Spesolimab

How it works

It blocks signalling through the interleukin-36 receptor, interrupting a key inflammatory pathway that drives the neutrophilic pustular eruption of generalised pustular psoriasis.

Prescribing in practice

• Exclude active infection, including tuberculosis, before administration because of the risk of serious infection.
• Drug reaction with eosinophilia and systemic symptoms (DRESS) has been reported, so monitor for and act on signs of severe hypersensitivity.
• Avoid live vaccines around the time of treatment.

Monitoring

Monitor for signs of infection and hypersensitivity reactions during and after administration.

Counselling the patient

• Treatment is given as an infusion or injection by a healthcare professional for acute flares.
• Report fever, spreading rash or signs of infection promptly.
• Seek urgent advice if a widespread rash with facial swelling or fever develops.

Evidence & guidelines

Efficacy in rapidly clearing generalised pustular psoriasis flares was demonstrated in the EFFISAYIL 1 trial.