EXHIBIT I

JOINT FILING AGREEMENT

This will confirm the agreement by and among the undersigned that the Schedule 13G filed with the Securities and Exchange Commission on or about the date hereof with respect to the beneficial ownership by the undersigned of the Common Stock, par value $0.0001 per share, of Spruce Biosciences, Inc. will be filed on behalf of each of the persons and entities named below in accordance with Rule 13d-1(k) under the Securities Exchange Act of 1934, as amended. This Agreement may be executed in two or more counterparts, each of which shall be deemed an original, but all of which together shall constitute one and the same instrument.

Dated: February 23, 2026

	INTEGRATED CORE STRATEGIES (US) LLC

	By:	Integrated Holding Group LP,
		its Managing Member

	By:	Millennium Management LLC,
		its General Partner

	By:	/s/ Gil Raviv
	Name: Gil Raviv
	Title: Global General Counsel


	MILLENNIUM MANAGEMENT LLC

	By:	/s/ Gil Raviv
	Name: Gil Raviv
	Title: Global General Counsel


	MILLENNIUM GROUP MANAGEMENT LLC

	By:	/s/ Gil Raviv
	Name: Gil Raviv
	Title: Global General Counsel


	/s/ Israel A. Englander
	Israel A. Englander

SPRUCE BIOSCIENCES, INC. SCHEDULE 13G