Safety and Efficacy of the Oral IL-23 Receptor Antagonist Icotrokinra for Plaque Psoriasis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Plaque psoriasis is a chronic inflammatory skin disease that significantly impacts patients' quality of life and psychological well-being. Icotrokinra is a novel oral peptide that selectively targets the interleukin-23 receptor and has shown promising results in treating plaque psoriasis. We conducted a comprehensive search of PubMed, Scopus, Web of Science, and the Cochrane Library to identify randomized controlled trials comparing icotrokinra with placebo. Five studies involving 2121 patients were included. Icotrokinra increased the proportion of patients achieving an Investigator's Global Assessment (IGA) score of 0 or 1, an IGA score of 0, Psoriasis Area and Severity Index (PASI) 100, PASI 90, and PASI 75 compared with placebo [risk ratio (RR): 7.27; 23.89; 31.85; 15.04; 6.61, all <i>P</i> < .00001]. No significant differences were observed in total adverse events (RR: 0.96, <i>P</i> = .56) or serious adverse events (RR: 0.74, <i>P</i> = .40) between icotrokinra and placebo. These results indicate that icotrokinra significantly improves IGA and PASI scores while maintaining a favourable safety profile. However, given the industry sponsorship and high risk for selective reporting, the results should be interpreted with caution, and the long-term efficacy of icotrokinra remains to be fully evaluated.