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2024-03-27T10:13:43.000Z

Case study: Spesolimab for the treatment of GPP flare

Mar 27, 2024
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Learning objective: After reading this article, learners will be able to cite a clinical approach to generalized pustular psoriasis.

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Generalized pustular psoriasis (GPP) results in acute, widespread onset of erythematous plaques with pustules, and can be difficult-to-treat.1 Spesolimab, an interleukin-36 inhibitor, has previously shown efficacy in treating GPP flares in the Effisayil-1 trial.1 Here, we summarize a case study by Brigenti et al.1 published in Sage Open Medical Case Reports on the treatment of GPP flare with spesolimab. 


Patient history1 

  • A 48-year-old patient, with a long history of psoriasis experienced a GPP flare after previously having stable disease, controlled by secukinumab for 6 years (Figure 1).  

Figure 1. Patient history* 

GPP, generalized pustular psoriasis. 
*Data from Brigenti, et al.1 Created with BioRender.com. 

Flare and treatment1 

  • In October 2022, the patient experienced a severe GPP flare (Figure 2). In addition, she experienced fatigue, malaise, fever, and agitation.  

  • To treat the flare, two doses of spesolimab 900 mg were administered intravenously (Figure 3). After 5 months of follow-up, the patient achieved complete clinical remission. 

Figure 2. Characteristics of GPP flare* 

DLQI, Dermatology Life Quality Index; GPPASI, Generalized Pustular Psoriasis Area and Severity Index; GPPGA, Generalized Pustular Psoriasis Physician’s Global Assessment. 
*Data from Brigenti, et al.1 Created with BioRender.com. 

 

Figure 3. Treatment timeline* 

GPP, generalized pustular psoriasis. 
*Data from Brigenti, et al.1 Created with BioRender.com. 

 

After GPP reoccurrence at 5 months, treatment with secukinumab 300mg led to clinical remission (measured at 8 months) 

  • Generalized Pustular Psoriasis Physician’s Global Assessment score: 0 

  • Generalized Pustular Psoriasis Area and Severity Index score: 0 

  • Dermatology Life Quality Index: 1 

Key learnings 

  • In this case study, spesolimab resulted in clinical remission of both GPP and plaque psoriasis within 5 months of treatment. 

  • Additional studies are needed to assess the long-term effects of spesolimab on patients with GPP and length of remission in these patients. 

  1. Brigenti N, Gisondi P, Bellinato F, et al. Generalized pustular psoriasis successfully treated with spesolimab: A case report. SAGE Open Med Case Rep. 2024;12:2050313X241235451. DOI: 10.1177/2050313X241235451 

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