Check the appropriate box to designate the rule pursuant to which this Schedule is filed:
   Rule 13d-1(b)
   Rule 13d-1(c)
   Rule 13d-1(d)






SCHEDULE 13G




Comment for Type of Reporting Person:   (1) The figures in Items 6, 8, and 9 represent common stock, par value $0.0001 per share ("Common Stock") of Spruce Biosciences Inc. (the "Issuer") held by Ikarian Healthcare Master Fund, L.P., a Cayman Islands exempted limited partnership (the "Fund"), and certain separate managed accounts. See Item 2 for more information. (2) The figure in Item 11 is based upon 563,042 shares of Common Stock outstanding as of August 12, 2025, as disclosed in the Issuer's quarterly report on Form 10-Q for the quarterly period ended June 30, 2025, filed with the U.S. Securities and Exchange Commission (the "SEC") on August 14, 2025.


SCHEDULE 13G




Comment for Type of Reporting Person:   (1) The figures in Items 6, 8, and 9 represent Common Stock of the Issuer held by the Fund and certain separate managed accounts. See Item 2 for more information. (2) The figure in Item 11 is based upon 563,042 shares of Common Stock outstanding as of August 12, 2025, as disclosed in the Issuer's quarterly report on Form 10-Q for the quarterly period ended June 30, 2025, filed with the SEC on August 14, 2025.


SCHEDULE 13G



 
Ikarian Capital, LLC
 
Signature:/s/ Neil Shahrestani
Name/Title:Neil Shahrestani, Sole Manager
Date:10/08/2025
 
Neil Shahrestani
 
Signature:/s/ Neil Shahrestani
Name/Title:Neil Shahrestani
Date:10/08/2025

ATTACHMENTS / EXHIBITS

ATTACHMENTS / EXHIBITS

EX-99.1