A NIS Evaluating Various Injectable and Oral Treatments in Patients With Relapsing Multiple Sclerosis

A Non-interventional Study Evaluating Injectable Treatments (Ofatumumab, Glatiramer Acetate and Interferon β1) and Oral Treatments (Teriflunomide, Dimethyl Fumarate and Diroximel Fumarate) in Patients With Relapsing Multiple Sclerosis [AIOLOS]

This is an observational, non-interventional, multicenter, open-label study in patients being treated with any approved injectable or selected oral DMT for RMS in Germany.

Prospective, primary data will be collected via questionnaires and an electronic case report form (eCRF) over a period of up to four years. Additionally, medical history of participants will be collected including disease duration, laboratory values, EDSS, MRI parameters and relapses.

The prerequisite for participation in this observational study is the independent decision of the treating physician and patient to start an approved injectable or oral DMT for RMS as routine medical treatment. This decision must have been made prior to enrollment in this study.

Cohort 1: The prospective observational period per patient in the core part will be up to approx. two years from the time of consent (2 years +2 months visit window). If a patient re-consents to the extension part, then the prospective extension observational period will be additional approx. two years, resulting in a total observational period (prospectively for the core and extension part & retrospectively for the potential gap between core and extension part) of approx. 4 years (+ 2 month visit window).

Cohort 2: The prospective observational period per patient will be up to approx. two years from the time of consent (2 years + 2 months visit window).

The observational period will not be dictated by the protocol. The follow-up documentation will take place at a frequency defined as per investigator's discretion. The diagnostic or monitoring procedures are only those ordinarily applied to the therapeutic strategy and to routine clinical care, can be performed as telemedicine visits and will take place as per investigator's discretion.

Cohort 1 Inclusion Criteria:

1. Signed informed consent must be obtained prior to participation in the study
2. Male or female patients aged ≥18 years at enrollment
3. Diagnosis of MS according to the 2017 revised McDonald criteria (Thompson et al 2018b)
4. RMS with active disease as defined by Lublin et al. (2014)
5. Max. 1 relapse during the previous year and max. 2 relapses during the previous two years prior to enrollment
6. Disability status at enrollment with an EDSS score of 0 to 2.5 (inclusive)
7. Planned initiation or initiation within the past 14 days with an approved injectable DMT for MS as routine medical treatment

Cohort 2 Inclusion Criteria:

1. Signed informed consent must be obtained prior to participation,

2. Male or female patients aged ≥18 years at enrollment,

3. Diagnosis of MS according to the 2024 revised McDonald criteria (Montalban et al., 2025),

4. RMS with active disease as defined by Lublin et al. (2014) ,

5. Max. 1 relapse during the previous year and max. 2 relapses during the previous two years prior to enrollment,

6. Disability status at enrollment with an EDSS score of 0 to 3.0 (inclusive),

7. Planned initiation or initiation within the past 14 days with an approved injectable or oral DMT for MS as routine medical treatment:

   • Ofatumumab: only naïve patients or patients previously treated with max. one DMT other than ofatumumab
   • IFN-β1, GA, teriflunomide, DMF or DRF: only naïve patients

Cohort 1 Exclusion Criteria:

1. Patients being treated outside of the approved label
2. > 5 years since first symptom(s) (leading to MS diagnosis) at enrollment
3. Previous therapy with any DMT for the treatment of MS prior to enrollment (except within the past 14 days with an approved injectable DMT for MS as routine medical treatment; see Inclusion criteria #7)
4. Relapse prior to enrollment which has led to a severe deficit relevant to everyday life upon discretion of the investigator after exhaustion of the relapse therapy
5. Poor recovery from the first two relapses prior to enrollment upon discretion of the investigator
6. EDSS Functional System Score "Pyramidal Functions" ≥ 2 at enrollment
7. Simultaneous participation in any investigational trial or simultaneous participation in another Novartis-sponsored non-interventional study with Ofatumumab

Cohort 2 Exclusion Criteria:

1. Patients being treated outside of the approved label,
2. >5 years since first symptom(s) (leading to MS diagnosis) at enrollment,
3. Simultaneous participation in any investigational trial or simultaneous participation in another Novartis-sponsored non-interventional study with Ofatumumab,
4. Patients being previously enrolled in cohort 1 are not eligible to be enrolled into cohort 2