An FcRn blocker that did not beat steroids in pemphigus, and an oral IL-23 option for psoriasis

The edition in brief

A meta-analysis of five randomised trials found that icotrokinra, an oral peptide blocking the IL-23 receptor, made clear or almost clear skin about seven times more likely than placebo at week 16 in moderate-to-severe plaque psoriasis, with similar adverse event rates; there are no head-to-head data against injectable biologics. English registry data for 2013 to 2022 show cutaneous squamous cell carcinoma still rising, especially under 60 and over 80, and non-melanoma skin cancer mortality climbing about 4% a year. A European review proposes a five-tier skin cancer risk framework for organ recipients who receive a second or third transplant. The practice-changer is the phase III ADDRESS trial in 222 people with pemphigus: subcutaneous efgartigimod with prednisone did not raise complete remission on minimal steroid compared with prednisone alone, despite lowering desmoglein antibodies.