Efficacy and Safety of Icotrokinra (an Interleukin-23 Inhibitor) in the Management of Moderate-to-Severe Plaque Psoriasis: A Systematic Review and Meta-Analysis

Abstract

Background: Plaque psoriasis, which is a chronic immune-mediated inflammatory skin condition, significantly reduces patients’ quality of life. The cytokine interleukin-23 (IL-23) is a pivotal factor in the development of psoriasis, and icotrokinra is a new oral IL-23 receptor antagonist that has shown potential effectiveness in clinical trials. The main goal of this systematic review and meta-analysis was to assess the effectiveness and safety of icotrokinra in adults and adolescents with moderate-to-severe plaque-type psoriasis. Methods: A comprehensive literature search in PubMed, ScienceDirect, and the Cochrane Library, conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards, identified randomized controlled trials that evaluated daily oral icotrokinra 200 mg versus placebo. The primary outcomes were Psoriasis Area and Severity Index (PASI) 90, Investigator’s Global Assessment (IGA) 0/1, and adverse events (AEs) at 16 weeks. Risk ratios with 95% confidence intervals were summed up through a random-effects model. Results: A total of five randomized controlled trials involving 2,755 participants were included. Icotrokinra showed a significant increase in PASI 90, IGA 0/1, IGA 0, and Psoriasis Symptoms and Signs Diary 0 responses compared to placebo. The overall frequency of AEs was similar in both groups, but the rate of treatment discontinuation due to AEs was lower with icotrokinra. Conclusions: Icotrokinra is an effective and well-tolerated oral treatment for moderate-to-severe plaque psoriasis with considerable clinical and patient-reported benefits.