Evidence map›Paper›PMID 34497100›Full record

ArticleNeurology(R) neuroimmunology & neuroinflammation2021

Balancing Potential Benefits and Risks of Bruton Tyrosine Kinase Inhibitor Therapies in Multiple Sclerosis During the COVID-19 Pandemic.

Martin S Weber, Jacqueline A Nicholas, Michael R Yeaman

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology(R) neuroimmunology & neuroinflammation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.7field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 10 citations in OpenAlex.

  1. Trial
  2. Review
  3. Review
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 1 institution in 1 country.

Martin S WeberFrom the Institute of Neuropathology (M.S.W.), University Medical Center; Department of Neurology (M.S.W.), University Medical Center, Göttingen, Germany; OhioHealth Multiple Sclerosis Center (J.A.N.), Riverside Methodist Hospital, Columbus, OH; David Geffen School of Medicine (M.R.Y.), University of California, Los Angeles (UCLA); Divisions of Molecular Medicine and Infectious Diseases (M.R.Y.), Harbor-UCLA Medical Center; and Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center (M.R.Y.), Torrance, CA. martin.weber@med.uni-goettingen.de.
Jacqueline A NicholasFrom the Institute of Neuropathology (M.S.W.), University Medical Center; Department of Neurology (M.S.W.), University Medical Center, Göttingen, Germany; OhioHealth Multiple Sclerosis Center (J.A.N.), Riverside Methodist Hospital, Columbus, OH; David Geffen School of Medicine (M.R.Y.), University of California, Los Angeles (UCLA); Divisions of Molecular Medicine and Infectious Diseases (M.R.Y.), Harbor-UCLA Medical Center; and Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center (M.R.Y.), Torrance, CA.
Michael R YeamanFrom the Institute of Neuropathology (M.S.W.), University Medical Center; Department of Neurology (M.S.W.), University Medical Center, Göttingen, Germany; OhioHealth Multiple Sclerosis Center (J.A.N.), Riverside Methodist Hospital, Columbus, OH; David Geffen School of Medicine (M.R.Y.), University of California, Los Angeles (UCLA); Divisions of Molecular Medicine and Infectious Diseases (M.R.Y.), Harbor-UCLA Medical Center; and Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center (M.R.Y.), Torrance, CA.ORCID 0000-0002-9468-5252
OhioHealth · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Bruton tyrosine kinase inhibitors (BTKis) encompass a new class of therapeutics currently being evaluated for the treatment of multiple sclerosis (MS). Whether BTKis affect COVID-19 risk or severity or reduce vaccine efficacy are important but unanswered questions. Here, we provide an overview on BTKi mechanisms relevant to COVID-19 infection and vaccination and review preliminary data on BTKi use in patients with COVID-19. BTKis block B-cell receptor- and myeloid fragment crystallizable receptor-mediated signaling, thereby dampening B-cell activation, antibody class-switching, expansion, and cytokine production. Beyond antibodies, COVID-19 severity and vaccine efficacy appear largely linked to T-cell responses and interferon induction, processes not directly affected by BTKis. Given that B cells have clear roles in antigen presentation to T cells, however, it is possible that BTKis may indirectly interfere with beneficial or detrimental T-cell responses during COVID-19 infection or vaccination. In addition to these possible effects on generating a protective immune response, BTKis may attenuate the hyperinflammatory dysregulation often seen in severe cases of COVID-19 that evolves as a key risk factor in this disease. Currently available outcomes from BTKi-treated patients with COVID-19 are discussed. Clinical trials are currently underway to evaluate the safety and efficacy of BTKis in individuals with MS. Although limited data suggest a potential benefit of BTKis on outcomes for some COVID-19 patients, data from adequately powered, prospective and randomized clinical trials are lacking. Likewise, the specific effect of BTKis on the safety and efficacy of COVID-19 vaccines remains to be determined. Any potential unknown risks that BTKi therapy may present to the patient relative to COVID-19 infection, severity, and vaccine efficacy must be balanced with the importance of timely intervention to prevent or minimize MS progression.

Indexed as

COVID-19PandemicsAdultAgammaglobulinaemia Tyrosine KinaseCOVID-19 VaccinesHumansMultiple SclerosisProspective StudiesProtein Kinase InhibitorsT-LymphocytesAgammaglobulinaemia Tyrosine KinaseBTK protein, humanCOVID-19 VaccinesProtein Kinase Inhibitors

Identifiers

PMID34497100
PMCPMC8428017
OpenAlexW3197960060

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.