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Spotlight -

This Year In Medicine 2025

Opinion|Videos|February 27, 2025

Differentiating BTK Inhibition From Genetic BTK Deficiency

Author(s)Giselle Mosnaim, MD, MS , Shyam Joshi, MD , Mark Lebwohl, MD

Panelists discuss how pharmacological Bruton tyrosine kinase (BTK) inhibition with agents like remibrutinib appears safer than genetic BTK deficiency (X-linked agammaglobulinemia [XLA]), as clinical studies show the drug doesn't significantly impact immunoglobulin levels or infection rates in patients with chronic spontaneous urticaria (CSU), unlike the severe immunodeficiency seen in XLA.

Episodes in this series

EP. 1 Chronic Spontaneous Urticaria and Bruton Tyrosine Kinase: A Multispecialty Expert Discussion

EP. 1 Chronic Spontaneous Urticaria and Bruton Tyrosine Kinase: A Multispecialty Expert Discussion

EP. 2 Pathophysiology of Chronic Spontaneous Urticaria

EP. 3 Current CSU Treatment Approach and the Role of Bruton Tyrosine Kinase

EP. 3 Current CSU Treatment Approach and the Role of Bruton Tyrosine Kinase

EP. 4 BTK Inhibition as a Strategy for CSU Treatment

EP. 4 BTK Inhibition as a Strategy for CSU Treatment

EP. 5 How BTK Inhibitors Differ From Current CSU Treatment Approaches

EP. 5 How BTK Inhibitors Differ From Current CSU Treatment Approaches

EP. 6 Overview of BTK Inhibitors in Development for CSU Treatment

EP. 6 Overview of BTK Inhibitors in Development for CSU Treatment

EP. 7 Differentiating BTK Inhibition From Genetic BTK Deficiency

EP. 7 Differentiating BTK Inhibition From Genetic BTK Deficiency

EP. 8 Overview of Remibrutinib Phase 3 Clinical Trials in CSU

EP. 8 Overview of Remibrutinib Phase 3 Clinical Trials in CSU

EP. 9 CSU Burden of Disease and Quality of Life

EP. 9 CSU Burden of Disease and Quality of Life

EP. 10 Early Clinical Trial Data for Rilzabrutinib in CSU and Future Study Directions

EP. 10 Early Clinical Trial Data for Rilzabrutinib in CSU and Future Study Directions

EP. 11 How BTK Inhibitors Might Address Unmet Treatment Needs in CSU

EP. 11 How BTK Inhibitors Might Address Unmet Treatment Needs in CSU

EP. 12 Evolving Paradigm for CSU Treatment

EP. 12 Evolving Paradigm for CSU Treatment

EP. 13 Additional Data Needs for BTK Inhibitors in CSU

EP. 13 Additional Data Needs for BTK Inhibitors in CSU

EP. 14 Key Takeaways and Considerations for the Use of BTK Inhibitors in CSU Treatment

EP. 14 Key Takeaways and Considerations for the Use of BTK Inhibitors in CSU Treatment

Video content above is prompted by the following:

How does inhibition of the BTK mechanism differ from manifestations of genetic BTK deficiency (XLA)?
BTK signaling plays a role in B-cell development, and BTK mutation linked to XLA has been shown to affect immunoglobulin levels, making patients with XLA more susceptible to serious infections; remibrutinib did not affect total serum Ig levels or infection rates in CSU patients in phase 2b core and extension studies or in phase 3 studies

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