Spesolimab

Improvements in Psoriasis Symptom Scale (PSS), Pain Visual Analog Scale (VAS) and Dermatology Life Quality Index (DLQI) scores were observed in post-hoc exploratory analyses of the EFFISAYIL® 2 trial Findings suggest the potential benefit of continuously treating generalized pustular psoriasis (GPP) with subcutaneous spesolimab RIDGEFIELD, Conn., March 7, 2025 /PRNewswire/ -- Today, Boehringer Ingelheim announced new analyses to be presented at the American Academy of Dermatology (AAD) annual meeting in Orlando that explore the effect that SPEVIGO® (spesolimab-sbzo) may have on the physical symptoms and mental health burden associated with generalized pustular psoriasis (GPP). These post-hoc exploratory analyses from the EFFISAYIL® 2 clinical trial assessed the efficacy and safety of subcutaneous SPEVIGO in patients suffering from GPP.1,2 Distinct from plaque psoriasis, GPP is a serious and rare, chronic, heterogenous, inflammatory neutrophilic disease associated with painful skin manifestations and systemic symptoms, such as fever, pain, and fatigue.3-6 GPP's unpredictable nature can potentially have significant long-term impacts on quality of life for people living with it and may cause fear and anxiety over the disease course.5,7 "Generalized pustular psoriasis profoundly affects patients' physical and mental well-being, often disrupting their education, careers, and personal relationships. We are encouraged by the improvements observed in patient-reported outcomes with spesolimab. These studies strengthen our commitment to delivering innovative treatments for those living with severe dermatological conditions like GPP," says Vicky Brown, Senior Vice President and Head of Immunology, Oncology, and Eye Health, Boehringer Ingelheim Pharmaceuticals, Inc. In the EFFISAYIL 2 clinical trial, patients with a history of GPP were randomized to receive one of three active treatment regimens or a placebo. Participants were asked to rate their GPP symptoms – including pain, redness, itching, and burning – using the Psoriasis Symptom Scale (PSS), the Pain Visual Analog Scale (VAS), and the Dermatology Life Quality Index (DLQI). The PSS ranges from 0 to 16, while the Pain VAS ranges from 0 to 100, with higher scores indicating more severe symptoms. Of the 30 patients randomized to receive subcutaneous spesolimab, 300 mg every four weeks after a 600mg loading dose, participants reported a reduction in mean Pain VAS scores over the course of the trial, with more than half (56.5%) of patients reporting a Pain VAS score of 0 at Week 48 and the mean PSS score decreasing from 5.34 to 2.96 by Week 48. Patients were also asked to rate the impact of GPP through a 10-item questionnaire to assess changes in quality of life using the DLQI. The results found that mean DLQI scores improved from a "very large effect on patient's life" score (11.14) at baseline to a "small effect on patient's life" score (4.57) at week 48 following treatment with SPEVIGO. Measurable improvements in mean PSS, Pain VAS and DLQI scores were observed by the first assessment at Week 4. "The results from EFFISAYIL 2 provide valuable insights into the chronicity of generalized pustular psoriasis," said Dr. Tina Bhutani, study author. "The data are a pivotal step in advancing patient-centered care in GPP." These findings may provide healthcare professionals with data that can help inform their choice of treatment regimens for people living with GPP. About SPEVIGO® SPEVIGO® is a novel, humanized, selective antibody that specifically blocks the activation of the IL-36R, a signaling pathway within the immune system shown to be involved in the pathogenesis of several autoinflammatory diseases, including GPP. It is the first targeted therapy for the treatment of GPP and has been evaluated in the largest clinical program specifically for the treatment of patients with GPP. What is SPEVIGO®? SPEVIGO® is a prescription medicine used to treat generalized pustular psoriasis (GPP) in adults and children 12 years of age and older who weigh at least 88 pounds (40 kg). It is not known if SPEVIGO® is safe and effective in children under 12 years of age or who weigh less than 88 pounds (40kg). Important Safety Information Do not receive SPEVIGO® if you or your child have had a severe or life-threatening allergic reaction to spesolimab-sbzo or any of the ingredients in SPEVIGO®. What is the most important information I should know about SPEVIGO®? SPEVIGO® may cause serious side effects, including: Infections. SPEVIGO® may lower the ability of your or your child's immune system to fight infections and may increase your or your child's risk of infections. Your healthcare provider should check you or your child for infections and tuberculosis (TB) before starting treatment with SPEVIGO® and may treat you or your child for TB before you begin treatment with SPEVIGO® if you have a history of TB or have active TB. Your healthcare provider should watch you or your child closely for signs and symptoms of TB during or after treatment with SPEVIGO®. Tell your healthcare provider right away if you or your child have an infection or have symptoms of an infection during or after treatment with SPEVIGO®, including: fevers, chills, or sweats muscle aches cough shortness of breath blood in your phlegm (mucus) burning when you urinate urinating more often than normal Allergic reactions and infusion-related reactions. Serious allergic reactions may happen during or after your or your child's SPEVIGO® injection. If you or your child have a serious allergic reaction, your healthcare provider will stop treatment with SPEVIGO®. If you or your child are given SPEVIGO® in a vein (intravenously) and have an infusion- related reaction, your healthcare provider will stop your or your child's SPEVIGO® infusion and treat your or your child's symptoms and may restart SPEVIGO® at a slower infusion rate. Tell your healthcare provider or get emergency medical help right away if you or your child get any of the following symptoms during or after your or your child's SPEVIGO® injection: feeling faint, dizzy, or lightheaded swelling of your face, eyelids, lips, mouth, tongue, or throat trouble breathing or throat tightness fever mouth sores chest tightness hives or skin rash that is different than the rash from generalized pustular psoriasis (GPP) itching swollen lymph nodes Before you or your child receive SPEVIGO®, tell your healthcare provider about all of your medical conditions, including if you or your child: have an infection that does not go away or that keeps coming back. have TB or have been in close contact with someone with TB. have recently received or are scheduled to receive an immunization (vaccine). You or your child should not receive live vaccines during and for at least 16 weeks after treatment with SPEVIGO®. You or your child should be brought up to date with all vaccines before starting SPEVIGO®. are pregnant or plan to become pregnant. It is not known if SPEVIGO® can harm your or your child's unborn baby. are breastfeeding or plan to breastfeed. It is not known if SPEVIGO® passes into your breast milk. Talk to your healthcare provider about the best way to feed your or your child's baby during treatment with SPEVIGO®. Tell your healthcare provider about all the medicines you or your child take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. What are the possible side effects of SPEVIGO®? The most common side effects of SPEVIGO® given in a vein (intravenously) for GPP flare treatment include: feeling tired or weak nausea and vomiting headache itching or itchy bumps a collection of blood under the skin at the infusion site or bruising urinary tract infection The most common side effects of SPEVIGO® when given under the skin (subcutaneously) for treatment of GPP when not experiencing a flare include: redness, pain, swelling, hardening, hives, or warmth at the injection site joint pain urinary tract infection itching These are not all of the possible side effects of SPEVIGO®. Call your doctor for medical advice about side effects. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit or call 1 ‐ 800 ‐ FDA ‐ 1088. Please see full Prescribing Information , Medication Guide, and Instructions for Use . About the EFFISAYIL® clinical trial program The EFFISAYIL® clinical trial program evaluated the largest and broadest population of GPP patients in trials of a therapy specifically targeting the IL-36 pathway for GPP: EFFISAYIL® 1: A Phase II study that demonstrated treatment with a single intravenous dose of spesolimab significantly improved signs and symptoms of GPP in patients experiencing a flare, including rapid pustular and skin clearance. These results supported the approval of spesolimab as the first specific treatment for GPP flares in adults in major markets EFFISAYIL® 2: A Phase IIb study that showed spesolimab significantly reduced the risk of GPP flares by 84% over 48 weeks compared to placebo. In the trial with 123 patients, no flares were observed after week 4 of spesolimab SC treatment in the high-dose group (n=30) EFFISAYIL® ON: An open-label extension study to evaluate the long-term safety and efficacy of spesolimab in patients with GPP who have completed previous spesolimab trials About generalized pustular psoriasis GPP is a chronic, heterogenous, neutrophilic inflammatory disease associated with skin and systemic symptoms that is distinct from plaque psoriasis. GPP is recognized as a separate clinical entity from other forms of psoriasis, with the IL-36 pathway being a key driver of GPP and triggering response to treatment. Prevalence of GPP is low and varies considerably across geographical regions, ranging from 1.76 to 124 patients per million persons in reports from key countries, including France, Japan, Sweden, and South Korea. GPP can become life-threatening (mortality rates ranging from 2% to 16%) due to severe complications, such as multisystem organ failure and sepsis requiring urgent hospital care; many GPP patients also suffer from various comorbidities, which contribute to the ongoing burden for the patient and healthcare systems. GPP symptoms appear unpredictable and present on a continuum, which greatly impacts a patient's quality of life, and may cause fear and anxiety over the disease course, as well as long-term impacts on quality of life related to work/school, emotional health, social activities, and finances. About Boehringer Ingelheim Boehringer Ingelheim is a biopharmaceutical company active in both human and animal health. As one of the industry's top investors in Research and Development, the company focuses on developing innovative therapies in areas of high unmet medical need. Independent since its foundation in 1885, Boehringer takes a long-term perspective, embedding sustainability along the entire value chain. More than 53,500 employees serve over 130 markets to build a healthier, more sustainable, and equitable tomorrow. Learn more at . 1Bhutani T, et al. Spesolimab improves quality of life as measured by Psoriasis Symptom Scale (PSS) and Pain Visual Analog Scale (VAS) in generalized pustular psoriasis (GPP) over time: Results from the EFFISAYIL® 2 trial. Poster presented at 2025 AAD Annual Meeting; March 2025; Orlando. 2Gordon K, et al. Spesolimab improves quality of life as measured by Dermatology Life Quality Index (DLQI) in generalized pustular psoriasis (GPP) over time: Results from the EFFISAYIL® 2 trial. Poster presented at 2025 AAD Annual Meeting; March 2025; Orlando. 3Marrakchi S, Puig L. Pathophysiology of generalized pustular psoriasis. Am J Clin Dermatol. 2022;23:13–19. 4Strober B, et al. Dermatol Ther. (Heidelb) 2021;11:529–41. 5Prinz JC, Choon SE, Griffiths CEM, et al. Prevalence, comorbidities and mortality of generalized pustular psoriasis: A literature review. J Eur Acad Dermatol Venereol. 2023;37:256–273. 6Reisner DV, Johnsson FD, Kotowsky N, et al. Impact of generalized pustular psoriasis from the perspective of people living with the condition: Results of an online survey. Am J Clin Dermatol. 2022;23:65–71. 7Gooderham MJ, Van Voorhees AS, Lebwohl MG. An update on generalized pustular psoriasis. Expert Rev Clin Immunol. 2019;15:907–919. Media Contact Jennifer Huron Boehringer Ingelheim Pharmaceuticals, Inc. Phone: +1 203-448-1263 Email: [email protected] SOURCE Boehringer Ingelheim WANT YOUR COMPANY'S NEWS FEATURED ON PRNEWSWIRE.COM? 440k+ Newsrooms & Influencers 9k+ Digital Media Outlets 270k+ Journalists Opted In GET STARTED

1 导语：认识炎症性肠病（IBD） 炎症性肠病（IBD）是一组累及胃肠道的慢性、复发性炎症性疾病，主要包括克罗恩病（CD）和溃疡性结肠炎（UC）。这些疾病的特点是持续炎症，导致各种并发症，症状包括腹痛、腹泻、便血等，严重者可致肠梗阻、穿孔甚至癌变，严重影响IBD患者的生活质量。全球范围内，IBD发病率近40年持续攀升，我国患者数量亦呈快速上升趋势。 目前可用的IBD治疗包括非靶向治疗（如氨基水杨酸、糖皮质激素和免疫调节剂）和靶向治疗（如抗TNF、抗IL-12/IL-23和抗α4β7整合素）。虽然生物靶向疗法对许多患者有效，但依然有高达30%的患者对初始治疗没有反应，高达50%的患者随着时间的推移反应消失。目前，分子生物学领域的最新进展和对IBD免疫途径的理解为创新药物疗法开辟了新的可能性。一些新兴疗法和药物有望打破IBD治疗的瓶颈，为IBD的患者的疾病改善带来福音。 2 核心战场：肠道免疫系统与IBD的发病机制 肠道免疫系统是IBD发生的关键枢纽。健康状态下，肠道需 “双重调节”：既要耐受食物抗原与共生菌群，又要抵御病原体侵袭。而IBD患者的免疫调控网络崩解，引发失控的炎症反应。  1. 先天免疫失控 巨噬细胞与树突状细胞：正常状态下呈现“免疫耐受”，但IBD患者中被异常激活，通过TLR/NLR受体识别病原体分子（如LPS），过度分泌IL-1β、IL-6等促炎因子。 中性粒细胞与NK细胞：炎症部位大量浸润，释放活性氧和蛋白酶，加重组织损伤。 2. 适应性免疫失衡 Th17/Treg细胞比例失调：IL-23驱动Th17细胞扩增，分泌IL-17、IL-22，促进炎症；而抗炎的Treg细胞功能受抑。 B细胞异常：产生自身抗体攻击肠道组织，加速慢性炎症。 3. 细胞因子风暴 促炎因子（IL-12、IL-23、TNF-α）与抗炎因子（IL-10、TGF-β）平衡打破，形成恶性循环。例如： IL-23/Th17轴：驱动黏膜免疫持续活化，与难治性IBD密切相关； TNF-α：促进中性粒细胞迁移和血管通透性增加，介导组织破坏。 4. 肠纤维化：被忽视的“终局挑战 ”约30%克罗恩病患者发生肠纤维化，病理特点为细胞外基质（ECM）过度沉积，导致肠道狭窄。纤维化机制涉及TGF-β、IL-13等因子激活成纤维细胞，而现有抗炎药物对其无效。 3 IBD治疗药物图谱：从传统疗法到精准靶向 目前IBD治疗药物分为生物制剂与小分子药物两类，关注点从“广谱抗炎”转向精准靶向免疫通路。 1. 经典生物制剂 抗TNF-α单抗： 抗TNF的抗体已广泛使用约25年。目前，四种TNF-α抑制剂已被批准用于临床，包括infliximab、adalimumab、golimumab和certolizumab pegol。infliximab可诱导粘膜溃疡愈合，这是第一种被批准用于CD肛周瘘的治疗方法，并被证明对CD和UC都有效。 抗α4β7整合素： 近年来，整合素受体已成为治疗IBD患者新疗法的可行靶点。整合素包括两个亚基，α和β，存在于特定的B和T淋巴细胞上。与细胞迁移到胃肠组织有关的是α2β2、α4β1和α4β7。通过拮抗这些受体，淋巴细胞在炎症过程中迁移到胃肠道粘膜受到抑制。抗α4β7整合素抗体Vedolizumab已于2020年获得欧洲药品管理局（EMA）的批准，用于治疗中重度UC或CD的成年患者。 2. 新世代靶向药 IL-23是IL-12细胞因子家族的一员，由p40和p19亚基组成，其中p19是IL-23所特有的。IL-23在调节和扩增辅助T细胞和激活各种先天免疫细胞方面发挥着至关重要的作用，这些细胞在UC和CD等慢性炎症性疾病的发展中很重要。Risankizumab是FDA批准的第一种用于治疗中重度CD患者的选择性IL-23p19抑制性抗体。 IL-36细胞因子是更广泛的IL-1细胞因子家族的成员。在过去的几年里，许多研究强调了IL-36R信号在慢性炎症条件下的作用，包括CD和UC。Spesolimab是一种新型人源化IgG1单克隆抗体，特异性抑制IL-36R信号传导，其已在涉及中重度UC患者的三项2/2a期临床试验中进行了评估，然而，尽管spesolimab对UC患者具有良好的耐受性，但并未达到疗效终点。目前，其正在进行一项2期临床试验，以测试spesolimab在造瘘CD患者中的应用。 Olamkicept（sgp130Fc）是一种选择性靶向IL-6反式信号传导的FC融合蛋白。在一项为期12周，涉及16名IBD患者的开放标签2a期研究中，结果显示: 19%的患者获得了临床缓解，44%的患者出现临床响应。此外，最常报告的不良事件包括季节性上呼吸道感染、唇疱疹复发以及皮肤和皮下疾病。目前，其正在进行一项更大规模的安慰剂对照临床研究（NCT03235752）。 3. 小分子药物的崛起 JAK抑制剂： 近年来，有许多研究聚焦于JAK-STAT途径，为改善IBD的治疗提供了新的治疗策略。JAK是一个细胞内酪氨酸激酶家族，包括JAK1、JAK2、JAK3和酪氨酸激酶2（TYK2），在通过STAT途径传递细胞因子介导的信号中发挥作用。这些激酶被各种细胞因子受体激活，通过T细胞增殖和分化以及B细胞活化导致炎症。 Izencitinib是一种泛JAK抑制剂，其在一项涉及239名UC患者的2b期临床试验中进行了测试。然而与安慰剂相比，临床缓解的主要次要终点均未实现。Ivarmacidinib（SHR0302）是一种选择性JAK1抑制剂，在涉及146名中重度活动性UC患者的一项2期临床研究中，与安慰剂相比，8 mg每日一次和4 mg每日两次给药方案在第8周显示出显著更高的临床响应率和临床缓解率，不良事件没有显著差异。这些有希望的结果导致其启动了一项3期研究，以进一步研究对UC的疗效。 S1P受体调节剂： 鞘氨醇-1磷酸（S1P）是一种来源于细胞膜的高度生物活性分子，主要通过激活细胞表面的五个G蛋白偶联受体发挥作用（S1P1-S1P5）。激活后，该过程触发一系列信号事件，控制广泛的生物学过程，如淋巴细胞迁移、内皮细胞通透性、血管生成以及细胞分化、增殖、存活和凋亡。S1P通路与胃肠道炎症相关的疾病有关。 Ozanimod是S1P受体的选择性调节剂，特异性靶向S1P1和S1P5受体，这两种受体分别存在于内皮细胞和少突胶质细胞上。在一项3期针对中重度UC患者的临床研究（TRUE NORTH）中，结果显示：相比与安慰剂组，Ozanimod组获得了更多的临床缓解（18.4% vs 6.0% p=0.001），此外，在诱导治疗的应答者中，37.0%的患者在52周后持续临床缓解，而安慰剂组为18.5%（p＜0.001）。 4. 抗纤维化药物曙光 针对TGF-β、TL1A靶点的药物（如PRA023）进入临床，旨在阻断纤维化核心通路，解决现有治疗空白。PF-06480605是一种抗TL1A的IgG1人源单克隆抗体，在一项针对中重度UC患者的2a期临床研究（TUSCANY）中，有一部分（38.2%）患者在第14周获得了内窥镜改善，这一比例具有统计学意义。此外，最常见的AE是UC疾病恶化和关节痛。组织病理学分析支持PF-06480605进一步的研究。 4 未来市场：百亿美元蓝海的争夺战 全球IBD药物市场持续扩容，中国市场规模从2019年的80.9亿元增长至2022年的96.7亿元，预计未来五年复合增长率将超10%。驱动因素包括： 1. 患者基数扩大：年轻群体生活压力与饮食结构变化推高发病率。 2. 政策支持：国家加快创新药审评，生物类似药（如阿达木单抗类似药）降低治疗成本。 3. 技术突破：肠道菌群调控（如益生菌、粪菌移植）、多组学技术助力个体化治疗。 未来趋势聚焦于： 多靶点药物：如双抗或联合疗法，以克服单靶点耐药性。 微生物组疗法：基于菌群代谢产物（如短链脂肪酸）的新型调节剂。 个性化医疗：通过基因检测与生物标志物（如粪便钙卫蛋白）实现精准用药。 5 结语：跨学科协作开启IBD治疗新纪元 尽管IBD仍无法根治，但免疫学与微生物组研究的深入为药物开发开辟了新路径。IBD药物开发已进入“深水区”，未来需融合免疫学、微生物组学与人工智能，构建精准治疗模型以攻克耐药性、肠外并发症等难题。对患者而言，早诊早治与长期管理是关键；IBD治疗的终极目标，是让患者重获无痛、自由的生活，更安全、长效的药物将不再是遥不可及的梦想。 参考文献： 1.Immunology of Inflammatory Bowel Disease: Molecular Mechanisms and Therapeutics. J Inflamm Res.2022; 15: 1825–1844. 2. Inflammatory Bowel Disease: Emerging Therapies and Future Treatment Strategies. Biomedicines.2023 Aug; 11(8): 2249. 公众号内回复“ADC”或扫描下方图片中的二维码免费下载《抗体偶联药物：从基础到临床》的PDF格式电子书！ 公众号已建立“小药说药专业交流群”微信行业交流群以及读者交流群，扫描下方小编二维码加入，入行业群请主动告知姓名、工作单位和职务。