Heat a large skillet over medium-high heat and add the sausage and onion.
Cook, crumbling, until sausage is browned.
Stir in garlic, Italian seasoning, salt and pepper and cook 2 minutes.
Add the broth, cream and roasted red peppers and bring to a simmer.
Stir in the uncooked pasta, cover and reduce heat to medium-low. Simmer, stirring often, until al dente.
Stir in spinach and Parmesan. Taste and adjust seasonings as needed before serving.
