Patients with either Relapsing-remitting MS (RRMS), Secondary progressive MS (SPMS), or Primary progressive MS (PPMS) by McDonald 2010 criteria.
Patients defined by subtype based on 2013 updated phenotypic criteria.
prospectively with an EDSS change of at least 1.0 points over the last two years, or
retrospectively, with any significant change in motor function over at least one year, unrelated to relapse.
55 years of age or older at time of randomization;
No evidence of recent new inflammatory disease activity (inactive by the Lublin criteria16) with no new relapse for at least five years and no new MRI lesion for at least three years
interferon ß-1a,
interferon ß-1b,
glatiramer acetate,
natalizumab,
fingolimod,
dimethyl fumarate, or
teriflunomide; continuously for no less than 5 years.
Taking most recent DMT continuously* for no less than two years.
Willing to be randomized per this protocol; each patient will be questioned as to their willingness to stay in the trial regardless of the group to which group they are randomized.
Willing to follow the protocol
Continuously will be defined as no less than 75% of all prescribed doses, with no time of greater than four weeks from last intended dose to have missed a dose (8 weeks for natalizumab, i.e. one missed dose).

NCT03073603_inc_T1
Condition
Relapsing-remitting MS (RRMS)
NCT03073603_inc_T2
Condition
Secondary progressive MS (SPMS)
NCT03073603_inc_T3
Condition
Primary progressive MS (PPMS)
NCT03073603_inc_T5
Condition
EDSS change
NCT03073603_inc_T6
Value
at least 1.0 points
NCT03073603_inc_T7
Temporal
over the last two years
NCT03073603_inc_T8
Qualifier
significant
NCT03073603_inc_T9
Condition
change in motor function
NCT03073603_inc_T10
Temporal
over at least one year
NCT03073603_inc_T11
Qualifier
unrelated to relapse
NCT03073603_inc_T12
Value
ears of lder at
NCT03073603_inc_T13
Person
age
NCT03073603_inc_T14
Temporal
at time of randomization
NCT03073603_inc_T15
Condition
inflammatory disease
NCT03073603_inc_T16
Measurement
Lublin criteria
NCT03073603_inc_T17
Value
inactive
NCT03073603_inc_T18
Qualifier
new
NCT03073603_inc_T19
Negation
No
NCT03073603_inc_T20
Condition
relapse
NCT03073603_inc_T21
Qualifier
new
NCT03073603_inc_T22
Negation
no
NCT03073603_inc_T23
Temporal
for at least five years
NCT03073603_inc_T24
Condition
lesion
NCT03073603_inc_T25
Procedure
MRI
NCT03073603_inc_T26
Temporal
for at least three years
NCT03073603_inc_T27
Negation
no
NCT03073603_inc_T28
Qualifier
new
NCT03073603_inc_T29
Drug
interferon ß-1a
NCT03073603_inc_T30
Drug
interferon ß-1b
NCT03073603_inc_T31
Drug
glatiramer acetate
NCT03073603_inc_T32
Drug
natalizumab
NCT03073603_inc_T33
Drug
fingolimod
NCT03073603_inc_T34
Drug
dimethyl fumarate
NCT03073603_inc_T35
Drug
teriflunomide
NCT03073603_inc_T36
Temporal
for no less than 5 years
NCT03073603_inc_T37
Multiplier
continuously
NCT03073603_inc_T38
Drug
DMT
NCT03073603_inc_T39
Multiplier
continuously
NCT03073603_inc_T40
Temporal
for no less than two years