Immunology

B-Cell Clinical aspects: available and future treatment

Anti-CD20 therapies have become a cornerstone of modern MS management, particularly when used early and strategically. The keynote balances strong efficacy data with real-world safety and practical issues such as switching, pregnancy and extended-interval dosing, and offers a glimpse of the next generation of B-cell–directed therapies.

In this keynote delivered in Athens, Professor Carlo Pozzilli takes the audience through the past, present and future of anti-CD20 therapies in multiple sclerosis. Starting from the early interferon era and the first monoclonal antibodies, Professor Pozzilli retraces how B-cell depletion moved from a provocative concept to a central pillar of MS management.

Drawing on pivotal trials, 10-year extension data and real-world evidence, the discussion adresses why starting high-efficacy therapy early matters, how anti-CD20 agents compare with other high-efficacy options such as natalizumab, and what we are learning about safety, pregnancy, dosing strategies and next-generation approaches like CAR-T.

This lecture is particularly relevant for clinicians re-thinking treatment sequencing, timing and individual risk–benefit in the anti-CD20 era.

Key Insights from the Lecture:

A treatment revolution: MS care has moved from classic injectables to B-cell depleting therapies as a central pillar of modern management.
Why B cells matter: Anti-CD20 success confirms that B cells are key drivers of MS, not just supporting actors.
Early, high-efficacy treatment: Data support starting high-efficacy therapy early rather than slowly escalating, to better protect long-term function.
Choosing between high-efficacy options: Anti-CD20 vs natalizumab: similar efficacy in many settings, but different risk profiles and practical constraints.
Safety and individualisation: Infection risk, hypogammaglobulinaemia, pregnancy, breastfeeding and COVID experience all push toward a more personalised, monitored use of anti-CD20.
What’s coming next: New formulations (e.g. SC dosing) and next-generation B-cell strategies (bispecifics, CAR-T) point to an even more refined future.

“B-cell Clinical Aspect: available and future treatment “.

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About the speaker:

Carlo Pozzilli

Professor of Clinical Neuroscience at University of Rome “La Sapienza”

Professor Pozzilli studied at the University of Rome “La Sapienza”. He then moved to the Hammersmith Hospital in London, UK, to take up a research post in 1980.In 1983, he became a Board Certified Neurologist at the University of Rome. In 1986 obtained a research grant in Neuroimaging at the Tohoku University, Sendai Japan.In 1987, he was awarded a PhD in Clinical Neurosciences by the University of Rome, where he became Full Professor in 2006. In 2002 he funded and become Director of the Multiple Sclerosis (MS) Center of OspedaleS.Andrea, University of Rome which is his actual position. Professor Pozzilli’s fields of interest include the clinical aspects and treatment of MS; he has published more than 350 papers and reviews on these subjects. Professor Pozzilli is a member of several National and International Societies. He has participated as a first investigator in at least 250 multicentre clinical trials on patients with MS. He was also member of the Steering Committee and Advisory Board inseveral multicentre trials.