Added oregano in place of red pepper flakes, and only used sausage for the "topping." Delicious with great post meal numbers at 1 hour.
Used the low setting on my broiler. Might try actually baking for a few minutes next time since the top was warmer than the rest of the ramekin.
For simplicity, I also used breakfast sausage, versus Italian Sausage. Great way to use up leftover sausage, though, I suppose.