Plaque psoriasis is a long-lasting skin condition that causes thick, scaly patches (plaques) on the skin. It happens when your immune system becomes overactive and speeds up the growth of skin cells. These plaques can be itchy and painful and may affect your quality of life. They can appear anywhere on your body, but they most commonly affect the scalp, elbows, knees, and back.
Many treatment options are available for plaque psoriasis, including topical treatments that are applied to the skin, light therapy, and systemic medicines that work throughout the body. A health care provider or skin specialist (dermatologist) can help decide the right treatment plan for you.
One option is Icotyde (icotrokinra), an oral tablet that targets inflammation linked to psoriasis. The FDA approved Icotyde in 2026 for treating moderate-to-severe plaque psoriasis.
Below are frequently asked questions about Icotyde, including how it works, how it was studied, and what to expect while taking it.
Is Icotyde Right for My Plaque Psoriasis?
Before prescribing Icotyde, your health care provider will consider factors such as the type of psoriasis you have and how severe it is. They will also review your medical history to see if Icotyde is safe for you.
Icotyde is FDA-approved to treat moderate-to-severe plaque psoriasis in adults and children (12 years and older) who weigh at least 40 kilograms (88 pounds) and are able to receive systemic therapy (medicine that works throughout the body) or light therapy.
Your health care provider will examine your skin and discuss your symptoms to know if your psoriasis is moderate to severe. This is usually based on how much of your body is affected and how much your symptoms affect your daily life.
It is not known if Icotyde is safe or effective for children younger than 12 years or people who weigh less than 40 kilograms.
How Does Icotyde Work for Plaque Psoriasis?
Icotyde is thought to help psoriasis symptoms by reducing inflammation in the body. In people with psoriasis, a protein called interleukin-23 (IL-23) activates immune cells that cause inflammation and rapid skin cell growth. Icotyde blocks the receptor for IL-23, which prevents IL-23 from attaching and sending signals that lead to inflammation.
Unlike other medicines that target IL-23, Icotyde is taken by mouth; it is not given as an injection.
How Do I Take Icotyde?
Icotyde is a tablet that is taken by mouth once a day. The recommended dose is 200 milligrams. Take Icotyde as soon as you wake up, on an empty stomach, with water. After you take Icotyde, wait at least 30 minutes before eating any food.
If possible, swallow the tablet whole. Do not crush, split, or chew it.
If you have trouble swallowing it whole, you can follow these steps:
- Place one tablet in a cup with at least 4 ounces (120 milliliters) of water.
- Wait a few minutes for the tablet to break apart (disperse). It may not fully dissolve.
- Gently swirl the cup to mix the contents. The mixture may look yellow, milky, or cloudy, and you may see small pieces. These are safe to swallow.
- Drink all of the mixture.
- Add another 4 ounces (120 milliliters) of water to the same cup, swirl again, and drink all of the liquid to make sure you get the full dose. Take the mixture within 15 minutes of dispersing the tablet in water.
Be sure to follow your health care provider’s instructions. If you have questions about how to take Icotyde, contact your health care provider.
How Was Icotyde Studied for Plaque Psoriasis?
Four clinical studies were done to see if Icotyde is effective for treating plaque psoriasis. These studies included a total of 2,500 adults and children with moderate-to-severe plaque psoriasis who were eligible for treatments that work throughout the body (systemic therapy) or light therapy (phototherapy).
Across the four studies, participants were mostly adults with plaque psoriasis, with average ages in the mid-40s. Most participants were White, but the studies also included people who were Asian or Black and people who identified as Hispanic or Latino. Most participants had significant disease at baseline with notable skin involvement. Many people had previously received systemic treatments, including phototherapy and biologics, to treat their psoriasis.
Certain people could not enter the studies, such as those with a form of psoriasis other than plaque psoriasis, psoriasis caused by a medicine, certain infections, or other medical conditions that could affect safety or study participation.
Two of the studies, ICONIC-ADVANCE 1 and ICONIC-ADVANCE 2, included a total of 1,505 adults with moderate-to-severe plaque psoriasis. Participants in these studies were randomly assigned to one of three once-daily treatments: (1) Icotyde, (2) another oral psoriasis medicine called deucravacitinib (Sotyktu), or (3) a placebo (a pill with no active medicine). After 16 weeks, people taking a placebo could switch to Icotyde. After 24 weeks, people taking deucravacitinib could also switch to Icotyde.
Another study, called ICONIC-LEAD, included 618 adults and 66 children (12 years and older) with moderate-to-severe plaque psoriasis. In this study, participants were randomly assigned to take Icotyde or a placebo for 16 weeks.
A fourth study, called ICONIC-TOTAL, included 305 adults and six children (12 years and older) with plaque psoriasis that affected certain hard-to-treat areas of the body, such as the scalp, genitals, hands, or feet. Compared to the other studies, some participants had less total body involvement but still had moderate-to-severe disease in these harder-to-treat areas. In this study, people were randomly assigned to take Icotyde or a placebo for 16 weeks. After 16 weeks, people taking placebo could switch to Icotyde.
The main goals of the studies were to measure how many people had clear or almost-clear skin and how many had a major improvement in their psoriasis symptoms after 16 weeks.
In some of the studies, participants could continue treatment for a longer period to see how well Icotyde worked over time, including what happened when treatment was stopped, switched, or restarted.
What Are the Benefits of Icotyde Based on Studies?
Overall, the studies showed that Icotyde improves psoriasis symptoms more than a placebo. To measure the effectiveness, the researchers looked at the number of people who achieved clear or almost-clear skin (with at least a 2-grade improvement in symptom severity score) and those who had at least a 90% improvement in their symptoms. Researchers also looked at other outcomes, such as complete skin clearance, earlier improvements in symptoms, and reductions in itching.
Across all four studies, many people who took Icotyde had clearer skin and less severe symptoms by week 16.
In the ICONIC-ADVANCE studies, most adults taking Icotyde achieved clear or almost-clear skin by week 16. Many also had major improvements in their symptoms, including a 90% or greater reduction in psoriasis severity. These results were seen more often in people taking Icotyde compared with those taking a placebo or another oral psoriasis medicine.
Similar results were seen in the ICONIC-LEAD study, which included both adults and children. Many people who took Icotyde had clear or almost-clear skin or major improvements in their symptoms after 16 weeks.
In longer-term results from the ICONIC-LEAD study, many people who responded to Icotyde continued to have clear or improved skin when they stayed on treatment. About 8 out of 10 people maintained their results after one year. In contrast, most people who stopped taking Icotyde lost their improvement, often within about 10 weeks.
The studies also suggested that Icotyde had benefits in people with psoriasis affecting harder-to-treat areas. In the ICONIC-TOTAL study, people taking Icotyde had improvements in areas such as the scalp and genital area, as well as reductions in itching and symptom severity.
Some of the main study results are shown in the tables below.
Percentage of people with clear or almost-clear skin after 16 weeks
| Study Name | Icotyde | Placebo |
| ICONIC-ADVANCE 1 | 68% | 11% |
| ICONIC-ADVANCE 2 | 71% | 9% |
| ICONIC-LEAD | 65% | 8% |
| ICONIC-TOTAL | 57% | 6% |
Percentage of people with a 90% improvement in symptoms after 16 weeks
| Study | Icotyde | Placebo |
|---|---|---|
| ICONIC-ADVANCE 1 | 55% | 4% |
| ICONIC-ADVANCE 2 | 58% | 1% |
| ICONIC-LEAD | 50% | 4% |
Percentage of people with improvements in hard-to-treat areas after 16 weeks
| ICONIC-TOTAL Study | Icotyde | Placebo |
|---|---|---|
| Scalp (improved by 90%) | 57% | 6% |
| Genital area (clear or almost clear) | 77% | 21% |
Researchers found that Icotyde worked similarly across different groups of people, including those of different ages, sexes, races, body weights, disease severity, and prior treatments.
Your results may be different from what was seen in studies.
What Can I Do to Prevent or Manage the Side Effects of Icotyde?
Icotyde is generally well tolerated. In studies, the most common side effects of Icotyde were similar to the side effects reported with placebo. Side effects that were slightly more common with Icotyde than with placebo were headache, nausea, cough, fungal infection, and tiredness. Below are tips to help ease these side effects.
Headache. Try drinking plenty of water and relaxing in a dark, quiet room. If needed, ask your health care provider about over-the-counter (OTC) pain relievers, such as acetaminophen (Tylenol).
Nausea. Take Icotyde exactly as directed on an empty stomach. Eating small, bland meals later in the day may help ease nausea.
Tiredness. Try to maintain a regular sleep schedule and pace your daily activities. If possible, a daily exercise session, such as walking, may help boost energy levels.
Fungal infection. Keep affected areas clean and dry. Mild fungal infections, such as athlete’s foot, may be treated with OTC antifungal creams or other topical products, but you should contact your health care provider if symptoms do not improve.
Because Icotyde affects your immune system, it may increase your risk for other infections. To help lower your risk, wash your hands often and avoid close contact with people who are ill. Contact your health care provider right away if you develop symptoms such as fever, chills, cough, or skin changes. Your provider may pause or stop Icotyde treatment if needed. Your health care provider may also check for tuberculosis (TB) before you start treatment and monitor you for symptoms during treatment, such as a persistent cough or trouble breathing.
In addition, you should check with your provider before receiving any vaccines while taking Icotyde. This is because certain vaccines (live vaccines) may not be safe while taking this medicine.
If side effects become bothersome or do not go away, tell your health care provider. They can help you find ways to manage them or decide if Icotyde is still the right treatment for you.
How Fast Does Icotyde Start to Work?
Icotyde starts working soon after your first dose, but you may not notice any changes in symptoms right away. In studies of Icotyde for plaque psoriasis, significant improvements were seen within 16 weeks (about four months) of starting treatment. But you may start to notice some improvement sooner than this. For example, some study participants reported improvements in itching by the fourth week of treatment.
Is There Any Cost Assistance Available?
A cost assistance program is available from Johnson & Johnson, the maker of Icotyde. It may help reduce your out-of-pocket cost. Whether you qualify to enroll may depend on what type of insurance you have or if you are uninsured. Visit this website or call 844-494-8463 to learn more about financial support options.
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