{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:17:10Z","timestamp":1787026630775,"version":"build-2736575974"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T00:00:00Z","timestamp":1768435200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Generalized pustular psoriasis (GPP) is a rare, auto-inflammatory skin disease characterized by unpredictable flares, often requiring hospitalization, and current therapies lack robust evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To systematically evaluate the efficacy and safety of spesolimab for acute GPP flares.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We searched Medline, Google Scholar and the Cochrane Central Register of Controlled Trials from inception to December 2024 and consulted\n                      <jats:ext-link>ClinicalTrials.gov<\/jats:ext-link>\n                      and the ISRCTN registry for ongoing studies. Randomized controlled trials enrolling adults experiencing GPP flares and comparing spesolimab with placebo or standard care were eligible. Non-randomized studies, studies without placebo comparators, or without full-text availability were excluded. Two reviewers independently assessed risk of bias using the Cochrane RoB 2 tool and extracted data. A random-effects model was used to pool odds ratios or mean differences with 95% confidence intervals.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four randomized controlled trials with 176 participants met the inclusion criteria. Compared with placebo, spesolimab significantly increased the proportion of patients achieving complete pustular clearance [GPPGA pustulation score 0; OR 4.87 (95% CI 2.03\u201311.68)] and a total GPPGA score of 0 or 1 [OR 5.68 (95% CI 2.27\u201314.23)]. Adverse event rates were similar between groups and were mostly mild or moderate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Limitations<\/jats:title>\n                    <jats:p>Evidence was limited by the small number and sample size of trials, heterogeneity between studies and short follow-up durations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Spesolimab provides clinically meaningful improvements in pustular clearance and symptom control during acute GPP flares and has a favorable safety profile; however, further large, long-term randomized trials are needed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD42025629994<\/jats:ext-link>\n                      , identifier CRD42025629994.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1749320","type":"journal-article","created":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T05:13:39Z","timestamp":1768454019000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["The efficacy and safety of spesolimab in patients with generalized pustular psoriasis flares: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"12","author":[{"given":"Dhaii","family":"Alzahrani","sequence":"first","affiliation":[{"name":"College of Medicine, King Saud bin Abdulaziz University for Health Sciences","place":["Jeddah, Saudi Arabia"]},{"name":"King Abdullah International Medical Research Center","place":["Jeddah, Saudi 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Abdulaziz University for Health Sciences","place":["Jeddah, Saudi Arabia"]},{"name":"King Abdullah International Medical Research Center","place":["Jeddah, Saudi Arabia"]},{"name":"Department of Dermatology, Ministry of the National Guard\u2014Health Affairs","place":["Jeddah, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renad","family":"Alshaikh","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud bin Abdulaziz University for Health Sciences","place":["Jeddah, Saudi Arabia"]},{"name":"King Abdullah International Medical Research Center","place":["Jeddah, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Almaha","family":"Alhijab","sequence":"additional","affiliation":[{"name":"College of Medicine, Arabian Gulf University","place":["Manama, Bahrain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faris","family":"Neazy","sequence":"additional","affiliation":[{"name":"College of 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