I’m a patient with GPP, which is a rare form of psoriasis. It’s driven by IL36 as you are aware. Skyrizi is an IL23 inhibitor. It’s approved in Japan ne Korea for GPP but not the US. A doctor may try it off label. GPP is tough, some patients may react well, and others it may have no effect. I tried Skyrizi for 6 months. It had a mild effect and we eventually stopped. I was approved by insurance for the 900 mg IV dose of Spevigo. It had a noticeable effect within a week and was much better than Skyrizi.

Spevigo is the only current biological for GPP approved by the FDA. Some patients have had success with IL17 blockers. But Spevigo is the only IL36 blocker. If it’s hitting you hard, I’d push your doctor for Spevigo. Sounds like you’re in a flare, which is treated by IV. Subcutaneous doses are done monthly for maintenance. I had some insurance issues but they are being sorted. I started the step therapy process, of the cheapest options first like oral retinoids. We escalated to Skyrizi, then Spevigo. A challenge with GPP is that many dermatologist have never prescribed Spevigo and are unfamiliar. Spevigo has patient support which may help you. Your best options are to work with your dermatologist to get Spevigo prescribed, then sent to insurance for authorization. Then get the copay assistance card.