- Design
- Phase 2, randomised, double-blind, placebo-controlled
- Population
- 33 patients with moderate-to-severe GPP flare in China
- Primary outcome
- GPPGA pustulation sub-score 0 or 1 at day 8
- Effect
- 86.4% vs 9.1%; difference 77.3% (95% CI 42.5 to 88.9)
A multicentre phase 2 trial in China randomised 33 patients with moderate-to-severe generalised pustular psoriasis flares 2:1 to one intravenous dose of recibokibart 1050 mg or placebo.
At day 8, 86.4% on recibokibart had a pustulation sub-score of 0 or 1, against 9.1% on placebo (difference 77.3%, 95% CI 42.5 to 88.9). Complete pustule clearance was 54.5% vs 0%. Improvement was seen within 24 hours. By week 4, 72.7% reached GPPASI 75, though later timepoints included open-label rescue. Common adverse events were low protein, raised triglycerides and itch.
The result mirrors spesolimab, which already targets the same receptor. GPP flares are dangerous and have few options, so a second agent in the class matters. This is phase 2 in 33 patients; it is not available outside trials.
- Recognise GPP early: sterile pustules on erythema, fever and raised inflammatory markers.
- Check albumin, calcium and liver function at presentation — hypoalbuminaemia is common.
- Stop systemic steroids that may have triggered the flare only under supervision.
- Refer early to a centre with access to IL-36 pathway therapy.
Why it matters
It adds a second IL-36 receptor antibody to a condition with very few effective acute treatments.
Don't overread it
Phase 2 with 33 patients; later results were confounded by open-label treatment.
The statistics, in plain English
A 77-point difference is very large, but with only 33 patients the interval runs from 42 to 89 points. The benefit is clear; its exact size is not. Rare adverse effects cannot be judged from a trial this small.
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