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BIIB091 + diroximel fumarate is a pharmaceutical combination under investigation for the treatment of relapsing forms of multiple sclerosis (MS). BIIB091 is an orally administered, potent, selective, and reversible small-molecule inhibitor of Bruton's tyrosine kinase (BTK), targeting B cell and myeloid cell signaling, with an expected mechanism to suppress B-cell activation and associated immune-mediated CNS damage. Diroximel fumarate is an oral Nrf2 activator that acts as an immunomodulatory agent and anti-inflammatory, used in approved therapies for relapsing forms of MS, and is administered as a delayed-release formulation to limit gastrointestinal side effects. The combination is being studied for potential synergistic immunomodulatory effects in MS patients.
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