New Spesolimab Data Showed Significant Improvement in Patients with Generalized Pustular Psoriasis (GPP) Flares

Boehringer Ingelheim has announced new data from the pivotal Phase II Effisayil 1 trial, presented at the 2022 American Academy of Dermatology (AAD) Annual Meeting in Boston.

The Effisayil 1 trial, recently published in The New England Journal of Medicine, showed significant clearance of skin pustules in patients with generalized pustular psoriasis (GPP) flares within the first week after treatment with spesolimab versus placebo. This effect was sustained over 12 weeks, according to data presented at AAD, which found that 84.4% of patients had no visible pustules after the 12-week trial duration and 81.3% had clear/almost clear skin, the company said.

“GPP is an unpredictable, painful, and potentially life-threatening rare skin disease with no available FDA-approved treatment options,” said Boni Elewski, M.D., trial investigator and Chair, Department of Dermatology at The University of Alabama School of Medicine. “The findings presented at this year’s AAD Annual Meeting showed that the efficacy of spesolimab is sustained over 12 weeks, providing further evidence of the rapid benefit that spesolimab could bring to patients living with the burden of GPP flares.”

GPP is a rare, potentially life-threatening neutrophilic skin disease, which is distinct from plaque psoriasis. It is characterized by episodes of widespread eruptions of painful, sterile pustules (blisters of non-infectious pus). GPP flares greatly affect a person’s quality of life and can lead to serious and life-threatening complications, including heart failure, renal failure, and sepsis, Boehringer explained.

According to additional data presented at the AAD Annual Meeting, rapid skin clearance observed in the first week following treatment with spesolimab was generally consistent across patient subgroups, including age, gender, ethnicity, and IL-36 gene mutation status. Also, significant improvements were shown within one week in patient-reported outcomes related to pain, fatigue, quality of life, and skin symptoms after treatment with spesolimab.

In the Effisayil 1 trial, adverse events were reported in 66% of patients treated with spesolimab and 56% of those receiving placebo after the first week. Infections were reported by 17% and 6% of patients in the spesolimab and placebo groups, respectively (at week one). Serious adverse events were reported in 6% of patients treated with spesolimab (at week one). Two patients receiving spesolimab were reported to have drug reactions with eosinophilia and systemic symptoms, the company said.

“With these additional data, we are gaining a more complete picture of spesolimab as a possible first-in-class treatment approved for GPP patients,” said Matt Frankel, M.D., Vice President, Clinical Development and Medical Affairs, Specialty Care, Boehringer Ingelheim. “GPP has a significant impact on a patient’s life, and we remain committed to bringing spesolimab to patients as quickly as possible.”

The U.S. Food and Drug Administration (FDA) accepted a Biologics License Application (BLA) and granted Priority Review for spesolimab for the treatment of GPP flares. The FDA has granted spesolimab Orphan Drug Designation for the treatment of GPP and Breakthrough Therapy Designation for spesolimab for the treatment of GPP flares in adults.