BTK inhibitors match Aubagio at reducing relapse rates in MS: Review

Further studies needed to determine if they provide lasting benefits

Written by Margarida Maia, PhD | February 3, 2026

• BTK inhibitors match Aubagio for relapse reduction in relapsing multiple sclerosis.
• BTK inhibitors show short-term disability benefits; Aubagio better reduces brain lesions.
• Long-term studies are needed to confirm sustained disability benefits of BTK inhibitors.

Experimental Bruton’s tyrosine kinase (BTK) inhibitors, such as tolebrutinib or evobrutinib, are as effective as the approved therapy Aubagio (teriflunomide) at preventing relapses in people with relapsing forms of multiple sclerosis (MS), according to a review of published studies.

The review found the therapies to be equally safe. BTK inhibitors are better at delaying short-term disability progression, while Aubagio is more effective at reducing inflammatory brain lesions.

However, “current evidence does not support prioritizing BTK inhibitors over [Aubagio],” researchers wrote, at least not for short-term control of relapses or for reducing lesions on MRI scans.

Further studies are now needed to determine if BTK inhibitors provide lasting benefits in slowing disability progression.

The study, “Efficacy and safety of Bruton’s tyrosine kinase inhibitors compared to teriflunomide in relapsing multiple sclerosis: A systematic review and meta-analysis,” was published in Multiple Sclerosis and Related Disorders.

BTK inhibitors reduce activity of immune cells involved in relapses

Symptoms of MS result from an immune system attack against the myelin sheath that covers nerve cells. Over time, accumulating damage leads to long-term disability.

Disease-modifying treatments can reduce the frequency of relapses, periods when new symptoms develop or old ones worsen. However, their ability to prevent long-term disability progression, particularly progression occurring independent of relapse activity, remains limited.

BTK inhibitors are a new class of therapies being developed for MS that reduce the activity of immune cells involved in relapses and new MRI activity. They also ease the chronic inflammatory processes inside the brain that contribute to disability progression outside of relapses.

While most clinical trials assessing BTK inhibitors in relapsing forms of MS have compared them against the approved therapy Aubagio, no studies have combined the results to understand how these drugs work as a whole compared with Aubagio.

To address this, a team of researchers in Brazil conducted a meta-analysis of four randomized controlled studies that compared tolebrutinib or evobrutinib with Aubagio in a total of 4,163 patients.

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