Physician Views snap poll: Gauging neurologist optimism towards BTK inhibitors in multiple sclerosis

The catalyst: Without revealing detailed results, Sanofi claimed last week that its experimental BTK inhibitor SAR442168 could emerge as a potential ‘best in disease’ therapy for the treatment of multiple sclerosis. It plans to initiate Phase III studies in relapsing, primary progressive and secondary progressive disease this year, following positive Phase II proof-of-concept results which will be presented at a future medical meeting. Another BTK inhibitor – Merck KGaA’s evobrutinib – entered pivotal-stage studies for relapsing MS last year.

See also – KOL Views: Early look at prospects for BTK inhibitors like Sanofi’s SAR442168 in MS

The poll: We are asking neurologists who treat MS (who are based in the US, France, Germany, Italy, Spain and UK) the following questions to gauge levels of prescriber interest around the potential clinical benefits that BTK inhibitors could offer MS patients…


Q. Taking currently available treatments into account, how would you rate the level of unmet patient need which relates to sources of multiple sclerosis damage in the brain?

1 – Very low      2            3            4            5 – Very high


Q. How promising an approach would you consider an experimental oral therapy which is designed to modulate both adaptive (B-cell activation; providing recovery in 5-7 days versus 6 months-plus for B-cell depletion) and innate (CNS microglial cells) immune cells linked to neuro-inflammation in the brain and spinal cord?

1 – Not promising           2            3            4            5 – Very promising


Q. Do you have concerns about using currently available treatments for MS which stimulate cognitive B-cell depletion?

1 – Not at all      2            3            4            5 – Yes; which prevent me from using them altogether


Q. The efficacy of one experimental therapy meeting these criteria (a BTK inhibitor known currently as SAR442168) in terms of effect on relapse rate, disability progression and underlying central nervous system damage is to be evaluated in a Phase III study versus Aubagio (teriflunomide). Based on its current position in the treatment algorithm, is teriflunomide a suitable comparator for this study?


Not ideal but useful



Q. Another BTK inhibitor (evobrutinib) has progressed into late-stage clinical studies after it met the Phase II primary endpoint over 24 weeks of treatment, where the total cumulative number of T1 gadolinium-enhancing lesions was reduced with evobrutinib compared with placebo. The reduction of T1 gadolinium-enhancing lesions was observed at 12 weeks, the first time point at which MRI data was available, and maintained through 48 weeks with evobrutinib 75 mg QD and 75 mg BID. Further data show that the effect on relapse reduction observed at Week 24 was maintained through 48 weeks.

How promising do you consider these data?

1 – Not positive 2            3            4            5 – Very positive


Results and related analysis will shortly be published for FirstWord Pharma PLUS subscribers to read, with the opportunity for non-FirstWord Pharma PLUS subscribers to purchase these findings. To be notified when poll results and analysis become available, please click here.

As always, FirstWord would very much like to receive your feedback and suggestions.

Note: FirstWord Physician Views are a fast-turnaround service to conduct instant polls of up to five questions with guaranteed samples that include physicians from dozens of specialties in major markets. To conduct this poll with a different audience, or an entirely different poll, contact us at

Disclaimer: FirstWord follows market research best practices in conducting its Physician Views polls.  However, Physician Views results should be considered directional and clients should use their market research resources for statistical analysis and conclusions required with very high confidence levels.

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