Generalized pustular psoriasis flares are rare, painful, and potentially life-threatening, and treatment relied on agents borrowed off-label from plaque psoriasis. Spevigo (spesolimab) was the first therapy approved for the flares themselves.
By blocking the IL-36 receptor, a pathway genetically implicated in the disease, it interrupts the cascade driving widespread pustule formation, with many patients clearing within a week of a single dose. The intravenous infusion treats generalized pustular psoriasis flares in adults.
Spevigo has since added subcutaneous dosing for ongoing flare prevention and expanded into pediatric patients, converting it from acute rescue therapy into chronic management. It holds orphan designation and remains the only approved GPP-specific agent.
