This subgroup analysis of the Effisayil 1 trial (NCT03782792) compared patient characteristics and assessed the effects of spesolimab in patients with a GPP flare with/without baseline systemic inflammation. Patients were randomised 2:1 to a single infusion of IV spesolimab 900 mg or placebo. Systemic inflammation at baseline was defined as elevated CRP (>ULN 10 mg/L) or neutrophil count (>ULN, 7.23x109/L). GPPGA pustulation subscore of 0 (primary endpoint) and GPPGA total score of 0/1 (key secondary endpoint) were assessed at Week 1. Missing GPPGA values or any use of other medication for GPP were regarded as non-response. Among patients with available baseline data, 33 of 48 had CRP >ULN and 30 of 49 had neutrophils >ULN; 23 had both. At baseline, patients with CRP >ULN had higher median GPPASI scores (30.8) vs those with CRP ≤ULN (15.1) and a higher percentage were hospitalised for current GPP flare (61% vs 20%); a lower median FACIT-fatigue score was also observed in patients with systemic inflammation. In all systemic inflammation subgroups, more patients achieved the primary endpoint after receiving spesolimab compared with placebo; for each systemic inflammation subgroup, results (spesolimab vs placebo) were: CRP >ULN (55.0% vs 7.7%); CRP ≤ULN (41.7% vs 0%); neutrophils >ULN (60.0% vs 0%); neutrophils ≤ULN (53.8% vs 16.7%). Key secondary endpoint data were consistent. Patients with systemic inflammation had more extensive and severe skin lesions than those without; spesolimab achieved rapid pustular and skin clearance compared with placebo, irrespective of baseline systemic inflammation.

ESDR379 - Efficacy of spesolimab in patients with generalized pustular psoriasis (GPP) flares with and without systemic inflammation

The scientific meeting of the European Society for Dermatological Research (ESDR) is held yearly, usually in September. With an international attendance of more than 1000 skin scientists from around the globe, the four-day event includes short oral presentations from peer-reviewed abstracts, keynote lectures from international experts, sponsored symposia, satellite programs, educational events as well as an important focus on posters, networking and building collaborations amongst scientists. For more information about this year’s meeting visit our website.