Ikarian reports 121,356 shares (4.8%) of Spruce Biosciences

Spruce Biosciences ownership update: Ikarian Capital, LLC and Neil Shahrestani report shared beneficial ownership of 121,356 shares of Common Stock, representing 4.8% of the class.

Rhea-AI Filing Summary

Spruce Biosciences ownership update: Ikarian Capital, LLC and Neil Shahrestani report shared beneficial ownership of 121,356 shares of Common Stock, representing 4.8% of the class.

The percentage is calculated using 2,522,043 shares outstanding as of April 22, 2026, per the Issuer's prospectus. The filing states these shares are held by Ikarian Healthcare Master Fund, L.P. and certain managed accounts, with Ikarian Capital exercising investment discretion and Mr. Shahrestani deemed to indirectly control Ikarian Capital.

Key Figures

Reported shares beneficially owned: 121,356 shares Percent of class: 4.8% Shares outstanding used for calculation: 2,522,043 shares

3 metrics

Reported shares beneficially owned 121,356 shares Amount held by Ikarian Healthcare Master Fund and managed accounts

Percent of class 4.8% Percent based on shares outstanding as of April 22, 2026

Shares outstanding used for calculation 2,522,043 shares Outstanding shares as of April 22, 2026 per the Issuer's prospectus

Key Terms

beneficial ownership, shared dispositive power, Section 13(d) or 13(g)

3 terms

beneficial ownership regulatory

"The figures in Items 6, 8, and 9 represent common stock ... held by Ikarian Healthcare Master Fund"

Beneficial ownership means the person or entity that actually enjoys the benefits of owning shares or other assets — such as receiving dividends, voting rights, or price gains — even if the legal title is held in another name. For investors it matters because knowing who truly controls and profits from a company reveals who can influence decisions, exposes potential conflicts of interest or hidden concentration of power, and affects transparency and risk in the stock.

shared dispositive power regulatory

"Shared Dispositive Power 121,356.00"

Section 13(d) or 13(g) regulatory

"shall be construed as an admission that such person is, for the purposes of Section 13(d) or 13(g) of the Act"

FAQ

AI-generated questions and answers. How Rhea-AI works. Not financial advice.

How many Spruce Biosciences (SPRB) shares does Ikarian Capital report owning?

Ikarian Capital and related reporting persons report beneficial ownership of 121,356 shares. The filing attributes these shares to Ikarian Healthcare Master Fund, L.P. and certain managed accounts managed by Ikarian Capital.

What percent of SPRB does 121,356 shares represent?

The 121,356 shares represent 4.8% of the class. That percentage uses a base of 2,522,043 shares outstanding as of April 22, 2026, cited in the prospectus referenced in the filing.

Who is the reporting person on the Schedule 13G/A for SPRB?

The joint filing is made by Ikarian Capital, LLC and Neil Shahrestani. Ikarian Capital is the investment adviser; Mr. Shahrestani is described as indirectly controlling Ikarian Capital and may be deemed to beneficially own the securities.

Are the shares held directly by the reporting persons or by funds/accounts?

The filing states the shares are held by Ikarian Healthcare Master Fund, L.P. and certain separately managed accounts. The Fund and the Managed Accounts are record owners; the filing explains disclaimers of beneficial ownership between those entities.

AI-generated analysis. How Rhea-AI works. Not financial advice.

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Accepted by SEC EDGAR 05/07/2026 - 05:13 PM Learn about SEC filing dates

SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

SCHEDULE 13G

UNDER THE SECURITIES EXCHANGE ACT OF 1934

(Amendment No. 2)

Spruce Biosciences Inc.

(Name of Issuer)

Common Stock, par value $0.0001 per share

(Title of Class of Securities)

85209E208

(CUSIP Number)

04/30/2026

(Date of Event Which Requires Filing of this Statement)

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)

schemaVersion:

SCHEDULE 13G

CUSIP Number(s): 85209E208

1

Names of Reporting Persons

Ikarian Capital, LLC

2

Check the appropriate box if a member of a Group (see instructions)

(a)
(b)

3

Sec Use Only

4

Citizenship or Place of Organization

DELAWARE

Number of Shares Beneficially Owned by Each Reporting Person With:

5	Sole Voting Power 0.00
6	Shared Voting Power 121,356.00
7	Sole Dispositive Power 0.00
8	Shared Dispositive Power 121,356.00

9

Aggregate Amount Beneficially Owned by Each Reporting Person

121,356.00

10

Check box if the aggregate amount in row (9) excludes certain shares (See Instructions)

11

Percent of class represented by amount in row (9)

4.8 %

12

Type of Reporting Person (See Instructions)

IA

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 2,522,043 shares of Common Stock outstanding as of April 22, 2026, as disclosed in the Issuer's prospectus filed with the U.S. Securities and Exchange Commission (the "SEC") on April 21, 2026.

SCHEDULE 13G

CUSIP Number(s): 85209E208

1

Names of Reporting Persons

Neil Shahrestani

2

Check the appropriate box if a member of a Group (see instructions)

(a)
(b)

3

Sec Use Only

4

Citizenship or Place of Organization

UNITED STATES

Number of Shares Beneficially Owned by Each Reporting Person With:

5	Sole Voting Power 0.00
6	Shared Voting Power 121,356.00
7	Sole Dispositive Power 0.00
8	Shared Dispositive Power 121,356.00

9

Aggregate Amount Beneficially Owned by Each Reporting Person

121,356.00

10

Check box if the aggregate amount in row (9) excludes certain shares (See Instructions)

11

Percent of class represented by amount in row (9)

4.8 %

12

Type of Reporting Person (See Instructions)

IN, HC

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 2,522,043 shares of Common Stock outstanding as of April 22, 2026, as disclosed in the Issuer's prospectus filed with the SEC on April 21, 2026.

SCHEDULE 13G

Item 1.
(a)	Name of issuer: Spruce Biosciences Inc.
(b)	Address of issuer's principal executive offices: 611 Gateway Boulevard, Suite 740, South San Francisco, CA 94080
Item 2.
(a)	Name of person filing: This statement is filed jointly by and on behalf of each of Ikarian Capital, LLC, a Delaware limited liability company ("Ikarian Capital"), and Neil Shahrestani (together referred herein as the "Reporting Persons"). The Fund, and certain separately managed accounts managed by Ikarian Capital (collectively, the "Managed Accounts"), are the record owners of the securities covered by this statement. Ikarian Capital is an investment adviser registered under the Investment Advisers Act of 1940, as amended, and serves as investment manager to the Fund and as sub-adviser to the Managed Accounts, and may be deemed to have beneficial ownership of the securities covered by this statement through the investment discretion it has over the Fund and the Managed Accounts. Ikarian Capital is ultimately controlled, indirectly, by Mr. Shahrestani. Accordingly, Mr. Shahrestani may be deemed to indirectly beneficially own securities beneficially owned by Ikarian Capital. The Fund disclaims beneficial ownership of the shares held by the Managed Accounts. The Managed Accounts disclaim beneficial ownership of the shares held by the Fund. Each Reporting Person declares that neither the filing of this statement nor anything herein shall be construed as an admission that such person is, for the purposes of Section 13(d) or 13(g) of the Act or any other purpose, the beneficial owner of any securities covered by this statement. Each Reporting Person may be deemed to be a member of a group with respect to the issuer or securities of the issuer for the purpose of Section 13(d) or 13(g) of the Act. Each of the Reporting Persons declares that neither the filing of this statement nor anything herein shall be construed as an admission that such person is, for the purpose of Section 13(d) or 13(g) of the Act or any other purpose, (i) acting (or has agreed or is agreeing to act together with any other person) as a partnership, limited partnership, syndicate, or other group for the purpose of acquiring, holding, or disposing of securities of the issuer or otherwise with respect to the issuer or any securities of the issuer or (ii) a member of any group with respect to the issuer or any securities of the issuer.
(b)	Address or principal business office or, if none, residence: The address of the principal business office of each of the Reporting Persons is c/o Ikarian Capital, LLC, 100 Crescent Court, Suite 1620, Dallas, Texas 75201.
(c)	Citizenship: See Item 4 on the cover page(s) hereto
(d)	Title of class of securities: Common Stock, par value $0.0001 per share
(e)	CUSIP No.: 85209E208
Item 3.	If this statement is filed pursuant to §§ 240.13d-1(b) or 240.13d-2(b) or (c), check whether the person filing is a:
(a)	Broker or dealer registered under section 15 of the Act (15 U.S.C. 78o);
(b)	Bank as defined in section 3(a)(6) of the Act (15 U.S.C. 78c);
(c)	Insurance company as defined in section 3(a)(19) of the Act (15 U.S.C. 78c);
(d)	Investment company registered under section 8 of the Investment Company Act of 1940 (15 U.S.C. 80a-8);
(e)	An investment adviser in accordance with § 240.13d-1(b)(1)(ii)(E);
(f)	An employee benefit plan or endowment fund in accordance with § 240.13d-1(b)(1)(ii)(F);
(g)	A parent holding company or control person in accordance with § 240.13d-1(b)(1)(ii)(G);
(h)	A savings associations as defined in Section 3(b) of the Federal Deposit Insurance Act (12 U.S.C. 1813);
(i)	A church plan that is excluded from the definition of an investment company under section 3(c)(14) of the Investment Company Act of 1940 (15 U.S.C. 80a-3);
(j)	A non-U.S. institution in accordance with § 240.13d-1(b)(1)(ii)(J). If filing as a non-U.S. institution in accordance with § 240.13d-1(b)(1)(ii)(J), please specify the type of institution:
(k)	Group, in accordance with Rule 240.13d-1(b)(1)(ii)(K).
Item 4.	Ownership
(a)	Amount beneficially owned: See Item 9 on the cover pages(s) hereto.
(b)	Percent of class: See Item 11 on the cover page(s) hereto.
(c)	Number of shares as to which the person has:
	(i) Sole power to vote or to direct the vote: See Item 5 on the cover page(s) hereto.
	(ii) Shared power to vote or to direct the vote: See Item 6 on the cover page(s) hereto.
	(iii) Sole power to dispose or to direct the disposition of: See Item 7 on the cover page(s) hereto.
	(iv) Shared power to dispose or to direct the disposition of: See Item 8 on the cover page(s) hereto.
Item 5.	Ownership of 5 Percent or Less of a Class.
	Ownership of 5 percent or less of a class
Item 6.	Ownership of more than 5 Percent on Behalf of Another Person.
	If any other person is known to have the right to receive or the power to direct the receipt of dividends from, or the proceeds from the sale of, such securities, a statement to that effect should be included in response to this item and, if such interest relates to more than 5 percent of the class, such person should be identified. A listing of the shareholders of an investment company registered under the Investment Company Act of 1940 or the beneficiaries of employee benefit plan, pension fund or endowment fund is not required. The information set forth in Item 2(a) is incorporated by reference herein.
Item 7.	Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company or Control Person.
	Not Applicable
Item 8.	Identification and Classification of Members of the Group.
	Not Applicable
Item 9.	Notice of Dissolution of Group.
	Not Applicable

Item 10.

Certifications:

By signing below I certify that, to the best of my knowledge and belief, the securities referred to above were acquired and are held in the ordinary course of business and were not acquired and are not held for the purpose of or with the effect of changing or influencing the control of the issuer of the securities and were not acquired and are not held in connection with or as a participant in any transaction having that purpose or effect, other than activities solely in connection with a nomination under ?? 240.14a-11.

SIGNATURE

After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.

Ikarian Capital, LLC

Signature:	/s/ Neil Shahrestani
Name/Title:	Neil Shahrestani, Sole Manager
Date:	05/07/2026

Neil Shahrestani

Signature:	/s/ Neil Shahrestani
Name/Title:	Neil Shahrestani
Date:	05/07/2026

Comments accompanying signature: A Joint Filing Agreement is incorporated herein by reference to Exhibit 99.1 to the Schedule 13G filed on October 8, 2025 by the Reporting Persons with the SEC.