SynthesisFrontiers in immunology2026
Safety and efficacy of oral icotrokinra for moderate-to-severe plaque psoriasis: a systematic review and meta-analysis of randomized controlled trials.
Synthesis in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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6 authors.
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Abstract
Background: Biologic therapies targeting inflammatory cytokines have transformed the management of plaque psoriasis; however, their use is limited by high cost, parenteral administration, and monitoring requirements. Icotrokinra (JNJ-77242113) is a first-in-class oral peptide that selectively inhibits the interleukin-23 (IL-23) receptor and represents a potential oral alternative. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of oral icotrokinra in moderate-to-severe plaque psoriasis. Methods: A comprehensive search of PubMed, Scopus, Web of Science, and the Cochrane Library was performed to identify randomized controlled trials (RCTs) published up to November 2025. Eligible studies enrolled adolescents or adults with moderate-to-severe plaque psoriasis treated with oral icotrokinra (200 mg once daily) versus placebo. A random-effects model was applied, and dichotomous outcomes were pooled as risk ratios (RRs) with 95% confidence intervals (CIs). Risk of bias was assessed using RoB 2, and trial sequential analysis (TSA) was performed to evaluate the conclusiveness of evidence. Results: Five RCTs comprising 1,951 participants were included. At week 16, icotrokinra significantly improved Investigator's Global Assessment (IGA) 0/1 (RR = 7.27, 95% CI 5.62-9.40) and Psoriasis Area and Severity Index (PASI) 75 responses (RR = 6.70, 95% CI 5.20-8.62) compared with placebo (both Conclusion: Oral icotrokinra demonstrates potential efficacy across multiple clinical and patient-reported endpoints with a safety profile comparable to placebo in moderate-to-severe plaque psoriasis. However, TSA indicates that the required information size has not been reached. Therefore, current evidence remains insufficient to draw definitive conclusions. Future RCTs with long-term follow-up are required to confirm these findings. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=1237937, identifier CRD420251237937.
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