Indication

Psoriasis - Pustular flares

RAG rating

Red

Document type

NICE technology appraisal

Place

Hertfordshire and West Essex ICB

Output type

Pharmacy / Prescribing

Spesolimab

 

HERTFORDSHIRE AND WEST ESSEX AREA PRESCRIBING COMMITTEE (HWE APC) 

Spesolimab for treating generalised pustular psoriasis flares

RED

Recommended for restricted prescribing by specialist only.

Not recommended for primary care prescribing.

 

Name generic (trade):	Spesolimab (Spevigo)
What it is:	Immunosuppressants, interleukin inhibitors
Indication:	Treatment of generalised pustular psoriasis (GPP) flares
Date decision last revised:	July 2025
NICE	NICE TA 1070 recommended

HWE APC recommendation:

Spesolimab is recommended as an option for treating generalised pustular psoriasis (GPP) flares in adults in line with NICE TA1070, only if it is used to treat:

• initial moderate to severe flares when:

o  the Generalized Pustular Psoriasis Physician Global Assessment (GPPGA) total score is 3 or more (at least moderate), and

o  there are fresh pustules (new appearance or worsening of existing pustules), and

o  the GPPGA pustulation subscore is at least 2 (at least mild), and

o  at least 5% of the body's surface area is covered with erythema (abnormal redness of the skin or mucous membranes) and has pustules

• subsequent flares with a GPPGA pustulation subscore of 2 or more (at least mild), if the last flare was treated with spesolimab and resolved to a GPPGA pustulation subscore of 0 or 1 (clear or almost clear skin).

Spesolimab can only be used if the company provides it according to the commercial arrangement.

• A second dose of spesolimab can be used after 8 days if a flare has not resolved to a GPPGA pustulation subscore of 0 or 1.

Take into account how skin colour could affect the GPPGA score and make any adjustments needed.

Further information: for latest updates and more detailed information, including contra-indications, cautions and special warnings; please refer to summary of product characteristics SPC)

Blueteq forms have been developed for initial and subsequent flares.          

RED STATUS:

NOT RECOMMENDED FOR PRIMARY CARE PRESCRIBING.

RECOMMENDED FOR RESTRICTED PRESCRIBING BY SPECIALISTS 

Spesolimab is a black Triangle drug ▼ report all suspected adverse reactions at www.mhra.gov.uk/yellowcard.

 

These recommendations are not intended to affect treatment with sparsentan that was started in the NHS before this guidance was published. People having treatment outside these recommendations may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS healthcare professional consider it appropriate to stop.

 

Version number

1

Developed by

Pharmacy and Medicines Optimisation Team, Hertfordshire and West Essex (HWE) ICB with relevant HWE ICS stakeholders.

Approved by

Hertfordshire & West Essex Area Prescribing Committee

Date approved / updated

July 2025

Review date

This HWE APC recommendation is based upon the evidence available at the time of publication. This recommendation will be reviewed upon request in the light of new evidence becoming available.

Superseded version

NA