psoriasis sites at 52 weeks, according to new phase 3 data
Both adults and adolescents with scalp, genital, and hand/foot involvement responded well to daily oral dosing.
No new safety signals emerged in the year-long Phase 3 ICONIC-TOTAL study.
Icotrokinra, a novel oral IL-23 inhibitor, was associated with imporvements in plaque psoriasis in difficult-to-treat areas of the body, according to new data presented at 2025 Fall Clinical Dermatology Conference in Las Vegas.
Researchers for the ICONIC-TOTAL study evaluated icotrokinra in adults and adolescents (≥12 years) with moderate plaque psoriasis affecting high-impact areas including the scalp, genitals, and hands/feet, assessing once-daily icotrokinra in patients with ≥1% BSA involvement in at least one high-impact site.
According to the results, at week 52, 72% of patients with scalp psoriasis achieved a scalp-specific Investigator’s Global Assessment (ss-IGA) score of 0/1, and 57% achieved complete clearance (ss-IGA 0). Among patients with genital psoriasis, 85% achieved a score of 0/1 on the static Physician’s Global Assessment of Genitalia (sPGA-G), and 73% achieved sPGA-G 0. In the hand/foot subgroup, hf-PGA 0/1 responses rose from 42% at week 16 to 62% at week 52. Overall, 67% of patients receiving icotrokinra achieved IGA 0/1 and 44% reached IGA 0 by week 52, with comparable responses among patients initially randomized to icotrokinra and those who switched from placebo at week 16. No new safety signals were identified.
“The new long-term data from ICONIC-TOTAL adds to the robust findings seen across several studies this year, including the recently reported ICONIC-LEAD 52-week data,” said Liza O’Dowd, MD, Vice President, Immunodermatology and Respiratory Disease Areas Lead, Johnson & Johnson Innovative Medicine. “Psoriasis that affects high-impact skin sites often results in greater physical discomfort for patients due to the sensitivity of these areas. Icotrokinra is being developed with the goal of setting a new standard of treatment that offers patients the precision of a targeted therapy, high level skin clearance and favorable safety profile with the ease of a once daily pill.”
Source: J&J press release. October 24, 2025.