Ahmed Obeidat, MD, PhD, Medical College of Wisconsin, Milwaukee, WI, delves into details of the second-generation Bruton’s tyrosine kinase (BTK) inhibitors currently in clinical trials for the treatment of multiple sclerosis (MS). These second-generation inhibitors have both; 1) improved desired, on-target effects, like the modulation of B-cell activity, and 2) less off-target effects, such as bleeding. With a variety of BTK inhibitors available, Dr Obeidat mentions that it is still unknown which ones are more favorable as we await results of Phase III trials. These results will be particularly important because the missing piece in MS treatment is how to tackle progressive MS. The hope is that the BTK inhibitors will prevent the neurodegenerative process in progressive MS in addition to effectively reducing relapses. Understanding the effect of BTK inhibitors on microglia and other cell types within the central nervous system will bring researchers closer to where they want to be in the therapeutic landscape of MS. This interview took place at the Consortium of Multiple Sclerosis Centers (CMSC) congress 2022 in Maryland.