Declaration of Competing Interest CMA and MDW have nothing to declare, JJF has participated on Consulting and Advisory Boards for Sanofi and has received a Sylvia Lawry fellowship grant from National Multiple Sclerosis Society, MM has participated on Consulting and Advisory Boards for Genzyme and Genetech and has received a Slyvia Lawry grant from NMSS. DO has received research support from National Multiple Sclerosis Society, National Institutes of Health, Patient Centered Research Institute, Race to Erase MS Foundation, Genentech, and Genzyme. He has also received consulting fees from Biogen Idec, Genentech/Roche, Genzyme, Novartis and Merck. ET reports personal consulting fees and support to attend educational meetings from Roche, support to attend educational meetings from Merck and Novartis. ET received salary from Biogen as part of a MS Registry Fellowship, and currently contributes to work in a joint-working research study funded by Novartis. NE has received honoraria and advisory fees from Merck, Novartis, Roche, Biogen and Genzyme.