The U.S. Food and Drug Administration (FDA) has approved a new daily pill to treat moderate to severe plaque psoriasis, offering people with thick, scaly skin lesions another alternative to injectable medications.
Icotyde (icotrokinra) is not the first oral drug to treat plaque psoriasis, a chronic autoimmune condition. But it is the first in the interleukin-23 (IL-23) receptor antagonist class of medications, which are dominated by injectable drugs like Skyrizi (risankizumab), Tremfaya (guselkumab), and Ilumya (tildrakizumab).
“It’s the first in its class to be oral. That’s a big deal,” says Ife J. Rodney, MD, the founding director of Eternal Dermatology + Aesthetics in Fulton, Maryland.
Adam Friedman, MD, a professor and the chair of dermatology at GW Medical Faculty Associates, agrees. “For the first time, we have a targeted oral therapy hitting the IL-23 pathway, which we know is one of the most effective mechanisms in this disease,” he says. “Historically, that level of precision, and in turn, effectiveness, has been reserved for injectables, but now we can offer it in a pill.”
How Icotyde Works to Treat Plaque Psoriasis
Icotyde binds to the interleukin-23 (IL-23) receptor, blocking it and thus interrupting the signaling pathway in the body that drives inflammation. The result is clearer skin.
Icotyde performed well in four phase 3 clinical trials that included 2,500 patients. After 16 weeks on the medication, about 70 percent of patients developed clear or nearly-clear skin, and 55 percent had a 90 percent reduction in their psoriasis severity.
Johnson & Johnson, which makes Icotyde, tested the drug in patients ages 12 and up. “It is approved down to age 12, which is a good option for kids,” says Cindy Wassef, MD, a dermatologist at Premier Health Associates in Randolph, New Jersey.
Icotyde takes time to kick in. “The medicine requires a few weeks to start exerting its effect,” says Joshua Zeichner, MD, the director of cosmetic and clinical research at Mount Sinai Hospital in New York City. “Studies have shown that it gives significant benefits that are long-lasting with continued use.”
Side Effects Were Minimal
In all the phase 3 clinical trials, side effects for patients treated with Icotyde were within 1.1 percent of what people on a placebo experienced through 16 weeks on the medication. There were no new safety issues reported through 52 weeks on the medication.
The most common side effects included headache, nausea, cough, fungal infection, and fatigue. Johnson & Johnson notes that medications like Icotyde that interact with the immune system may lower your ability to fight infections and increase the risk of infections.
“It’s effective, targeted, oral, and safe,” Dr. Friedman says. “The label also requires less rigorous, and often overkill, laboratory tests prior to starting, which can be a roadblock for some. Overall that means less time undertreated, faster control of disease, and ultimately better outcomes.”
Icotyde Offers an Alternative to Injectable Biologic Medications
Skyrizi, Tremfya, and Ilumya each have slightly different dosing; patients needs to take an injection every 8 to 12 weeks.
“A once-daily pill is very appealing compared to some of the injectables and biologics,” Dr. Rodney says. “Not everyone likes an injection.”
People with psoriasis who prefer a pill to an injection also have the option of taking Otezla (apremilast) or Sotyktu (deucravacitinib).
“For some people, taking a pill is super easy; others prefer an injection that’s less frequent. Either way, it’s good to have choices,” Rodney says.
Price and Availability
Johnson & Johnson has not released details about when Icotyde will be available to patients or how much it will cost.
EDITORIAL SOURCES
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Resources
FDA Approval of Icotyde (icotrokinra) Ushers in New Era for First-Line Systemic Treatment of Plaque Psoriasis With a Targeted Oral Peptide. Johnson & Johnson. March 18, 2026.
What Are Possible Side Effects of Icotyde? Johnson & Johnson. March 18, 2026.
Emily Kay Votruba has copy edited and fact-checked for national magazines, websites, and books since 1997, including Self, GQ, Gourmet, Golf Magazine,Outside, Cornell University Press, Penguin Random House, and Harper's Magazine. Her projects have included cookbooks (Padma Lakshmi's Tangy Tart Hot & Sweet), self-help and advice titles (Mika Brzezinski's Know Your Value: Women, Money, and Getting What You're Worth), memoirs (Larry King's My Remarkable Journey), and science (Now You See It: How the Brain Science of Attention Will Transform How We Live, Work, and Learn, by Cathy Davidson). She started freelancing for Everyday Health in 2016.
Korin Miller is a health journalist with more than a decade of experience in the field. She covers a range of health topics, including nutrition, recent research, wellness, fitness, mental health, and infectious diseases.
Miller received a double bachelor's in international relations and marketing from The College of William & Mary and master's in interactive media from American University. She has been published in The Washington Post, Prevention, Cosmopolitan, Women's Health, The Bump, and Yahoo News, among others.
When she's not working, Miller is focused on raising her four young kids.
