DrugAlternative line
Ibrutinib
BTK inhibitor
- Response rate
- Complete in case reports
- Onset
- 2 weeks – 3 months
- Route
- Oral 420mg daily
- Line
- Alternative
- IgM effect
- Reduces IgM
- Evidence level
- default
Evidence summary
The only drug shown to reduce both inflammatory symptoms AND IgM levels. Currently limited to case reports.
Molecular targets
| Molecule | Role | Expression | Evidence |
|---|---|---|---|
| MYD88 | TLR signalling adaptor | L265P in ~30% | moderate |
| BTK | B-cell receptor kinase | Active | moderate |
| IgM (monoclonal) | Diagnostic paraprotein | Present (obligate) | established |