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Does Spesolimab Control Generalized Pustular Psoriasis Flare Symptoms?

Spesolimab effects rapid control, with 60 percent of patients achieving GPPGA pustulation subscore of 0 and GPPGA total score of 0 or 1 by week 12

By Dermsquared Editorial Team | June 28, 2023

WEDNESDAY, June 28, 2023 -- For patients with generalized pustular psoriasis flare, a single infusion of the anti-interleukin-36 receptor antibody, spesolimab, leads to rapid pustular clearance and clear/almost clear skin, according to a study published in the July issue of the Journal of the American Academy of Dermatology.

Boni E. Elewski, M.D., from the University of Alabama School of Medicine in Birmingham, and colleagues examined the effects of spesolimab over a 12-week study for patients presenting with a generalized pustular psoriasis flare. A total of 53 patients were randomly assigned to receive a single intravenous dose of 900 mg spesolimab or placebo on day 1 in a 2:1 ratio. On day 8, patients could receive open-label spesolimab for persistent flare symptoms.

The researchers found that most patients receiving spesolimab achieved a Generalized Pustular Psoriasis Physician Global Assessment (GPPGA) pustulation subscore of 0 (60.0 percent) and a GPPGA total score of 0 or 1 (60.0 percent) by week 12. The proportion of patients with GPPGA postulation subscore of 0 increased from 5.6 percent at day 8 to 83.3 percent at week 2 in those randomly assigned to placebo who received open-label spesolimab on day 8. No factors were identified in patient demographics or clinical characteristics that predicted spesolimab response.

"Although clinically meaningful improvements can be achieved in most patients with a single dose, an optional second dose may be needed in some patients," the authors write.

Several authors disclosed ties to pharmaceutical companies, including Boehringer Ingelheim, which manufactures spesolimab and funded the study.

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