Recent advancements in psoriasis treatment were highlighted during a Peer Exchange featuring experts, including Linda Stein Gold, MD. The discussion centered on the ongoing challenges in psoriasis care, despite the growing availability of therapeutic options. Data from the ENCOMPASS and Stein Gold 2025 surveys revealed significant patient dissatisfaction with current therapies, with a strong preference for oral medications over injectable treatments.
The panelists explored how factors such as patient lifestyle, comorbidities, and psychosocial considerations impact shared decision-making and treatment adherence. They also examined the new definition of “topical failure” from the International Psoriasis Council (IPC), discussing its potential to minimize “topical churn” and promote earlier systemic therapy in the disease course.
New Insights from Clinical Trials
A significant portion of the discussion focused on the investigational drug pipeline and its role in addressing current care gaps. The experts reviewed the clinical development program for icotrokinra (ICO), summarizing the findings from the ICONIC-ADVANCE 1 and 2 Trials. These trials demonstrated superior efficacy of ICO compared to deucravacitinib at both 16 and 24 weeks, alongside favorable safety and tolerability profiles.
Moreover, new data from the week 52 ICONIC-LEAD study showed sustained clearance in adults and adolescents, with no new safety signals reported. The panel reflected on ICO’s implications for treating adolescent psoriasis, noting that early, aggressive oral intervention could help prevent progression to psoriatic arthritis, marking a pivotal development in the field of oral IL-23–targeted therapies.
Advancements in Psoriatic Arthritis Management
The final segment of the session shifted focus to managing active psoriatic arthritis (PsA). Experts discussed new findings from the APEX phase 3b study, which demonstrated the first clear evidence of IL-23–mediated inhibition of structural joint damage using guselkumab. This reinforces the rationale for early biologic intervention in high-risk patients.
The panel compared the results of the APEX study with earlier IL-23 trials and discussed the implications for therapy sequencing. They also highlighted emerging data from the upcoming Fall Clinical 2025 conference, including insights from the SPECTREM and PSOLAR studies.
In conclusion, Linda Stein Gold and her colleagues advocated for a forward-thinking approach that emphasizes personalized therapy selection, early detection of psoriatic arthritis, and enhanced collaboration across specialties. This strategy aims to elevate the standards of psoriasis care and improve patient outcomes in the evolving therapeutic landscape.
