J&J's Icotrokinra: A Game-Changer for Psoriasis and a Challenge to Bristol's Market Position

The psoriasis treatment market is on the cusp of a transformative shift, driven by Johnson & Johnson's (J&J) experimental drug, icotrokinra, a first-in-class oral peptide targeting the IL-23 receptor. With the global market projected to grow at a 10.2% CAGR, reaching $57.68 billion by 2032Psoriasis Treatment Market Size, Share & Global Report [2032]^[1], J&J's submission of a New Drug Application (NDA) to the FDA in July 2025 signals a potential paradigm shift. This move could directly challenge Bristol Myers Squibb's (BMY) position in the psoriasis space, particularly as BMY's flagship therapy, Sotyktu (deucravacitinib), faces head-to-head competition from J&J's superior-performing candidate.

Bristol Myers Squibb's Current Position in Psoriasis

BMY's market share in the broader pharmaceutical industry stood at 5.84% in Q2 2025Bristol Myers Squibb Market share relative to its competitors, as^[2], but its specific dominance in the psoriasis segment remains opaque. The company's primary offering, Sotyktu, has demonstrated durable efficacy in moderate-to-severe plaque psoriasis, with five-year data showing 45.9% of patients achieving PASI 90 (90% improvement in disease severity) and a consistent safety profileBristol Myers Squibb - New Five-Year Sotyktu …^[3]. However, Sotyktu's performance, while robust, faces a critical challenge: J&J's icotrokinra has shown statistically superior outcomes in Phase 3 trials.

J&J's Icotrokinra: A Disruptive Force

J&J's experimental drug has emerged as a standout in clinical trials. In the ICONIC-LEAD study, 65% of patients achieved clear or almost clear skin (IGA 0/1) at Week 16, with improvements climbing to 74% by Week 24Icotrokinra results show potential to set a new standard of treatment in plaque psoriasis^[4]. By Week 52, sustained skin clearance was maintained without new safety signals. More notably, the ICONIC-ADVANCE 1 & 2 trials demonstrated icotrokinra's superiority over deucravacitinib, with higher response rates and comparable adverse event profilesIcotrokinra shows superiority to deucravacitinib in first reported head-to-head trials^[5]. These results, coupled with its oral administration (a convenience factor over injectable biologics), position icotrokinra as a compelling alternative.

The drug's potential is further amplified by its first-in-class mechanism—a targeted oral peptide that selectively blocks IL-23, a key driver of psoriasis pathology. This differentiates it from existing therapies, including BMY's TYK2 inhibitor, and aligns with market trends favoring oral treatments over injectablesPsoriasis Drugs Market Size, Report, Share & Growth …^[6].

Market Dynamics and Competitive Landscape

The psoriasis market is highly competitive, with biologics and small-molecule therapies vying for dominance. While BMY is a key player in psoriatic arthritis and related conditionsPsoriatic Arthritis Market Report 2025-2035^[7], its specific market share in psoriasis remains undefined. J&J, by contrast, holds a broader pharmaceutical market share (11.10% in Q2 2025Bristol Myers Squibb Market share relative to its competitors, as^[2]) and leverages its robust commercial infrastructure to accelerate adoption.

The projected $29.15 billion market size in 2025Psoriasis Treatment Market Size, Share & Global Report [2032]^[1] underscores the stakes. If approved, icotrokinra could capture a significant portion of this market, particularly among patients seeking oral therapies with proven efficacy. BMY's Sotyktu, though effective, may struggle to retain market share if icotrokinra's advantages—superior skin clearance, oral convenience, and a favorable safety profile—translate into real-world adoption.

Investment Implications

For investors, the key variables are FDA approval timelines and post-approval uptake. J&J's NDA submission in July 2025 suggests a potential 2025-2026 launch, capitalizing on the market's growth trajectory. BMY's response will be critical: will it invest in next-generation TYK2 inhibitors or explore combination therapies to counter icotrokinra? The latter's head-to-head superiorityIcotrokinra shows superiority to deucravacitinib in first reported head-to-head trials^[5] complicates such strategies, but BMY's R&D pipeline and partnerships could mitigate risks.

Conclusion

J&J's icotrokinra represents a paradigm shift in psoriasis treatment, with clinical data and market positioning poised to disrupt BMY's current offerings. While BMY's Sotyktu remains a durable option, the competitive edge of icotrokinra—backed by superior trial results and oral convenience—could redefine treatment standards. Investors should closely monitor the FDA's decision and J&J's commercialization strategy, as the psoriasis market's projected growth offers substantial upside for the winner.