Potential Advantages of Oral BTKi in CSU Management

The oral administration of Bruton tyrosine kinase inhibitors (BTKi) such as remibrutinib confers several advantages over injectable therapies in the treatment of chronic spontaneous urticaria (CSU). For many patients, oral therapy aligns with preferences for convenience, ease of use, and avoidance of injection-site complications. Remibrutinib's efficacy, established in phase 3 trials, offers a non-invasive alternative without compromising clinical effectiveness or safety.

Patient autonomy in selecting therapy is increasingly recognized as central to shared decision-making in chronic disease management. Shyam Joshi, MD, assistant professor of medicine in the Section of Allergy and Clinical Immunology at Oregon Health & Science University (OHSU) School of Medicine, emphasizes that many individuals with CSU prioritize not only therapeutic benefit and safety but also the practical considerations of daily administration. When clinical efficacy and safety profiles are comparable, the oral route may improve adherence and facilitate rapid symptom control, contributing to improved patient satisfaction.

Importantly, the expansion of approved therapies for CSU—from a single injectable agent to multiple options, including oral BTK inhibitors—enhances clinicians' ability to tailor management strategies to individual patient circumstances. This broadened therapeutic landscape allows for more nuanced discussions addressing each patient’s unique treatment goals, comorbidities, and lifestyle requirements, optimizing outcomes in CSU care.