Taking responsibility for profits and losses, Janek Pawlik was an operations managers for Siebel Systems in Chicago. Among Janek Pawlik’s interests is research into multiple sclerosis (MS), a disease that degrades the protective myelin sheath surrounding nerves, which negatively affects mobility and balance, among other body functions.

Although MS is presently incurable, several disease-modifying therapies (DMTs) combat the tendency of the immune system to attack the myelin sheath. Many of them treat relapses, the flare-ups of symptoms that alternate with periods of relative health. However, all DMTs have side effects of varying severity.

Some of them work by attacking a subset of immune cells known as B cells that trigger MS symptoms. However, some B cells are actually beneficial. A recent innovation known as BTK inhibitors are more selective about which B cells they go after. In addition, another kind of immune cells, known as microglia, induce symptoms. BTK targets these as well, which helps reduce relapses as well as the appearance of brain lesions.

Currently, four BTK inhibitors are in clinical trials, and the results look promising, although more research is needed. Holding back adoption of BTKs are doctors’ concerns that potential side effects could be greater than patients could withstand.