Efficacy and safety of Bruton's tyrosine kinase inhibitors in the treatment of pemphigus: A comprehensive literature review and future perspective

Abstract

Bruton's tyrosine kinase (BTK) is a protein involved in B-cell-receptor signaling and B-cell proliferation. The pathophysiology of several autoimmune diseases, such as pemphigus disorder, relies on the BTK signaling pathway. Therefore, BTK inhibitors were found to be beneficial alternatives to conventional treatmentsThe current study aimed to assess the efficacy and safety of BTK inhibitors in treating pemphigus. A complete search was performed on databases including PubMed/MedLine, Scopus, Web of Science, as well as Google Scholar search engine for studies published by September 20th, 2023. The current review indicates that BTK inhibitors alone or in combination with conventional treatments are promising options in the management of pemphigus. The overall safety profile of BTK inhibitors has been acceptable, and the reported adverse reactions were not severe or life-threatening.

Highlights

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  Pemphigus is a group of immunobullous disorders involving the mucocutaneous membranes' desmosomes with high mortality and morbidity rates.

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  Previous treatment options, such as high-dose oral corticosteroids and rituximab, were found to be associated with considerable adverse events with uncertain safety and efficacy.

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  Bruton Tyrosine Kinase (BTK) plays an important role in several immunological pathways; hence, they are potential treatments for certain autoimmune disorders.

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  Administration of reversible BTK inhibitors alone or in addition to conventional treatments can be promising combinations in managing pemphigus due to their high response rate, mild and limited side effects, and acceptable results in terms of safety and efficacy.