Wayrilz: A New Twice-Daily Pill for Persistent and Chronic Immune Thrombocytopenia

Wayrilz (rilzabrutinib) is a new oral medicine for adults with persistent (lasting 3-12 months) or chronic (lasting more than 12 months) immune thrombocytopenia (ITP) who haven’t had success with a prior treatment. ITP is a disease where your immune system mistakenly attacks your platelets (cells that help your blood clot). A significant decrease in platelets can cause easy bruising, bleeding, tiredness, and may cause life-threatening bleeding in the brain.

Wayrilz works by selectively blocking a protein in your immune system called Bruton’s tyrosine kinase (BTK). BTK sends signals to the immune system to destroy platelets. Wayrilz protects platelets by reducing the signals that mark them for destruction and preventing their breakdown by the immune system.

Wayrilz is the first BTK blocker approved for ITP, offering a new way to manage the disease.

Why Was It Approved?

Wayrilz was approved after a study showed that it quickly and consistently raised platelet counts in adults with chronic or persistent ITP who had not responded well to another treatment.

All people in the study first received 12 weeks of treatment in what is called a “double-blind period.” This means neither the study participants nor the researchers knew who was getting the study drug or a placebo. People whose platelet count successfully improved after those first 12 weeks were eligible to continue the treatment for the full 24-week period (64% of patients in the Wayrilz group and 32% of patients in the placebo group). At week 25, 23% of people taking Wayrilz had a steady increase in their platelet counts, whereas no one in the placebo group showed a similar response. People taking Wayrilz also saw faster results, with most seeing an improvement in just over a month.

The most common side effects were diarrhea, nausea, headache, stomach pain, and COVID-19. Serious infections like pneumonia or urinary tract infections were seen in rare cases. Liver problems were reported in some cases, for which your health care provider may do some blood tests to check your liver function during treatment.

What Do I Need to Know?

Wayrilz is taken by mouth twice a day, about the same time each day, with or without food. If you have stomach issues like nausea, diarrhea, or pain in your belly area, taking it with food may help. Swallow the tablets whole – don’t crush, cut, or chew them. If you miss a dose, take it as soon as you remember, but only if it’s at least two hours before your next dose.

Avoid taking Wayrilz if you have moderate or severe liver or kidney problems since it hasn’t been tested in people with these conditions. Be sure to tell your health care provider about any liver or kidney problems that you may have.

Also tell your health care provider about all medicines you take, including over-the-counter products and supplements, as Wayrilz may interact with medicines, especially those that affect liver enzymes or stomach acid (such as antacids). Avoid grapefruit, starfruit, and products having these fruits and Seville oranges (often used in marmalades) while taking Wayrilz, as they can affect how the medicine works.

Wayrilz may harm an unborn baby. Talk to your health care provider if you’re pregnant or breastfeeding. If you can become pregnant, use birth control while taking the medicine and for a week after your last dose. Breastfeeding is not recommended during treatment and for at least a week after stopping the medicine.

Visit your health care provider at once if you get an infection or have a fever, chills, or flu-like symptoms. Call your health care provider right away if you notice dark or “tea-colored” urine, yellowing of the skin or the white part of your eyes, or pain or discomfort in your belly area, as these may mean you have liver problems.