# EDGAR Filing Document

**Accession Number:** 0001683553
**File Stem:** 0001493152-26-007364
**Filing Date:** 2026-2
**Character Count:** 29172
**Document Hash:** 8db7f49c963576ff2c7d1a6f3d1a6768
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001493152-26-007364.hdr.sgml**: 20260218

**ACCESSION NUMBER**: 0001493152-26-007364

**CONFORMED SUBMISSION TYPE**: SCHEDULE 13D/A

**PUBLIC DOCUMENT COUNT**: 1

**FILED AS OF DATE**: 20260218

**DATE AS OF CHANGE**: 20260218

**SUBJECT COMPANY**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** SPRUCE BIOSCIENCES, INC.
- **CENTRAL INDEX KEY:** 0001683553
- **STANDARD INDUSTRIAL CLASSIFICATION:** PHARMACEUTICAL PREPARATIONS [2834]
- **ORGANIZATION NAME:** 03 Life Sciences
- **EIN:** 812154263
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**FILING VALUES:**
- **FORM TYPE:** SCHEDULE 13D/A
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 005-91764
- **FILM NUMBER:** 26650335

**BUSINESS ADDRESS:**
- **STREET 1:** 611 GATEWAY BOULEVARD, SUITE 740
- **CITY:** SOUTH SAN FRANCISCO
- **STATE:** CA
- **ZIP:** 94080
- **BUSINESS PHONE:** (415) 655-4168

**MAIL ADDRESS:**
- **STREET 1:** 611 GATEWAY BOULEVARD, SUITE 740
- **CITY:** SOUTH SAN FRANCISCO
- **STATE:** CA
- **ZIP:** 94080
**FILED BY**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** Carlyle Group Inc.
- **CENTRAL INDEX KEY:** 0001527166
- **STANDARD INDUSTRIAL CLASSIFICATION:** INVESTMENT ADVICE [6282]
- **ORGANIZATION NAME:** 02 Finance
- **EIN:** 452832612
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**FILING VALUES:**
- **FORM TYPE:** SCHEDULE 13D/A

**BUSINESS ADDRESS:**
- **STREET 1:** C/O THE CARLYLE GROUP
- **STREET 2:** 1001 PENNSYLVANIA AVENUE, N.W.
- **CITY:** WASHINGTON
- **STATE:** DC
- **ZIP:** 20004
- **BUSINESS PHONE:** 202 729 5626

**MAIL ADDRESS:**
- **STREET 1:** C/O THE CARLYLE GROUP
- **STREET 2:** 1001 PENNSYLVANIA AVENUE, N.W.
- **CITY:** WASHINGTON
- **STATE:** DC
- **ZIP:** 20004

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** Carlyle Group L.P.
- **DATE OF NAME CHANGE:** 20110801

### UNITED STATES SECURITIES AND EXCHANGE COMMISSION
**Washington, D.C. 20549**

## SCHEDULE 13D

### Under the Securities Exchange Act of 1934

**(Amendment No. 3)**

**Spruce Biosciences, Inc.**

*(Name of Issuer)*

**Common Stock, par value $0.0001 per share**

*(Title of Class of Securities)*

**85209E208**

*(CUSIP Number)*

**Jeffrey Ferguson**<br>The Carlyle Group<br>1001 Pennsylvania Avenue, NW, Suite 220S<br>Washington DC 20004<br>(202) 729-5626

*(Name, Address and Telephone Number of Person Authorized to Receive Notices and Communications)*

**02/18/2026**

*(Date of Event Which Requires Filing of this Statement)*

| **CUSIP No.** | **85209E208** |

---

| | | | |
|:--|:--|:--|:--|
| 1 | Name of reporting person<br>**The Carlyle Group Inc.** | Name of reporting person<br>**The Carlyle Group Inc.** | |
| 2 | Check the appropriate box if a member of a Group (See Instructions)<br>[x] (a)<br>[ ] (b) | Check the appropriate box if a member of a Group (See Instructions)<br>[x] (a)<br>[ ] (b) | |
| 3 | SEC use only | SEC use only | |
| 4 | Source of funds (See Instructions)<br>**OO** | Source of funds (See Instructions)<br>**OO** | |
| 5 | Check if disclosure of legal proceedings is required pursuant to Items 2(d) or 2(e)<br>[ ] | Check if disclosure of legal proceedings is required pursuant to Items 2(d) or 2(e)<br>[ ] | |
| 6 | Citizenship or place of organization<br>**DELAWARE** | Citizenship or place of organization<br>**DELAWARE** | |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 7 | Sole Voting Power<br>**0.00** |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 8 | Shared Voting Power<br>**50893.00** |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 9 | Sole Dispositive Power<br>**0.00** |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 10 | Shared Dispositive Power<br>**50893.00** |
| 11 | Aggregate amount beneficially owned by each reporting person<br>**50893.00** | Aggregate amount beneficially owned by each reporting person<br>**50893.00** | |
| 12 | Check if the aggregate amount in Row (11) excludes certain shares (See Instructions)<br>[ ] | Check if the aggregate amount in Row (11) excludes certain shares (See Instructions)<br>[ ] | |
| 13 | Percent of class represented by amount in Row (11)<br>**4.7%** | Percent of class represented by amount in Row (11)<br>**4.7%** | |
| 14 | Type of Reporting Person (See Instructions)<br>**CO** | Type of Reporting Person (See Instructions)<br>**CO** | |

---

| **CUSIP No.** | **85209E208** |

---

| | | | |
|:--|:--|:--|:--|
| 1 | Name of reporting person<br>**Carlyle Holdings I GP Inc.** | Name of reporting person<br>**Carlyle Holdings I GP Inc.** | |
| 2 | Check the appropriate box if a member of a Group (See Instructions)<br>[x] (a)<br>[ ] (b) | Check the appropriate box if a member of a Group (See Instructions)<br>[x] (a)<br>[ ] (b) | |
| 3 | SEC use only | SEC use only | |
| 4 | Source of funds (See Instructions)<br>**OO** | Source of funds (See Instructions)<br>**OO** | |
| 5 | Check if disclosure of legal proceedings is required pursuant to Items 2(d) or 2(e)<br>[ ] | Check if disclosure of legal proceedings is required pursuant to Items 2(d) or 2(e)<br>[ ] | |
| 6 | Citizenship or place of organization<br>**DELAWARE** | Citizenship or place of organization<br>**DELAWARE** | |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 7 | Sole Voting Power<br>**0.00** |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 8 | Shared Voting Power<br>**50893.00** |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 9 | Sole Dispositive Power<br>**0.00** |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 10 | Shared Dispositive Power<br>**50893.00** |
| 11 | Aggregate amount beneficially owned by each reporting person<br>**50893.00** | Aggregate amount beneficially owned by each reporting person<br>**50893.00** | |
| 12 | Check if the aggregate amount in Row (11) excludes certain shares (See Instructions)<br>[ ] | Check if the aggregate amount in Row (11) excludes certain shares (See Instructions)<br>[ ] | |
| 13 | Percent of class represented by amount in Row (11)<br>**4.7%** | Percent of class represented by amount in Row (11)<br>**4.7%** | |
| 14 | Type of Reporting Person (See Instructions)<br>**CO** | Type of Reporting Person (See Instructions)<br>**CO** | |

---

| **CUSIP No.** | **85209E208** |

---

| | | | |
|:--|:--|:--|:--|
| 1 | Name of reporting person<br>**Carlyle Holdings I GP Sub L.L.C.** | Name of reporting person<br>**Carlyle Holdings I GP Sub L.L.C.** | |
| 2 | Check the appropriate box if a member of a Group (See Instructions)<br>[x] (a)<br>[ ] (b) | Check the appropriate box if a member of a Group (See Instructions)<br>[x] (a)<br>[ ] (b) | |
| 3 | SEC use only | SEC use only | |
| 4 | Source of funds (See Instructions)<br>**OO** | Source of funds (See Instructions)<br>**OO** | |
| 5 | Check if disclosure of legal proceedings is required pursuant to Items 2(d) or 2(e)<br>[ ] | Check if disclosure of legal proceedings is required pursuant to Items 2(d) or 2(e)<br>[ ] | |
| 6 | Citizenship or place of organization<br>**DELAWARE** | Citizenship or place of organization<br>**DELAWARE** | |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 7 | Sole Voting Power<br>**0.00** |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 8 | Shared Voting Power<br>**50893.00** |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 9 | Sole Dispositive Power<br>**0.00** |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 10 | Shared Dispositive Power<br>**50893.00** |
| 11 | Aggregate amount beneficially owned by each reporting person<br>**50893.00** | Aggregate amount beneficially owned by each reporting person<br>**50893.00** | |
| 12 | Check if the aggregate amount in Row (11) excludes certain shares (See Instructions)<br>[ ] | Check if the aggregate amount in Row (11) excludes certain shares (See Instructions)<br>[ ] | |
| 13 | Percent of class represented by amount in Row (11)<br>**4.7%** | Percent of class represented by amount in Row (11)<br>**4.7%** | |
| 14 | Type of Reporting Person (See Instructions)<br>**OO** | Type of Reporting Person (See Instructions)<br>**OO** | |

---

**Comment for Reporting Person:** Limited Liability Company

| **CUSIP No.** | **85209E208** |

---

| | | | |
|:--|:--|:--|:--|
| 1 | Name of reporting person<br>**Carlyle Holdings I L.P.** | Name of reporting person<br>**Carlyle Holdings I L.P.** | |
| 2 | Check the appropriate box if a member of a Group (See Instructions)<br>[x] (a)<br>[ ] (b) | Check the appropriate box if a member of a Group (See Instructions)<br>[x] (a)<br>[ ] (b) | |
| 3 | SEC use only | SEC use only | |
| 4 | Source of funds (See Instructions)<br>**OO** | Source of funds (See Instructions)<br>**OO** | |
| 5 | Check if disclosure of legal proceedings is required pursuant to Items 2(d) or 2(e)<br>[ ] | Check if disclosure of legal proceedings is required pursuant to Items 2(d) or 2(e)<br>[ ] | |
| 6 | Citizenship or place of organization<br>**DELAWARE** | Citizenship or place of organization<br>**DELAWARE** | |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 7 | Sole Voting Power<br>**0.00** |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 8 | Shared Voting Power<br>**50893.00** |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 9 | Sole Dispositive Power<br>**0.00** |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 10 | Shared Dispositive Power<br>**50893.00** |
| 11 | Aggregate amount beneficially owned by each reporting person<br>**50893.00** | Aggregate amount beneficially owned by each reporting person<br>**50893.00** | |
| 12 | Check if the aggregate amount in Row (11) excludes certain shares (See Instructions)<br>[ ] | Check if the aggregate amount in Row (11) excludes certain shares (See Instructions)<br>[ ] | |
| 13 | Percent of class represented by amount in Row (11)<br>**4.7%** | Percent of class represented by amount in Row (11)<br>**4.7%** | |
| 14 | Type of Reporting Person (See Instructions)<br>**PN** | Type of Reporting Person (See Instructions)<br>**PN** | |

---

| **CUSIP No.** | **85209E208** |

---

| | | | |
|:--|:--|:--|:--|
| 1 | Name of reporting person<br>**CG Subsidiary Holdings L.L.C.** | Name of reporting person<br>**CG Subsidiary Holdings L.L.C.** | |
| 2 | Check the appropriate box if a member of a Group (See Instructions)<br>[x] (a)<br>[ ] (b) | Check the appropriate box if a member of a Group (See Instructions)<br>[x] (a)<br>[ ] (b) | |
| 3 | SEC use only | SEC use only | |
| 4 | Source of funds (See Instructions)<br>**OO** | Source of funds (See Instructions)<br>**OO** | |
| 5 | Check if disclosure of legal proceedings is required pursuant to Items 2(d) or 2(e)<br>[ ] | Check if disclosure of legal proceedings is required pursuant to Items 2(d) or 2(e)<br>[ ] | |
| 6 | Citizenship or place of organization<br>**DELAWARE** | Citizenship or place of organization<br>**DELAWARE** | |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 7 | Sole Voting Power<br>**0.00** |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 8 | Shared Voting Power<br>**50893.00** |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 9 | Sole Dispositive Power<br>**0.00** |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 10 | Shared Dispositive Power<br>**50893.00** |
| 11 | Aggregate amount beneficially owned by each reporting person<br>**50893.00** | Aggregate amount beneficially owned by each reporting person<br>**50893.00** | |
| 12 | Check if the aggregate amount in Row (11) excludes certain shares (See Instructions)<br>[ ] | Check if the aggregate amount in Row (11) excludes certain shares (See Instructions)<br>[ ] | |
| 13 | Percent of class represented by amount in Row (11)<br>**4.7%** | Percent of class represented by amount in Row (11)<br>**4.7%** | |
| 14 | Type of Reporting Person (See Instructions)<br>**OO** | Type of Reporting Person (See Instructions)<br>**OO** | |

---

**Comment for Reporting Person:** Limited Liability Company

| **CUSIP No.** | **85209E208** |

---

| | | | |
|:--|:--|:--|:--|
| 1 | Name of reporting person<br>**TC Group, L.L.C.** | Name of reporting person<br>**TC Group, L.L.C.** | |
| 2 | Check the appropriate box if a member of a Group (See Instructions)<br>[x] (a)<br>[ ] (b) | Check the appropriate box if a member of a Group (See Instructions)<br>[x] (a)<br>[ ] (b) | |
| 3 | SEC use only | SEC use only | |
| 4 | Source of funds (See Instructions)<br>**OO** | Source of funds (See Instructions)<br>**OO** | |
| 5 | Check if disclosure of legal proceedings is required pursuant to Items 2(d) or 2(e)<br>[ ] | Check if disclosure of legal proceedings is required pursuant to Items 2(d) or 2(e)<br>[ ] | |
| 6 | Citizenship or place of organization<br>**DELAWARE** | Citizenship or place of organization<br>**DELAWARE** | |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 7 | Sole Voting Power<br>**0.00** |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 8 | Shared Voting Power<br>**50893.00** |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 9 | Sole Dispositive Power<br>**0.00** |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 10 | Shared Dispositive Power<br>**50893.00** |
| 11 | Aggregate amount beneficially owned by each reporting person<br>**50893.00** | Aggregate amount beneficially owned by each reporting person<br>**50893.00** | |
| 12 | Check if the aggregate amount in Row (11) excludes certain shares (See Instructions)<br>[ ] | Check if the aggregate amount in Row (11) excludes certain shares (See Instructions)<br>[ ] | |
| 13 | Percent of class represented by amount in Row (11)<br>**4.7%** | Percent of class represented by amount in Row (11)<br>**4.7%** | |
| 14 | Type of Reporting Person (See Instructions)<br>**OO** | Type of Reporting Person (See Instructions)<br>**OO** | |

---

**Comment for Reporting Person:** Limited Liability Company

| **CUSIP No.** | **85209E208** |

---

| | | | |
|:--|:--|:--|:--|
| 1 | Name of reporting person<br>**Carlyle Investment Management L.L.C.** | Name of reporting person<br>**Carlyle Investment Management L.L.C.** | |
| 2 | Check the appropriate box if a member of a Group (See Instructions)<br>[x] (a)<br>[ ] (b) | Check the appropriate box if a member of a Group (See Instructions)<br>[x] (a)<br>[ ] (b) | |
| 3 | SEC use only | SEC use only | |
| 4 | Source of funds (See Instructions)<br>**OO** | Source of funds (See Instructions)<br>**OO** | |
| 5 | Check if disclosure of legal proceedings is required pursuant to Items 2(d) or 2(e)<br>[ ] | Check if disclosure of legal proceedings is required pursuant to Items 2(d) or 2(e)<br>[ ] | |
| 6 | Citizenship or place of organization<br>**DELAWARE** | Citizenship or place of organization<br>**DELAWARE** | |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 7 | Sole Voting Power<br>**0.00** |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 8 | Shared Voting Power<br>**50893.00** |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 9 | Sole Dispositive Power<br>**0.00** |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 10 | Shared Dispositive Power<br>**50893.00** |
| 11 | Aggregate amount beneficially owned by each reporting person<br>**50893.00** | Aggregate amount beneficially owned by each reporting person<br>**50893.00** | |
| 12 | Check if the aggregate amount in Row (11) excludes certain shares (See Instructions)<br>[ ] | Check if the aggregate amount in Row (11) excludes certain shares (See Instructions)<br>[ ] | |
| 13 | Percent of class represented by amount in Row (11)<br>**4.7%** | Percent of class represented by amount in Row (11)<br>**4.7%** | |
| 14 | Type of Reporting Person (See Instructions)<br>**OO** | Type of Reporting Person (See Instructions)<br>**OO** | |

---

**Comment for Reporting Person:** Limited Liability Company

| **CUSIP No.** | **85209E208** |

---

| | | | |
|:--|:--|:--|:--|
| 1 | Name of reporting person<br>**Carlyle Genesis UK LLC** | Name of reporting person<br>**Carlyle Genesis UK LLC** | |
| 2 | Check the appropriate box if a member of a Group (See Instructions)<br>[x] (a)<br>[ ] (b) | Check the appropriate box if a member of a Group (See Instructions)<br>[x] (a)<br>[ ] (b) | |
| 3 | SEC use only | SEC use only | |
| 4 | Source of funds (See Instructions)<br>**OO** | Source of funds (See Instructions)<br>**OO** | |
| 5 | Check if disclosure of legal proceedings is required pursuant to Items 2(d) or 2(e)<br>[ ] | Check if disclosure of legal proceedings is required pursuant to Items 2(d) or 2(e)<br>[ ] | |
| 6 | Citizenship or place of organization<br>**DELAWARE** | Citizenship or place of organization<br>**DELAWARE** | |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 7 | Sole Voting Power<br>**0.00** |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 8 | Shared Voting Power<br>**50893.00** |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 9 | Sole Dispositive Power<br>**0.00** |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 10 | Shared Dispositive Power<br>**50893.00** |
| 11 | Aggregate amount beneficially owned by each reporting person<br>**50893.00** | Aggregate amount beneficially owned by each reporting person<br>**50893.00** | |
| 12 | Check if the aggregate amount in Row (11) excludes certain shares (See Instructions)<br>[ ] | Check if the aggregate amount in Row (11) excludes certain shares (See Instructions)<br>[ ] | |
| 13 | Percent of class represented by amount in Row (11)<br>**4.7%** | Percent of class represented by amount in Row (11)<br>**4.7%** | |
| 14 | Type of Reporting Person (See Instructions)<br>**OO** | Type of Reporting Person (See Instructions)<br>**OO** | |

---

**Comment for Reporting Person:** Limited Liability Company

| **CUSIP No.** | **85209E208** |

---

| | | | |
|:--|:--|:--|:--|
| 1 | Name of reporting person<br>**Abingworth LLP** | Name of reporting person<br>**Abingworth LLP** | |
| 2 | Check the appropriate box if a member of a Group (See Instructions)<br>[x] (a)<br>[ ] (b) | Check the appropriate box if a member of a Group (See Instructions)<br>[x] (a)<br>[ ] (b) | |
| 3 | SEC use only | SEC use only | |
| 4 | Source of funds (See Instructions)<br>**OO** | Source of funds (See Instructions)<br>**OO** | |
| 5 | Check if disclosure of legal proceedings is required pursuant to Items 2(d) or 2(e)<br>[ ] | Check if disclosure of legal proceedings is required pursuant to Items 2(d) or 2(e)<br>[ ] | |
| 6 | Citizenship or place of organization<br>**X0** | Citizenship or place of organization<br>**X0** | |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 7 | Sole Voting Power<br>**0.00** |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 8 | Shared Voting Power<br>**50893.00** |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 9 | Sole Dispositive Power<br>**0.00** |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 10 | Shared Dispositive Power<br>**50893.00** |
| 11 | Aggregate amount beneficially owned by each reporting person<br>**50893.00** | Aggregate amount beneficially owned by each reporting person<br>**50893.00** | |
| 12 | Check if the aggregate amount in Row (11) excludes certain shares (See Instructions)<br>[ ] | Check if the aggregate amount in Row (11) excludes certain shares (See Instructions)<br>[ ] | |
| 13 | Percent of class represented by amount in Row (11)<br>**4.7%** | Percent of class represented by amount in Row (11)<br>**4.7%** | |
| 14 | Type of Reporting Person (See Instructions)<br>**PN** | Type of Reporting Person (See Instructions)<br>**PN** | |

---

| **CUSIP No.** | **85209E208** |

---

| | | | |
|:--|:--|:--|:--|
| 1 | Name of reporting person<br>**Abingworth Bioventures VII LP** | Name of reporting person<br>**Abingworth Bioventures VII LP** | |
| 2 | Check the appropriate box if a member of a Group (See Instructions)<br>[x] (a)<br>[ ] (b) | Check the appropriate box if a member of a Group (See Instructions)<br>[x] (a)<br>[ ] (b) | |
| 3 | SEC use only | SEC use only | |
| 4 | Source of funds (See Instructions)<br>**OO** | Source of funds (See Instructions)<br>**OO** | |
| 5 | Check if disclosure of legal proceedings is required pursuant to Items 2(d) or 2(e)<br>[ ] | Check if disclosure of legal proceedings is required pursuant to Items 2(d) or 2(e)<br>[ ] | |
| 6 | Citizenship or place of organization<br>**X0** | Citizenship or place of organization<br>**X0** | |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 7 | Sole Voting Power<br>**0.00** |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 8 | Shared Voting Power<br>**50893.00** |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 9 | Sole Dispositive Power<br>**0.00** |
| Number of Shares<br>Beneficially Owned by<br>Each Reporting Person With: | 10 | Shared Dispositive Power<br>**50893.00** |
| 11 | Aggregate amount beneficially owned by each reporting person<br>**50893.00** | Aggregate amount beneficially owned by each reporting person<br>**50893.00** | |
| 12 | Check if the aggregate amount in Row (11) excludes certain shares (See Instructions)<br>[ ] | Check if the aggregate amount in Row (11) excludes certain shares (See Instructions)<br>[ ] | |
| 13 | Percent of class represented by amount in Row (11)<br>**4.7%** | Percent of class represented by amount in Row (11)<br>**4.7%** | |
| 14 | Type of Reporting Person (See Instructions)<br>**PN** | Type of Reporting Person (See Instructions)<br>**PN** | |

---

**Item 1. Security and Issuer**

**(a) Title of Class of Securities:**
Common Stock, par value $0.0001 per share

**(b) Name of Issuer:**
Spruce Biosciences, Inc.

**(c) Address of Issuer's Principal Executive Offices:**
611 Gateway Boulevard, Suite 740, South San Francisco, CA, 94080

Explanatory Note

This Amendment No. 3 to Schedule 13D ("Amendment No. 3") amends and supplements the Schedule 13D originally filed with the United States Securities and Exchange Commission (the "SEC") on October 16, 2020 (as amended to date, the "Schedule 13D"), relating to the shares of common stock, par value $0.0001 per share (the "Common Stock"), of Spruce Biosciences, Inc., a Delaware corporation (the "Issuer"). Capitalized terms used herein without definition shall have the meanings set forth in the Schedule 13D.

**Item 4. Purpose of Transaction**

Item 4 of the Schedule 13D is hereby amended as follows:

Bali Muralidhar, who represented Abingworth Bioventures VII LP on the Issuer's board of directors, resigned as a director in October 2025.

**Item 5. Interest in Securities of the Issuer**

**(a)**
Item 5 of the Schedule 13D is hereby amended and restated in its entirety as follows:

The following sets forth, as of the date of this Schedule 13D, the aggregate number of shares of Common Stock and percentage of Common Stock beneficially owned by each of the Reporting Persons, based on 1,070,370 shares of Common Stock outstanding as of November 7, 2025, as disclosed in the Issuer's Quarterly Report on Form 10-Q filed with the SEC on November 10, 2025. The amount of Common Stock reported herein reflects a 1-for-75 reverse stock split effected by the Issuer on August 4, 2025.

The Reporting Persons beneficially own 50,893 shares of Common Stock, or approximately 4.7% of the shares of Common Stock outstanding, which include (i) 38,620 shares of Common Stock held of record by Abingworth Bioventures VII LP, (ii) 1,233 shares of Common Stock underlying stock options exercisable within 60 days of the date hereof held for the benefit of Abingworth Bioventures VII LP and (iii) 11,040 shares of Common Stock underlying the Standard Warrants exercisable within 60 days of the date hereof.

The Carlyle Group Inc., which is a publicly traded entity listed on Nasdaq, is the sole shareholder of Carlyle Holdings I GP Inc., which is the sole member of Carlyle Holdings I GP Sub L.L.C., which is the general partner of Carlyle Holdings I L.P., which, with respect to the securities reported herein, is the managing member of CG Subsidiary Holdings L.L.C., which is the managing member of TC Group, L.L.C., which is the managing member of Carlyle Investment Management, L.L.C., which is the sole member of Carlyle Genesis UK LLC, which is the principal member of Abingworth LLP. Abingworth Bioventures VII LP has delegated to Abingworth LLP all investment and dispositive power over the securities held of record by Abingworth Bioventures VII LP. Accordingly, each of the foregoing entities may be deemed to share beneficial ownership of the securities held of record by Abingworth Bioventures VII LP, but each disclaims beneficial ownership of such securities.

**(b)**
Sole power to vote or to direct the vote: 0

Shared power to vote or to direct the vote: 50,893

Sole power to dispose or to direct the disposition: 0

Shared power to dispose or to direct the disposition: 50,893

**(c)**
During the past 60 days, the Reporting Persons have not effected any transactions with respect to the Common Stock.

### 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.

**Reporting Person:** The Carlyle Group Inc.

**Signature:** /s/ Anne K. Frederick

**Name/Title:** Anne K. Frederick, Corporate Secretary

**Date:** 02/18/2026

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.

**Reporting Person:** Carlyle Holdings I GP Inc.

**Signature:** /s/ Anne K. Frederick

**Name/Title:** Anne K. Frederick, Managing Director

**Date:** 02/18/2026

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.

**Reporting Person:** Carlyle Holdings I GP Sub L.L.C.

**Signature:** By: Carlyle Holdings I GP Inc., its sole member, /s/ Anne K. Frederick

**Name/Title:** Anne K. Frederick, Managing Director

**Date:** 02/18/2026

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.

**Reporting Person:** Carlyle Holdings I L.P.

**Signature:** /s/ Anne K. Frederick

**Name/Title:** Anne K. Frederick, Managing Director

**Date:** 02/18/2026

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.

**Reporting Person:** CG Subsidiary Holdings L.L.C.

**Signature:** /s/ Anne K. Frederick

**Name/Title:** Anne K. Frederick, Managing Director

**Date:** 02/18/2026

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.

**Reporting Person:** TC Group, L.L.C.

**Signature:** /s/ Anne K. Frederick

**Name/Title:** Anne K. Frederick, Managing Director

**Date:** 02/18/2026

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.

**Reporting Person:** Carlyle Investment Management L.L.C.

**Signature:** /s/ Anne K. Frederick

**Name/Title:** Anne K. Frederick, Managing Director

**Date:** 02/18/2026

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.

**Reporting Person:** Carlyle Genesis UK LLC

**Signature:** By: Carlyle Investment Management L.L.C., its sole member, /s/ Anne K. Frederick

**Name/Title:** Anne K. Frederick, Managing Director

**Date:** 02/18/2026

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.

**Reporting Person:** Abingworth LLP

**Signature:** /s/ Emma O'Reilly

**Name/Title:** Emma O'Reilly, Authorized Signatory

**Date:** 02/18/2026

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.

**Reporting Person:** Abingworth Bioventures VII LP

**Signature:** /s/ Emma O'Reilly

**Name/Title:** Emma O'Reilly, Authorized Signatory

**Date:** 02/18/2026