Comparison of Brain Atrophy Rates, Cognition, and Patient-Reported Outcomes in MS Patients Using Long-term Fingolimod and Glatiramer Acetate

Rates of brain atrophy for long term users of fingolimod when compared to glatiramer acetate
have not been examined in patients with relapsing forms of multiple sclerosis (MS). As
patients on long term therapy typically have little or no overt signs of white matter
inflammatory activity (T2, gad lesions), brain atrophy measures can provide insight into
whether there is continued progression of MS in these patients. What remains unknown is
whether patients on a particular therapy have a slower rate of brain atrophy. This would
provide convincing evidence that central nervous system tissue injury is further suppressed.
Such information would be of substantial clinical benefit when deciding between various
therapies.

The investigators will estimate the impact of long term use of fingolimod therapy (defined as
a minimum of two years on therapy) on whole brain atrophy in treated patients with relapsing
forms of MS as compared to age and gender matched patients on Glatiramer Acetate.

The investigators secondary goal is to determine the correlation between brain atrophy and
cognitive performance in treated patients with relapsing forms of MS.

The investigators will also examine the correlation between the NeuroQualityofLife (NeuroQOL)
PROs, patient self-reports of disability, clinical assessment of physical disability, work
productivity, clinical assessments of cognitive functioning with whole brain volume loss for
patients on long term fingolimod vs. long term glatiramer acetate therapy matched on age and
gender.

The investigators anticipate the findings of this study will generate relevant hypotheses
about these relationships.