Tolebrutinib for non-relapsing secondary progressive multiple sclerosis: a critical therapeutic gap

Bruton tyrosine kinase inhibitors (BTKi) represent a promising strategy to limit disability accumulation in multiple sclerosis (MS). Results from the HERCULES trial1 showed that tolebrutinib, a brain-penetrant BTKi, reduced by 31% the risk of disability progression in non-relapsing secondary progressive MS patients, with a good safety profile. Tolebrutininb may represent a major advance for this MS population with no treatment currently approved.