Icotrokinra
Icotrokinra (oral IL-23 receptor targeting peptide)
Written by Aaron CuhaReviewed Sep 2026
Also known as: JNJ-2113, JNJ-77242113, Icotyde
A 13 amino acid peptide taken as a tablet that blocks the IL-23 receptor. The first oral drug to hit that pathway, in a class that was injection only.
Overview
Interleukin-23 drives plaque psoriasis, and the drugs that block it are among the most effective treatments there are. All of them were injected antibodies. Icotrokinra is a 13 amino acid peptide that binds the IL-23 receptor with very high affinity and is taken by mouth, which makes it the first oral drug to target this pathway specifically. It was approved in 2026 for plaque psoriasis. Through one year, roughly two thirds to seven tenths of patients reached clear or almost clear skin, and clearance rates at the scalp and genital sites were higher still. It is on this site as a landmark in oral peptide delivery rather than because anyone reading this is likely to take it.
Mechanism of action
Binds the IL-23 receptor with picomolar affinity and blocks IL-23 signalling. Conventional IL-23 drugs are antibodies that bind the cytokine itself; this binds the receptor, and its small peptide size is what makes oral dosing possible.
Human evidence
Strong and unusually complete for a recently approved drug, with multiple phase 3 trials, one year durability data and a comparison against the injectable alternatives.
- ICONIC-TOTAL: 311 participants including adolescents from age 12, randomised against placebo with crossover at week 16.
- Clear or almost clear overall skin in 67 to 70 percent of treated participants across weeks 24 to 52.
- Genital psoriasis responded best at 85 to 90 percent clear or almost clear, scalp at 72 to 78 percent.
- Hand and foot psoriasis was the weakest site at 54 to 62 percent, which is worth knowing if that is where your disease is.
- 88 percent of participants completed 52 weeks of treatment.
What this does not tell you: Psoriasis clearance scales are physician-assessed and partly subjective, though they are the accepted endpoints in this field. The trials are manufacturer funded. And the relevant comparison for most patients is not against placebo but against the injected antibodies, which are highly effective; the published comparison against those is worth reading before concluding the oral route is simply better.
Reading the research record
The reason a psoriasis drug appears in a longevity and peptide catalogue is delivery. A 13 amino acid peptide taken as a daily tablet, achieving clearance rates in the same territory as injected monoclonal antibodies, is a demonstration that the oral peptide problem is solvable for at least some targets.
Read alongside enlicitide, which does the same thing for cholesterol at a much larger molecular size, this is the clearest signal in the current literature that the injection-only assumption behind most of this catalogue is starting to erode.
The evidence, charted
Fig. 1 · evidence composition
2of 3 citations (67%) are in people
Counted from the citation list on this page. The Human count is the same number shown in the badge at the top. Both understate any literature larger than the sources we cite.
Fig. 2 · evidence over time
Every citation here was published in 2026.
Too few distinct publication years on this page to plot as a timeline.
Fig. 3 · legal status at a glance
US
Approved
UK
Prescription
AU
Prescription
CA
Prescription
Approved in 1 of 4, prescription route in 3, not approved in 0. A jurisdiction's classification is a regulatory fact, not a verdict on the science; see Legal status below for the full text and any notes.
Key studies & citations
- Human2026
Durability of response to icotrokinra for high-impact site psoriasis: 1-year ICONIC-TOTAL findings
311 participants aged 12 and over randomised 2:1 to icotrokinra 200 mg daily or placebo, with placebo crossing over at week 16. At weeks 24 to 52, clear or almost clear overall skin in 67 to 70 percent, scalp 72 to 78 percent, genital 85 to 90 percent. Hand and foot psoriasis lagged the other sites at 54 to 62 percent. 88 percent completed 52 weeks.
Journal of the European Academy of Dermatology and Venereology - Human2026
Safety of icotrokinra through 1 year for the treatment of moderate-to-severe plaque psoriasis
One year safety reporting. Adverse event rates through week 16 were similar between icotrokinra and placebo.
Dermatologic Therapy - Review2026
The efficacy of oral icotrokinra versus injectable IL-23 inhibitors for moderate-to-severe plaque psoriasis
Comparison against the injected antibodies in the same class, which is the question that decides whether an oral option is worth switching to.
Journal of the American Academy of Dermatology
Frequently asked questions
Why is a psoriasis drug on this site?
For the delivery rather than the indication. It is a 13 amino acid peptide that works as a daily tablet against a target that previously required injected antibodies, which is a landmark for oral peptide drugs generally.
How well does it work?
Through one year, 67 to 70 percent of treated participants had clear or almost clear skin. Genital and scalp psoriasis responded better than that. Hand and foot psoriasis responded least well, at 54 to 62 percent.
Is it as good as the injections?
That comparison has been published and it is the one that matters for a patient choosing between them. The injected IL-23 antibodies are highly effective, so an oral option competes on convenience as much as on efficacy.