Autoimmune and MS | Next-Generation Therapeutics in MS and Autoimmune Neurology*
Date: October 18, 2026
Time: 3:30 pm to 5:00 pm
Room: Seaglass
Track: Traditional Special Interest Group (SIG)
Session Description
The fields of multiple sclerosis (MS) and autoimmune neurology are rapidly evolving, with an expanding therapeutic landscape and increasing opportunities for precision treatment. In MS, B cell–targeted therapies have transformed disease management, offering high efficacy in reducing disease activity and preventing relapses. However, long-term immunosuppression raises important safety and cost considerations, and emerging evidence suggests that extended-interval dosing strategies may help mitigate these risks.
In myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), there are currently no approved therapies, but advances in neuromyelitis optica spectrum disorder have accelerated the development of targeted clinical trials, with early results now emerging alongside growing real-world data. In parallel, chimeric antigen receptor (CAR) T-cell therapy is gaining attention as a novel approach for treating autoimmune neurologic disorders of the central nervous system.
This session will highlight these evolving therapeutic strategies, focusing on current evidence, clinical application, and future directions in MS and autoimmune neurology.
Learning Objectives
At the conclusion of this session, attendees will be able to:
- Describe the role of extended-interval dosing strategies for B cell–targeted therapies in MS.
- Discuss current and emerging therapeutic approaches for MOGAD.
- Evaluate the potential risks and clinical applications of CAR T-cell therapy in autoimmune neurology.
Speakers
- (Chair) Eoin P. Flanagan, MD, FANA
- (Co-Chair) Rajesh Gupta, MD, MBBS, MS, FANA
- (Speaker) Annette Langer-Gould, MD, PhD
- (Speaker) Michael Levy, MD, PhD
- (Speaker) Giovanna Manzano, MD
- (Speaker) Marinos Dalakas, MD, PhD, FAAN, FANA
- (Speaker) Sarosh Irani, BM, BCh, Dphil (2026 SIG Oral Presenter)
Extended Interval Dosing and Dose Reductions of Rituximab in the Treatment of Multiple Sclerosis
Description
B-cell–depleting therapies have become an important component of multiple sclerosis (MS) treatment, yet optimal dosing and dosing intervals remain incompletely defined by clinical evidence. Increasing data suggest that higher cumulative doses and prolonged exposure to rituximab may be associated with reduced immunoglobulin G (IgG) levels and an increased risk of infections, highlighting the need to balance treatment efficacy with long-term safety.
This presentation will review emerging evidence on dose de-escalation and extended-interval dosing of rituximab in people with relapsing MS. Participants will examine data suggesting that low-dose rituximab administered at extended intervals of up to 24 months may provide comparable disease control to standard-interval dosing, including in individuals with active disease at the time of rituximab initiation. The session will also review the Kaiser Permanente Southern California rituximab dose-de-escalation protocol and discuss practical considerations for incorporating individualized dosing strategies into clinical practice.
Attendees will leave with a greater understanding of the evolving evidence surrounding rituximab dosing in MS and practical insights into extended-interval and dose-de-escalation strategies. The session will provide clinicians with tools to balance disease control, treatment exposure, immunologic effects, and infection risk when developing individualized treatment plans.
MOGAD Therapeutics in 2026: Evidence, Trials, and Real-World Decisions
Description
The therapeutic landscape for myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is evolving rapidly as new clinical trial data and real-world evidence continue to inform treatment strategies. Despite these advances, important questions remain regarding optimal acute management, relapse prevention, patient selection, and the duration of long-term immunotherapy.
This presentation will review current approaches and ongoing controversies in the treatment of MOGAD. Participants will examine evidence supporting acute therapies, including corticosteroids, plasma exchange, intravenous immunoglobulin, and emerging interventions, with discussion of treatment timing, incomplete treatment response, relapse following corticosteroid withdrawal, and differences across clinical phenotypes. Topics will also include strategies for relapse prevention, including immunoglobulin-based therapies, conventional immunosuppressive agents, B-cell–directed therapies, and cytokine-targeted treatments. Recent observational studies and Phase 3 clinical trial data will be reviewed to highlight evolving evidence regarding efficacy, safety, relapse reduction, and patient selection. Particular emphasis will be placed on practical clinical decision-making, including which patients are most likely to benefit from long-term therapy, how treatment duration should be determined, and how clinicians can individualize therapy based on the current evidence.
Attendees will leave with a greater understanding of the rapidly evolving treatment landscape for MOGAD and practical strategies for applying emerging evidence to optimize acute management, reduce relapse risk, and improve long-term outcomes for patients with this autoimmune demyelinating disorder.
CAR-T Treatments for Autoimmune CNS Neurologic Disorders
Description
Chimeric antigen receptor T-cell (CAR-T) therapy is emerging as a promising treatment strategy for autoimmune neurological diseases by selectively targeting pathogenic immune cells and potentially inducing durable immune remission. As clinical experience expands beyond oncology, CAR-T therapy is being investigated for a growing number of central nervous system autoimmune disorders, with the potential to transform the management of treatment-refractory disease.
This presentation will provide an overview of the principles of CAR-T cell therapy, including its mechanism of action, therapeutic rationale, and potential systemic and neurological toxicities. Participants will review evidence from ongoing clinical trials evaluating CAR-T therapy in multiple sclerosis, neuromyelitis optica spectrum disorder, and autoimmune encephalitis, while also examining emerging applications in stiff person syndrome and myasthenia gravis. Topics will include early efficacy and safety data, patient selection, immune reconstitution, and the opportunities and challenges associated with implementing CAR-T therapy for autoimmune neurological disease. Particular emphasis will be placed on the future role of cellular immunotherapy and its potential to expand treatment options for refractory neuroimmune disorders.
Attendees will leave with a greater understanding of the evolving role of CAR-T therapy in autoimmune neurological disease and practical insights into the potential benefits, risks, and future clinical applications of this novel immunotherapeutic approach.
Miv-cel CD19 CAR T-Cell Therapy in Stiff Person Syndrome (SPS) in a Pivotal, Multicenter, Phase 2 Study (KYSA-8): Efficacy and Biomarker Analysis of Patients With >6 Months of Follow-up (2026 SIG Oral Presentation)
Description
Stiff person syndrome (SPS) is a rare autoimmune neurological disorder that can be highly disabling and difficult to treat in patients with refractory disease. Emerging cellular immunotherapies, including CD19-directed CAR T-cell therapy, offer the potential to induce durable immune reprogramming and sustained clinical remission by targeting the underlying autoimmune process.
This presentation will review efficacy and biomarker findings from the pivotal, multicenter Phase 2 KYSA-8 trial evaluating miv-cel CD19 CAR T-cell therapy in patients with antibody-positive refractory stiff person syndrome. Participants will examine clinical outcomes observed after more than six months of follow-up, including improvements in mobility, stiffness, functional status, and disability measures. Topics will also include immunological findings demonstrating profound B-cell depletion, reductions in pathogenic autoantibody levels, restoration of naïve B-cell populations, decreases in class-switched memory B cells, and expansion of regulatory T cells, highlighting evidence of a broad immune reset associated with durable, immunotherapy-free remissions.
Attendees will leave with a greater understanding of the therapeutic potential of CD19 CAR T-cell therapy in refractory stiff person syndrome and practical insights into the clinical and immunological biomarkers that may inform future treatment strategies for autoimmune neurological diseases.
Permissive Central Tolerance and Defective Peripheral Tolerance as Sequential Steps to License CASPR2-directed Pathology
Description
Autoantibody-mediated neurological diseases provide a unique opportunity to investigate the mechanisms that drive the development of pathogenic B cells and autoantibodies. Understanding how failures in immune tolerance contribute to these disorders is essential for identifying new therapeutic targets and advancing precision immunotherapy.
This presentation will explore the sequential roles of permissive central tolerance and defective peripheral tolerance in the development of CASPR2-directed autoimmunity. Participants will examine how disruptions in immune tolerance permit the emergence of disease-causing B cells and autoantibodies targeting a single neuronal autoantigen, review current insights into the immunobiology of CASPR2-associated disease, and discuss the implications of these findings for disease pathogenesis and therapeutic intervention. Topics will also include how studying autoantibody-mediated disorders can provide broader insights into the mechanisms underlying autoimmune neurological diseases.
Attendees will leave with a greater understanding of the immunological pathways that give rise to pathogenic autoantibody responses and practical insights into how advances in immune tolerance research may inform the development of targeted therapies for autoimmune neurological disorders.
