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Last update 04 Nov 2025
Icotrokinra
Last update 04 Nov 2025
Overview
Basic Info
Drug Type Synthetic peptide |
Synonyms JNJ 67864238, JNJ-2113, JNJ-4238 + [7] |
Target |
Action inhibitors |
Mechanism IL-23R inhibitors(Interleukin 23 Receptor inhibitors) |
Therapeutic Areas |
Active Indication |
Inactive Indication- |
Originator Organization |
Inactive Organization |
License Organization |
Drug Highest PhaseNDA/BLA |
First Approval Date- |
Regulation- |
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Structure/Sequence
Sequence Code 1311911322
Source: *****
Related
31
Clinical Trials associated with IcotrokinraNCT07196722
A Phase 2b/3 Randomized, Double-blind, Placebo-Controlled, Parallel Group, Multicenter Protocol to Evaluate the Efficacy and Safety of Icotrokinra in Participants With Moderately to Severely Active Crohn's Disease
The purpose of this study is to evaluate how-well icotrokinra works (clinical efficacy) and how safe it is (safety) in participants with moderately to severely active Crohn's disease (CD; a long-term condition causing severe inflammation of the intestinal tract).
Start Date03 Oct 2025 |
Sponsor / Collaborator |
NCT07196748
A Phase 3 Randomized, Double-blind, Placebo-Controlled, Parallel Group, Multicenter Protocol in Adults With an Open Label Study in Adolescents to Evaluate the Efficacy and Safety of Induction and Maintenance Therapy With Icotrokinra in Participants With Moderately to Severely Active Ulcerative Colitis
The purpose of this protocol is to evaluate the efficacy (how well it works), safety and tolerability of oral icotrokinra as therapy in adult and adolescent participants with moderately to severely active ulcerative colitis (UC, a chronic disease of the large intestine in which the lining of the colon becomes inflamed and develops tiny open ulcers).
Start Date01 Oct 2025 |
Sponsor / Collaborator |
CTRI/2025/04/084956
A Phase 3, Multicenter, Randomized, Double-blind, Placebo-controlled Study Evaluating the Efficacy and Safety of JNJ-77242113 for the Treatment of Biologic-experienced Participants with Active Psoriatic Arthritis - ICONIC-PsA 2
Start Date16 May 2025 |
Sponsor / Collaborator- |
100 Clinical Results associated with Icotrokinra
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100 Translational Medicine associated with Icotrokinra
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100 Patents (Medical) associated with Icotrokinra
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8
Literatures (Medical) associated with Icotrokinra01 Sep 2025·Dermatology and Therapy
Translational Pharmacokinetics of Icotrokinra, a Targeted Oral Peptide that Selectively Blocks Interleukin-23 Receptor and Inhibits Signaling
Article
Author: Patel, Shefali ; Baguet, Tristan ; Shi, Yifan ; Ndifor, Anthony ; Wang, Jianyao ; Somani, Sandeep ; Sensenhauser, Carlo ; Park, Seonghee ; Adriaenssen, Lieve ; Leclercq, Laurent ; Fourie, Anne ; Mardirosian, Saro ; Monshouwer, Mario ; Chaudhuri, Siladitya Ray ; Dallas, Shannon ; Knight, Beverly ; Sukumaran, Siddharth ; Polidori, David ; Patch, Raymond ; Sun, Chengzao ; DiLoreto, Karen ; Barros, Stephanie A ; Tammara, Brinda ; Geist, Brian ; Modi, Nishit B ; Moss, Darren ; Laenen, Aline
INTRODUCTION:
Icotrokinra (formerly JNJ-77242113 or PN-21235) is a targeted oral peptide that selectively inhibits interleukin-23 receptor signaling. The studies described here assessed its absorption, distribution, metabolism, and excretion (ADME), and potential for drug-drug interactions (DDI).
METHODS:
In vitro assays evaluated permeability, plasma protein binding, blood-to-plasma partitioning, metabolic stability, and interactions with drug transporters and metabolic enzymes. The nonclinical pharmacokinetic properties of icotrokinra were studied in vivo in rats and monkeys. Phase 1 studies evaluated the pharmacokinetic profile, metabolic profile and excretion in healthy volunteers.
RESULTS:
Icotrokinra demonstrated oral bioavailability of 0.1-0.3% in animals, with evidence of systemic pharmacodynamic activity, without the use of an absorption enhancer. The compound was stable across species in plasma, gastrointestinal matrices, and hepatocytes. Protein binding was low across species (~ 50% in human plasma), and icotrokinra distributed freely to tissues, including skin, joints, and gastrointestinal tissues. Following oral dosing in both rats and monkeys, fecal excretion of unabsorbed drug was the primary elimination route, and metabolite levels were low (each < 2% of dose) in plasma and excreta, with unchanged icotrokinra being the main circulating component. Icotrokinra was neither a substrate nor an inhibitor of prototypical drug transporters or cytochrome P450 enzymes. Icotrokinra exhibited dose-proportional pharmacokinetics from 25 mg to 1000 mg in a first-in-human study, and no serious adverse events were identified following single and multiple dose administrations. Unchanged icotrokinra was the only drug-related component in human plasma.
CONCLUSIONS:
Icotrokinra exhibited high stability and an ADME profile consistent with that of a small peptide, with no risk of DDI identified on the basis of in vitro studies. Clinical data demonstrated linear pharmacokinetics and no major metabolites.
TRIAL REGISTRATION NUMBER:
ClinicalTrials.gov, NCT04621630. Euclinicaltrials.eu, EUCT: 2023-504720-26-00. A Graphical Abstract is available for this article.
01 Sep 2025·LANCET
Once-daily oral icotrokinra versus placebo and once-daily oral deucravacitinib in participants with moderate-to-severe plaque psoriasis (ICONIC-ADVANCE 1 & 2): two phase 3, randomised, placebo-controlled and active-comparator-controlled trials
Article
Author: Papp, Kim A ; Bissonnette, Robert ; Magnolo, Nina ; Arnone, Marcelo ; Schwarz, Beate ; Kephart, Lea ; Riera-Monroig, Josep ; Gonzalez-Cantero, Alvaro ; Galimberti, Maria Laura ; Vender, Ronald B ; Kircik, Leon ; Campbell, Jennifer H ; Nunes, Fabio ; Edem, Bassey Effiom ; Tada, Yayoi ; Sebastian, Michael ; Waibel, Jill ; DeKlotz, Cynthia M C ; Tsianakas, Athanasios ; Cecchini, Michael ; Simon, Margrit ; Li, Shu ; Reyes-Servin, Ofelia ; Shen, Yaung-Kaung ; Gold, Linda Stein ; Cresswell, Kellen ; Wallace, Paul ; Armstrong, April W ; Gerdes, Sascha ; Ehst, Benjamin
BACKGROUND:
Monoclonal antibodies targeting interleukin-23 and interleukin-12 are efficacious in treating plaque psoriasis but must be delivered via intravenous or subcutaneous injection. Here, we aimed to evaluate the efficacy and safety of icotrokinra (JNJ-77242113), a targeted oral peptide that selectively binds the interleukin-23 receptor, compared with both placebo and deucravacitinib in adults with moderate-to-severe plaque psoriasis.
METHODS:
The phase 3, randomised, double-blind, placebo-controlled and active-comparator-controlled ICONIC-ADVANCE 1 and ICONIC-ADVANCE 2 trials, which are being done at 149 sites across 13 countries and 114 sites across 11 countries, respectively, randomly assigned (2:1:2 and 4:1:4, respectively) adults with moderate-to-severe plaque psoriasis diagnosed for at least 26 weeks (body-surface-area involvement ≤10%, Psoriasis Area and Severity Index [PASI] ≤12, and Investigator's Global Assessment [IGA] ≤3) to once-daily oral icotrokinra 200 mg, placebo, or deucravacitinib 6 mg; participants randomly assigned to placebo or deucravacitinib transitioned to icotrokinra at week 16 or week 24, respectively. Coprimary endpoints were proportions of participants achieving IGA 0 or 1 (clear or almost clear skin) with at least a two-grade improvement and at least 90% improvement in PASI (PASI 90) at week 16 with icotrokinra versus placebo. These studies are registered with ClinicalTrials.gov, NCT06143878 (ADVANCE 1) and NCT06220604 (ADVANCE 2), and are ongoing.
FINDINGS:
ICONIC-ADVANCE 1 enrolled participants from Jan 17, 2024, to May 24, 2024, and ICONIC-ADVANCE 2 enrolled participants from March 9, 2024, to June 13, 2024. Participants (ADVANCE 1: 774 of 988 patients screened; ADVANCE 2: 731 of 917 patients screened) were randomly assigned to icotrokinra (n=311 and 322), placebo (n=156 and 82), or deucravacitinib (n=307 and 327). All coprimary endpoints were met in both trials. Higher proportions of icotrokinra-treated versus placebo-treated participants achieved IGA 0 or 1 (ADVANCE 1: 213 [68%] of 311 vs 17 [11%] of 156, treatment difference 95% CI 58% [50-64]; ADVANCE 2: 227 [70%] of 322 vs seven [9%] of 82, 62% [53-69]; both p<0·0001) and PASI 90 (ADVANCE 1: 171 [55%] of 311 vs six [4%] of 156, treatment difference 95% CI 51% [44-57]; ADVANCE 2: 184 [57%] of 322 vs one [1%] of 82, 56% [48-62]; both p<0·0001) at week 16. Across studies, adverse event rates to week 16 were 303 (48%) of 632 and 136 (57%) of 237 with icotrokinra and placebo, respectively; the most common adverse events were nasopharyngitis (37 [6%] of 632 and 13 [5%] of 237) and upper respiratory tract infection (23 [4%] of 632 and eight [3%] of 237). To week 24, adverse event rates were lower than with icotrokinra (359 [57%] of 632) than deucravacitinib (411 [65%] of 634).
INTERPRETATION:
Icotrokinra showed superior clinical response rates versus placebo and deucravacitinib in phase 3 moderate-to-severe plaque psoriasis trials, with similar adverse event rates to placebo. These findings suggest the potential of once-daily oral icotrokinra to provide robust efficacy and a favourable safety profile.
FUNDING:
Johnson & Johnson.
01 Sep 2025·LANCET
Icotrokinra in psoriasis: IL-23 receptor antagonism via oral peptide with biologic-level efficacy
Article
Author: Puig, Luis
157
News (Medical) associated with Icotrokinra27 Oct 2025
Building on 12-week findings, icotrokinra demonstrated clinically meaningful outcomes at Week 28 with 31.7% of patients achieving clinical remission and 38.1% showing endoscopic improvement versus placebo in the Phase 2b ANTHEM-UC study
Results support Phase 3 clinical development of icotrokinra, a first-in-class targeted oral peptide that precisely blocks the IL-23 receptor, in both moderately to severely active ulcerative colitis and Crohn's disease
PHOENIX, Oct. 27, 2025 /PRNewswire/ -- Johnson & Johnson (NYSE: JNJ) today announced Week 28 results from the Phase 2b ANTHEM-UC study of icotrokinra, a first-in-class investigational targeted oral peptide that precisely blocks the IL-23 receptor, in adults with moderately to severely active ulcerative colitis (UC). These results underscore the potential of icotrokinra to deliver a combination of therapeutic benefit and a favorable safety profile with once-daily oral dosing and will be featured among Johnson & Johnson's 23 accepted abstracts at the 2025 American College of Gastroenterology Annual Scientific Meeting (ACG).
At Week 28, icotrokinra demonstrated sustained and clinically meaningful results, with all doses (100 mg, 200 mg and 400 mg) showing higher rates of clinical responsea, clinical remissionb, endoscopic improvementc and histologic-endoscopic mucosal improvement (HEMI)d at Week 28 compared to placebo.1 These outcomes build on Week 12 data recently presented at United European Gastroenterology (UEG) Week 2025 where all doses of icotrokinra demonstrated superiority to placebo for the primary endpoint of clinical response.2
"The ANTHEM-UC results show that targeting the IL-23 pathway with a once-daily oral therapy can provide meaningful, sustained benefit and a favorable safety profile, giving healthcare providers a potential new approach to managing this challenging disease," said Vipul Jairath, MBChB, DPhil, Professor of Medicine at Western University in Ontario, and study investigator.e "For those living with ulcerative colitis, icotrokinra could represent an important step forward in how their disease is managed."
Similar proportions of participants reported adverse events and serious adverse events through Week 28 across all icotrokinra dose groups and the placebo group.1
"These exciting results show how we are harnessing our deep understanding of the IL-23 pathway to advance innovative treatments for inflammatory bowel disease that address the daily needs of patients," said Esi Lamousé-Smith, M.D., Ph.D., Vice President, Gastroenterology Disease Area Lead, Immunology, Johnson & Johnson. "With Phase 3 development now underway in both adult and adolescent patients, our aim is to establish icotrokinra as a promising therapy that could transform the treatment paradigm in ulcerative colitis and bring patients a potential new option."
Based on results from the Phase 2b ANTHEM-UC study, Johnson & Johnson has initiated the ICONIC-UC Phase 3 protocol in adults and adolescents with moderately to severely active UC as well as the ICONIC-CD Phase 2b/3 protocol in adults with moderate to severely active Crohn's disease. Icotrokinra is also being studied in the pivotal Phase 3 ICONIC program in moderate-to-severe plaque psoriasis and the ICONIC-PSA 1 and ICONIC-PSA 2 studies in active psoriatic arthritis. A New Drug Application (NDA) was submitted to the U.S. Food and Drug Administration (FDA) in July 2025 seeking the first approval of icotrokinra for the treatment of adults and pediatric patients 12 years of age and older with moderate to severe plaque psoriasis.
Editor's notes:
a. Clinical response was defined as a decrease from baseline in the modified Mayo score by greater than or equal to (>=) 30 percent (%) and >=2 points, with either a >=1-point decrease from baseline in the rectal bleeding subscore or a rectal bleeding subscore of 0 or 1.
b. Clinical remission was defined as a stool frequency subscore of 0 or 1, a rectal bleeding subscore of 0, and an endoscopy subscore of 0 or 1.
c. Endoscopic improvement was defined as an endoscopy subscore of 0 or 1.
d. Histologic-endoscopic mucosal improvement (HEMI) was defined as histologic remission (absence of neutrophils from the mucosa in both lamina propria and epithelium, no crypt destruction, and no erosions, ulcerations, or granulation tissue according to the Geboes grading system) and endoscopic improvement (MES of 0 or 1).
e. Dr. Jairath is a paid consultant for Johnson & Johnson. He has not been compensated for any media work.
About ANTHEM-UC
ANTHEM-UC (NCT06049017) is a Phase 2b multicenter, randomized, placebo-controlled, dose-ranging study to evaluate the efficacy and safety of icotrokinra (JNJ-77242113, JNJ-2113) in patients with moderately to severely active ulcerative colitis who had an inadequate response or intolerance to conventional therapy (e.g., thiopurines or corticosteroids), prior biologics (TNF antagonists or vedolizumab) and/or ozanimod or approved JAK inhibitors. The study is evaluating three once-daily dosages of icotrokinra taken orally. Participants who complete the Week 28 assessments and have achieved clinical response at Week 28 and who, in the opinion of the investigator, will continue to benefit from treatment with study intervention will continue in the 48-week long term extension (LTE) period and receive the same treatment up to Week 76.3
About Ulcerative Colitis
Ulcerative colitis (UC) is a chronic disease of the large intestine, also known as the colon, in which the lining of the colon becomes inflamed and develops tiny open sores, or ulcers, that produce pus and mucus. It is the result of the immune system's overactive response. Symptoms vary but may typically include loose and more urgent bowel movements, rectal bleeding or bloody stool, persistent diarrhea, abdominal pain, loss of appetite, weight loss, and fatigue.4
About Icotrokinra (JNJ-77242113, JNJ-2113)
Investigational icotrokinra is the first targeted oral peptide designed to precisely block the IL-23 receptor,5 which underpins the inflammatory response in moderate-to-severe plaque psoriasis, ulcerative colitis and offers potential in other IL-23-mediated diseases.6,7 Icotrokinra binds to the IL-23 receptor with single-digit picomolar affinity and demonstrated potent, precise inhibition of IL-23 signalling in human T cells.8 The license and collaboration agreement established between Protagonist Therapeutics, Inc. and Janssen Biotech, Inc., a Johnson & Johnson company, in 2017 enabled the companies to work together to discover and develop next-generation compounds that ultimately led to icotrokinra.9 Icotrokinra was jointly discovered and is being developed pursuant to the license and collaboration agreement between Protagonist and Johnson & Johnson. Johnson & Johnson retains exclusive worldwide rights to develop icotrokinra in Phase 2 clinical trials and beyond, and to commercialize compounds derived from the research conducted pursuant to the agreement against a broad range of indications.10,11,12
Icotrokinra is being studied in the Phase 3 ICONIC clinical development program in moderate-to-severe plaque psoriasis, active psoriatic arthritis, moderately to severely active ulcerative colitis and moderately to severely active Crohn's disease.
About Johnson & Johnson
At Johnson & Johnson, we believe health is everything. Our strength in healthcare innovation empowers us to build a world where complex diseases are prevented, treated, and cured, where treatments are smarter and less invasive, and solutions are personal. Through our expertise in Innovative Medicine and MedTech, we are uniquely positioned to innovate across the full spectrum of healthcare solutions today to deliver the breakthroughs of tomorrow and profoundly impact health for humanity.
Learn more at or at .
Follow us at @JNJInnovMed.
Cautions Concerning Forward-Looking Statements
This press release contains "forward-looking statements" as defined in the Private Securities Litigation Reform Act of 1995 regarding icotrokinra (JNJ-2113). The reader is cautioned not to rely on these forward-looking statements. These statements are based on current expectations of future events. If underlying assumptions prove inaccurate or known or unknown risks or uncertainties materialize, actual results could vary materially from the expectations and projections of Johnson & Johnson. Risks and uncertainties include, but are not limited to: challenges and uncertainties inherent in product research and development, including the uncertainty of clinical success and of obtaining regulatory approvals; uncertainty of commercial success; manufacturing difficulties and delays; competition, including technological advances, new products and patents attained by competitors; challenges to patents; product efficacy or safety concerns resulting in product recalls or regulatory action; changes in behavior and spending patterns of purchasers of health care products and services; changes to applicable laws and regulations, including global health care reforms; and trends toward health care cost containment. A further list and descriptions of these risks, uncertainties and other factors can be found in Johnson & Johnson's most recent Annual Report on Form 10-K, including in the sections captioned "Cautionary Note Regarding Forward-Looking Statements" and "Item 1A. Risk Factors," and in Johnson & Johnson's subsequent Quarterly Reports on Form 10-Q and other filings with the Securities and Exchange Commission. Copies of these filings are available online at , or on request from Johnson & Johnson. Johnson & Johnson does not undertake to update any forward-looking statement as a result of new information or future events or developments.
References:
1 Jairath V., et al. Efficacy and Safety of Icotrokinra, a Targeted Oral Peptide That Selectively Blocks IL-23 Receptor Activation, In Ulcerative Colitis: Results From Week 28 of ANTHEM-UC, a Phase 2b Dose-ranging Trial. Poster 1066 at ACG Annual Scientific Meeting 2025. October 2025.
2 Abreu M., et al. Icotrokinra, a targeted oral peptide that selectively blocks IL-23 receptor activation, in moderately to severely active ulcerative colitis: week 12 results from the phase 2b, randomized, double-blind, placebo-controlled, treat-through, dose-ranging ANTHEMUC trial. Oral presentation OP206 at United European Gastroenterology Week (UEGW) 2025. October 2025.
3 Clinicaltrials.gov. A Study of JNJ-77242113 in Participants With Moderately to Severely Active Ulcerative Colitis (ANTHEM-UC). Identifier NCT06049017. . Accessed February 2025.
4 Crohn's & Colitis Foundation. What is ulcerative colitis? Available at: . Accessed April 2024.
5 Bissonnette R, et al. Data presentation. A phase 2, randomized, placebo-controlled, dose-ranging study of oral JNJ-77242113 for the treatment of moderate-to-severe plaque psoriasis: FRONTIER 1. Presented at WCD 2023, July 3-8.
6 Razawy W, et al. The role of IL‐23 receptor signaling in inflammation‐mediated erosive autoimmune arthritis and bone remodeling. Eur J Immunol. 2018 Feb; 48(2): 220–229.
7 Tang C, et al. Interleukin-23: as a drug target for autoimmune inflammatory diseases. Immunology. 2012 Feb; 135(2): 112–124.
8 Pinter A, et al. Data Presentation. JNJ-77242113 Treatment Induces a Strong Systemic Pharmacodynamic Response Versus Placebo in Serum Samples of Patients with Plaque Psoriasis: Results from the Phase 2, FRONTIER 1 Study. Presented at EADV 2023, October 11-14.
9 Johnson & Johnson. Press release. Janssen enters into worldwide exclusive license and collaboration agreement with Protagonist Therapeutics, Inc. for the oral Interlukin-23 receptor antagonist drug candidate for the treatment of Inflammatory Bowel Disease. Available at: . Accessed November 2024.
10 Protagonist Therapeutics. Press release. Protagonist Therapeutics announces amendment of agreement with Janssen Biotech for the continued development and commercialization of IL-23 antagonists. Available at: . Accessed November 2024.
11 Protagonist Therapeutics. Press release. Protagonist Reports positive results from Phase 1 and pre-clinical studies of oral Interleukin-23 receptor antagonist JNJ-2113. Available at: . Accessed November 2024.
12 Protagonist Therapeutics. Press release. Protagonist Therapeutics announces positive topline results for Phase 2b FRONTIER 1 clinical trial of oral IL-23 receptor antagonist JNJ-2113 (PN-235) in psoriasis. Available at: . Accessed November 2024.
SOURCE Johnson & Johnson
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Clinical ResultPhase 2Phase 3License out/inNDA
24 Oct 2025
In areas of high impact, 72% of patients with scalp psoriasis and 85% with genital psoriasis treated with icotrokinra achieved site-specific clear or almost clear skin at Week 52 in Phase 3 ICONIC-TOTAL study
67% of patients treated with icotrokinra achieved overall rates of clear or almost clear skin by Week 24, which was maintained through Week 52
Icotrokinra continues to show potential with its standout combination of exceptional skin clearance and favorable safety profile in a once daily pill
SPRING HOUSE, Pa., Oct. 24, 2025 /PRNewswire/ -- Johnson & Johnson (NYSE: JNJ) today announced new long-term 52-week data from the Phase 3 ICONIC-TOTAL studya evaluating icotrokinra, a first-in-class investigational targeted oral peptide that precisely blocks the IL-23 receptor, in adults and pediatric patients 12 years of age and older (adolescents) with plaque psoriasis (PsO) affecting high-impact sites.
The ICONIC-TOTAL study, presented at the 2025 Fall Clinical Dermatology Conference, simultaneously evaluated adults and adolescents with at least moderate scalp, genital and/or hand/foot plaque psoriasis with ≥1% Body Surface Area (BSA) affected. Through Week 52, icotrokinra demonstrated high and durable rates of site-specific psoriasis clearance affecting all of these high-impact and difficult-to-treat areas of the body.1
72% of patients with scalp psoriasis achieved a scalp-specific Investigator's Global Assessment (ss-IGA) 0/1 score and 57% achieved ss-IGA 0b
85% of patients with genital psoriasis achieved a Physician's Global Assessment of Genitalia (sPGA-G) 0/1 and 73% achieved sPGA-G 0c
In the smaller subset of patients with hand/foot psoriasis, treatment with icotrokinra showed a numerically higher rate of skin clearance at Week 16, which increased through Week 52 with patients achieving a hand and/or foot Physician's Global Assessment (hf-PGA)e score of 0/1 increasing from 42% to 62%.
"Many of the patients in my practice experience significant distress when psoriasis affects sensitive areas such as the scalp, genitals, hands, and feet," said Edward (Ted) Lain, MD, MBA Executive Director of the Austin Institute for Clinical Research in Austin, Texas, and study investigator. "The durable response rates observed in the ICONIC-TOTAL study show that icotrokinra has the potential to be a meaningful new option for effectively managing moderate-to-severe plaque psoriasis long-term in both adults and adolescents."
Overall response rates among patients treated with once daily icotrokinra were maintained through Week 52, with 67% of patients treated with icotrokinra achieving clear or almost clear skin (Investigator's Global Assessment (IGA)f 0/1) and 44% achieving completely clear skin (IGA 0) at Week 52. The overall response rates were also comparable among patients who received icotrokinra for all 52 weeks and those who transitioned from placebo to icotrokinra at Week 16 (67% versus 68% achieved IGA 0/1, respectively). Across treatment groups, adverse event and serious adverse event rates were similar through Week 52 compared to those through Week 16, with no new safety signals identified.
"The new long-term data from ICONIC-TOTAL adds to the robust findings seen across several studies this year, including the recently reported ICONIC-LEAD 52-week data," said Liza O'Dowd, MD, Vice President, Immunodermatology and Respiratory Disease Areas Lead, Johnson & Johnson Innovative Medicine. "Psoriasis that affects high-impact skin sites often results in greater physical discomfort for patients due to the sensitivity of these areas. Icotrokinra is being developed with the goal of setting a new standard of treatment that offers patients the precision of a targeted therapy, high level skin clearance and favorable safety profile with the ease of a once daily pill."
About the ICONIC Clinical Development Program
The pivotal Phase 3 ICONIC clinical development program of icotrokinra (JNJ-2113) in adult and pediatric patients 12 years of age and older with moderate-to-severe plaque PsO was initiated with two studies in Q4 2023 – ICONIC-LEAD and ICONIC-TOTAL – pursuant to the license and collaboration agreement between Protagonist Therapeutics, Inc. and Janssen Biotech, Inc., a Johnson & Johnson company.5
ICONIC-LEAD (NCT06095115) is a RCT to evaluate the efficacy and safety of icotrokinra compared with placebo in participants with moderate-to-severe plaque PsO, with PASI 90 and IGA score of 0 or 1 with at least a 2-grade improvement as co-primary endpoints.6
ICONIC-TOTAL (NCT06095102) is a RCT to evaluate the efficacy and safety of icotrokinra compared with placebo for the treatment of PsO in participants with at least moderate severity affecting special areas (e.g., scalp, genital, and/or hands and feet) with overall IGA score of 0 or 1 with at least a 2-grade improvement as the primary endpoint.7
Other Phase 3 studies in the development program include ICONIC-ADVANCE 1 (NCT06143878) and ICONIC-ADVANCE 2 (NCT06220604), which are evaluating the efficacy and safety of icotrokinra compared with both placebo and deucravacitinib in adults with moderate-to-severe plaque PsO.8,9 ICONIC-ASCEND will evaluate the efficacy and safety of icotrokinra compared with placebo and ustekinumab in participants with moderate-to-severe plaque psoriasis. ICONIC-PsA 1 (NCT06878404) and ICONIC-PsA 2 (NCT06807424) will evaluate the efficacy and safety of icotrokinra compared to placebo in participants with active psoriatic arthritis.10,11 ICONIC-UC (NCT07196748) will evaluate the efficacy and safety of icotrokinra in adults and adolescents with moderately to severely active ulcerative colitis (UC) and ICONIC-CD (NCT07196722) will evaluation the efficacy and safety of icotrokinra in adults with moderately to severely active Crohn's disease (CD).12,13
About Plaque Psoriasis
Plaque psoriasis (PsO) is a chronic immune-mediated disease resulting in overproduction of skin cells, which causes inflamed, scaly plaques that may be itchy or painful.14 It is estimated that 8 million Americans and more than 125 million people worldwide live with the disease.15 Nearly one-quarter of all people with plaque PsO have cases that are considered moderate-to-severe.15 Plaques typically appear as raised patches with a silvery white buildup of dead skin cells or scales. Plaques may appear red in lighter skin or more of a purple, gray or dark brown color in patients with darker skin tones. Plaques can appear anywhere on the body, although they most often appear on the scalp, knees, elbows, and torso.16 Living with plaque PsO can be a challenge and impact life beyond a person's physical health, including emotional health, relationships, and handling the stressors of life.17 Psoriasis on highly visible areas of the body or sensitive skin, such as the scalp, hands, feet, and genitals, can have an increased negative impact on quality of life.16,18
About Icotrokinra (JNJ-77242113, JNJ-2113)
Investigational icotrokinra is the first targeted oral peptide designed to precisely block the IL-23 receptor,19 which underpins the inflammatory response in moderate-to-severe plaque PsO, ulcerative colitis and offers potential in other IL-23-mediated diseases.20,21 Icotrokinra binds to the IL-23 receptor with single-digit picomolar affinity and demonstrated potent, precise inhibition of IL-23 signaling in human T cells.22 The license and collaboration agreement established between Protagonist Therapeutics, Inc. and Janssen Biotech, Inc., a Johnson & Johnson company, in 2017 enabled the companies to work together to discover and develop next-generation compounds that ultimately led to icotrokinra.23
Icotrokinra was jointly discovered and is being developed pursuant to the license and collaboration agreement between Protagonist and Johnson & Johnson. Johnson & Johnson retains exclusive worldwide rights to develop icotrokinra in Phase 2 clinical trials and beyond, and to commercialize compounds derived from the research conducted pursuant to the agreement against a broad range of indications.24,25,26
Icotrokinra is being studied in the pivotal Phase 3 ICONIC clinical development program in moderate-to-severe plaque psoriasis, active psoriatic arthritis, moderately to severely active ulcerative colitis and moderately to severely active Crohn's disease.
About Johnson & Johnson
At Johnson & Johnson, we believe health is everything. Our strength in healthcare innovation empowers us to build a world where complex diseases are prevented, treated, and cured, where treatments are smarter and less invasive, and solutions are personal. Through our expertise in Innovative Medicine and MedTech, we are uniquely positioned to innovate across the full spectrum of healthcare solutions today to deliver the breakthroughs of tomorrow and profoundly impact health for humanity.
Learn more at or at . Follow us at @JNJInnovMed.
Janssen Biotech, Inc. is a Johnson & Johnson company.
Cautions Concerning Forward-Looking Statements
This press release contains "forward-looking statements" as defined in the Private Securities Litigation Reform Act of 1995 regarding icotrokinra (JNJ-2113). The reader is cautioned not to rely on these forward-looking statements. These statements are based on current expectations of future events. If underlying assumptions prove inaccurate or known or unknown risks or uncertainties materialize, actual results could vary materially from the expectations and projections of Johnson & Johnson. Risks and uncertainties include, but are not limited to: challenges and uncertainties inherent in product research and development, including the uncertainty of clinical success and of obtaining regulatory approvals; uncertainty of commercial success; manufacturing difficulties and delays; competition, including technological advances, new products and patents attained by competitors; challenges to patents; product efficacy or safety concerns resulting in product recalls or regulatory action; changes in behavior and spending patterns of purchasers of health care products and services; changes to applicable laws and regulations, including global health care reforms; and trends toward health care cost containment. A further list and descriptions of these risks, uncertainties and other factors can be found in Johnson & Johnson's most recent Annual Report on Form 10-K, including in the sections captioned "Cautionary Note Regarding Forward-Looking Statements" and "Item 1A. Risk Factors," and in Johnson & Johnson's subsequent Quarterly Reports on Form 10-Q and other filings with the Securities and Exchange Commission. Copies of these filings are available online at , or on request from Johnson & Johnson. Johnson & Johnson does not undertake to update any forward-looking statement as a result of new information or future events or developments.
SOURCE Johnson & Johnson
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Phase 3Clinical ResultLicense out/inPhase 2
22 Oct 2025
iStock,
Denis_prof
The company cut back in areas while investing in internal and external opportunities to offset the loss of exclusivity on a product that, until recently, accounted for 20% of innovative medicine sales.
Johnson & Johnson has made a molehill out of a mountain. Facing the loss of exclusivity on a drug that accounted for 20% of innovative medicine sales in 2023, J&J has reshaped its business around other products and programs to leave analysts predicting a new era of growth for the company.
The anticipated arrival of biosimilar versions of Stelara, J&J’s blockbuster autoimmune disease drug, has occupied analysts for years. J&J executives have fielded questions about their preparations since at least 2021, reflecting how important the anti-IL-12 and IL-23 antibody became to the company after sales of chronic inflammatory disease drug Remicade began to erode in the face of off-patent rivals.
Stelara sales
peaked
at $10.9 billion in 2023. Biosimilar competition, first overseas and later in the U.S., caused sales to slip in 2024 and tumble further in 2025. Yet while sales of the drug
fell
40% over the first nine months of 2025, J&J still grew global innovative medicine revenue by 5%.
BioSpace
, Annalee Armstrong
Cutting and Investing
The growth reflects J&J’s multi-year effort to adapt its business for a post-Stelara future. Some parts of the business have been sacrificed to enable investment in the most promising programs. In 2023, J&J
axed
clinical-phase programs targeting hepatitis B, HIV and respiratory syncytial virus and
ended
R&D at an infectious disease and vaccine site in the Netherlands.
J&J CFO Joseph Wolk
framed
the infectious disease and vaccine changes in the context of Stelara at a Bernstein event in May; The company “probably had to cut some investment” to prepare for the entry of Stelara biosimilars, he said. J&J’s medtech business provides sales to offset slowdowns at the medicines unit but the company nonetheless had to pull back from some areas.
“We still make choices. You saw last year we exited infectious diseases and vaccines. We still prioritize, but it gives us a lot more flexibility to manage for that long term and have the robust pipeline and the growth outlook we have for the balance of this decade,” Wolk said.
As J&J pulled back from infectious diseases and vaccines, it invested in other areas to ensure new growth drivers were in place to ease the Stelara transition. At J&J’s immunology unit, rising sales of Tremfya and Simponi are partly offsetting the decline of Stelara and the development of
icotrokinra
,
JNJ-4804
and nipocalimab are laying the groundwork for a potential new-look portfolio. All three assets are in development for multiple indications, from plaque psoriasis to ulcerative colitis to psoriatic arthritis.
The emergence of oncology as J&J’s tentpole business has allowed the company to weather a period of falling immunology sales. Five years ago, J&J
reported
nine-month oncology revenue of $8.9 billion. Oncology sales for the first nine months of 2025 were $18.5 billion.
The growth reflects the blossoming of multiple myeloma drug Darzalex, plus product launches. Darzalex was a blockbuster in 2020, generating sales of $2.9 billion in just the first nine months of the year. It has grown significantly since then. The growth covers a period in which J&J launched a subcutaneous version of Darzalex and expanded the label. Sales hit $10.4 billion over the first nine months of 2025.
J&J has also turned its prostate cancer drug Erleada, which was approved in 2019, into a multi-billion dollar a year product. The CAR T cell therapy Carvykti became J&J’s latest cancer blockbuster in the third quarter of 2025, when total sales for the year reached $1.3 billion.
With sales of the bispecific antibodies Tecvayli, Talvey and Rybrevant still rising, and the bladder cancer drug Inlexzo new to the market, J&J is
aiming
to grow oncology revenues to $50 billion by 2030. The forecast was at least three times above the 2028 analyst consensus estimate when the company made the prediction in July, partly reflecting J&J’s belief that annual Inlexzo sales will exceed $5 billion.
Guggenheim Securities analysts recently discussed Inlexzo’s prospects with a community urologist. J&J could face competition from CG Oncology’s oncolytic immunotherapy cretostimogene grenadenorepvec. The urologist told the analysts that the ability to keep Inlexzo at room temperature, the lack of biohazard requirements and the option to administer the drug at the office give J&J an advantage.
“The speaker emphasized that in his community practice setting, practical convenience and logistical advantages would be the main determinants in choosing between the two products,” the analysts wrote in a note to investors. “As such, he envisions using Inlexzo in the large majority of his patients when both products are available in the future.”
Deals Drive Growth
Speaking on an earnings call in October, J&J CEO Joaquin Duato called Inlexzo an example of the company’s “outstanding business development model.” J&J
acquired
the asset through its 2019 takeover of Taris Biomedical. Wolk said on the earnings call that the company paid “a couple of hundred million dollars” for Taris, which was then in early clinical development.
Duato said J&J has completed “more than 60 deals of this kind” in the past 18 months. J&J has struck the early-stage deals alongside bigger bets such as its $14.6 billion
takeover
of Intra-Cellular Therapies. The deal added the schizophrenia and bipolar depression drug Caplyta to J&J’s neuroscience portfolio.
Caplyta generated $240 million in the third quarter, helping J&J grow neuroscience revenues despite sales of Concerta and Invega falling. Spravato is the other key product in J&J’s neuroscience portfolio. Sales grew more than 50% to near $1.2 billion over the first nine months of 2025. The drugs have established neuroscience as J&J’s third biggest innovative medicine unit after oncology and immunology.
J&J’s pulmonary hypertension and cardiovascular units also have blockbuster drugs, giving the company a broad base to offset future challenges. The nature of the pharma industry means new challenges are inevitable. J&J is now receiving questions about potential price negotiations and patent expirations for Darzalex.
Guggenheim analysts said they believe investors are “underappreciating Darzalex’s increased longevity and potentially improved economics,” but at some point J&J will need to adapt to pressure on its latest star drug. Having navigated the launches of Remicade and Stelara biosimilars over the past decade, the company has established a track record of managing such pressures and continuing to grow.
AcquisitionDrug ApprovalImmunotherapyBiosimilar
100 Deals associated with Icotrokinra
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R&D Status
10 top R&D records. to view more data
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| Indication | Highest Phase | Country/Location | Organization | Date |
|---|---|---|---|---|
| Plaque psoriasis | NDA/BLA | United States | 21 Jul 2025 | |
| Crohn Disease | Phase 3 | United States | 03 Oct 2025 | |
| Crohn Disease | Phase 3 | Japan | 03 Oct 2025 | |
| Colitis, Ulcerative | Phase 3 | United States | 01 Oct 2025 | |
| Colitis, Ulcerative | Phase 3 | Japan | 01 Oct 2025 | |
| Arthritis, Psoriatic | Phase 3 | United States | 09 Jan 2025 | |
| Arthritis, Psoriatic | Phase 3 | China | 09 Jan 2025 | |
| Arthritis, Psoriatic | Phase 3 | Japan | 09 Jan 2025 | |
| Arthritis, Psoriatic | Phase 3 | Argentina | 09 Jan 2025 | |
| Arthritis, Psoriatic | Phase 3 | Australia | 09 Jan 2025 |
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Clinical Result
Clinical Result
Indication
Phase
Evaluation
View All Results
| Study | Phase | Population | Analyzed Enrollment | Group | Results | Evaluation | Publication Date |
|---|
Phase 3 | 311 | lbprchzqiz(ivsbqvdcob) = iuxjdcovcm kctrbtcuda (buwktdmapl ) View more | Positive | 24 Oct 2025 | |||
Placebo | lbprchzqiz(ivsbqvdcob) = yubmzsonyw kctrbtcuda (buwktdmapl ) View more | ||||||
Phase 3 | 684 | dxsurwuiqh(zvvtjsafyc) = irkqiehhqf zhysszcgiq (bbcnumyffq ) View more | Positive | 24 Oct 2025 | |||
Placebo | dxsurwuiqh(zvvtjsafyc) = pyivacxiot zhysszcgiq (bbcnumyffq ) View more | ||||||
Phase 2 | 23 | axmrkncqow(vtgepisgwz) = uubphubpyu bqxsgpwahu (eyhypnudeq ) View more | Positive | 24 Oct 2025 | |||
Placebo | yoketmuyac(xnetkowhtd) = aiojihczce dlbnkyjgdc (vdxctjktuo ) View more | ||||||
Phase 2 | - | Icotrokinra 400 mg QD | tzwyavfsdd(gaybaopxpj) = hftxoikvjf temderimim (lodfqsvfwv ) Met View more | Positive | 07 Oct 2025 | ||
Icotrokinra 200 mg QD | tzwyavfsdd(gaybaopxpj) = wiprgplrkh temderimim (lodfqsvfwv ) Met View more | ||||||
Phase 3 | - | eiadwzqagz(tseyobitbf) = Icotrokinra showed superior skin clearance vs placebo (Week 16) and deucravacitinib (Weeks 16 and 24). xzwaffkwbv (kacfkslrya ) Met View more | Superior | 17 Sep 2025 | |||
Phase 3 | - | Icotrokinra (re-randomized at Week 24) | aaeyvjwnvz(squescgvde) = lwfcodibhq nbfnhhewul (ngtdtezgrj ) | Positive | 17 Sep 2025 | ||
Placebo (re-randomized at Week 24) | aaeyvjwnvz(squescgvde) = vvgfipphui nbfnhhewul (ngtdtezgrj ) | ||||||
Phase 3 | - | ujurstriwd(wuwrvxuudk) = vanpqrgrsr itqudvrazy (rriwsnpshl ) View more | Positive | 04 Aug 2025 | |||
Placebo | dvcpasxdnj(oekbpxtveq) = amrjhxvhsi qrhgbncuyd (vbptfhwpin ) | ||||||
Phase 1 | - | - | hnecgyenzn(hpkfcexzag) = htjkdomhas xduwquksee (zhcrfhzhct ) View more | Positive | 08 Jul 2025 | ||
Placebo | hnecgyenzn(hpkfcexzag) = bwisfjpbfq xduwquksee (zhcrfhzhct ) View more | ||||||
Phase 3 | 684 | cydokcirgv(nwzqbituhd): P-Value = <0.001 View more | Positive | 11 Jun 2025 | |||
Placebo | |||||||
Phase 3 | 311 | ewyxccvidb(ycqukxzffl): P-Value = <0.001 View more | Positive | 11 Jun 2025 | |||
Placebo |
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