Global Plaque Psoriasis Market

Psoriasis is the most prevalent immune-mediated multisystem inflammatory disease, with predominantly skin and joint involvement. 
Plaque psoriasis is the most common clinical type of psoriasis. It is characterized by large oval-circular plaques (raised red patches covered with a whitish build-up of dead skin cells called scale) over the scalp, trunk, and extensor body surface. The plaques have an extensive amount of scaling due to the hyperproliferation of the epidermal cells. Body surface area (BSA) is used to evaluate the psoriasis severity by the clinicians. The exact cause is still under research. However, genetics and immune system plays a major role in the development. The immune system attacks the healthy cells and in response causes inflammation of joints and overproduction of skin cells. Various conditions like trauma, infection, drugs, metabolic factors, stress, alcohol, and smoking can trigger the response.

Common signs and symptoms includes, Plaques of red skin, covered with silver-colored scales typically in a symmetrical distribution and affecting the extensor surfaces, Discoloration nails, including pitting of the nails and onycholysis (separation of nail plate from nail bed), Plaques of scales or crust on the scalp. The most widely used measures for assessing disease severity are: Body Surface Area (BSA), Physician’s Global Assessment (PGA), Psoriasis Area and Severity Score (PASI), Dermatology Life Quality Index (DLQI).

Common signs and symptoms
Plaques of red skin, covered with silver-colored scales typically in a symmetrical distribution and affecting the extensor surfaces 
Discoloration nails, including pitting of the nails and onycholysis (separation of nail plate from nail bed)
Plaques of scales or crust on the scalp
Symptoms are more severe in women

Disease Severity and Categorization of Plaque Psoriasis
The most widely used measures for assessing disease severity are:
Body Surface Area (BSA)
Physician’s Global Assessment (PGA)
Psoriasis Area and Severity Score (PASI) 
Dermatology Life Quality Index (DLQI).

Epidemiology and Patient Subgroups

About 2–3% (125 million)  of the world’s population is affected by psoriasis. It affects both genders equally, with a bimodal distribution peaking at 30–39 years and 60–69 years in men, and 10 years earlier in women. It is less common in children than in adults

United States: Prevalence of psoriasis in adults is 3% or ~7.5 million adults 20 years or older  (as per Dec 2020), Incidence at 78.9 per 100,000 person-years (as per 2016)

Types of Psoriasis:

• Plaque Psoriasis (80-90%):Inflamed skin and scaly, silvery, plaque with a clear border
• Inverse Psoriasis (21-30%): Rash appearing in skin folds
• Guttate Psoriasis (8%): Teardrop-shaped bumps seen. More common in children and adolescents than adults
• Pustular Psoriasis (3%): Push filled lesion seen. Generalized pustular psoriasis & localized pustular psoriasis are sub types
• Erythrodermic psoriasis (2%): Severely inflamed skin - erythema, edema, pruritus, scaling, exudative lesions are noted

Plaque Psoriasis: Treatment Options
The treatment goal is to reduce cutaneous signs and symptoms by at least 75% as measured by the PASI score (PASI75), and to guarantee a good quality of life, as measured by a DLQI score of 5 or less. With new therapeutic options, the goal is complete or almost complete clearing of skin lesions which correlates to PASI90.Treatment failure or inadequate response to therapy is defined by as the failure to achieve a PASI score of 50%—i.e. PASI50

Plaque Psoriasis: Recent News

Icotrokinra (JNJ-2113) – Potential Game-Changer in Plaque Psoriasis Treatment

Key Takeaways:

✅ New Standard of Care

Nearly 50% of patients with moderate-to-severe plaque psoriasis (PsO) treated with Icotrokinra achieved complete skin clearance (IGA 0) at Week 24 (ICONIC-LEAD study).

✅ Superior to Deucravacitinib: Phase 3 ICONIC-ADVANCE 1&2 studies met all primary and secondary endpoints, proving superiority over deucravacitinib.

✅ Head-to-Head with Biologics: J&J initiates the first-ever head-to-head study (ICONIC-ASCEND) to demonstrate oral Icotrokinra vs. injectable ustekinumab (Stelara).

✅ Favorable Safety Profile: Adverse events (AEs) in Icotrokinra (49%) vs. placebo (49%), no new safety signals identified.

Impact Analysis:

🔹 Market Disruption – A once-daily oral pill with biologic-like efficacy could shift patient preference away from injectables, impacting IL-23/IL-17 biologics (e.g., Skyrizi, Cosentyx, Stelara, Tremfya).

🔹 Regulatory Milestone – Positive Phase 3 results pave the way for FDA & EMA filings. Expect regulatory submission in H2 2025.

🔹 Competitive Landscape – Key players like AbbVie, Novartis, and BMS may accelerate oral PsO pipeline development to counter Icotrokinra’s advantage. 

🔹 Market Access & Pricing – Potential premium pricing & payer interest due to oral administration convenience vs. injectables.

Clinical Data Highlights:

📌 Phase 3 ICONIC-LEAD Study (PsO patients aged ≥12 years)

IGA 0/1 (Clear/Almost Clear Skin): 65% (Icotrokinra) vs. 8% (placebo) at Week 16

PASI 90 Response: 50% (Icotrokinra) vs. 4% (placebo) at Week 16

IGA 0 (Completely Clear Skin) at Week 24: 46%

PASI 100 (Full Clearance) at Week 24: 40%

No new safety signals; AEs comparable to placebo

📌 ICONIC-ADVANCE 1&2 Results:

Icotrokinra met all endpoints and demonstrated superiority over deucravacitinib.

High sustained skin clearance at Week 24.

📌 ICONIC-ASCEND Study Initiated:

First-ever oral vs. injectable biologic head-to-head trial

Competing against ustekinumab (Stelara) to prove oral superiority

Side Effects & Safety Profile:

⚠️ Adverse Events (AEs) – Similar proportions of AEs between Icotrokinra (49%) and placebo (49%). No severe safety concerns reported.

⚠️ Common AEs: Headache, nasopharyngitis, mild gastrointestinal symptoms

⚠️ No new safety signals detected.

Strategic Considerations:

🔹 Investment & Licensing – Potential pipeline acceleration for competitors (BMS, Novartis, Lilly, AbbVie) in oral PsO segment.

🔹 M&A Impact – Companies with IL-23/IL-17 portfolios may reassess acquisition strategies.

🔹 Digital Engagement – Patient preference for oral therapies may boost DTC marketing & digital adherence programs.