Study of Diroximel Fumarate in the Real-World Setting

Percentage of Participants on Treatment with DRF at 3 Months

Time frame: 3 months

Percentage of Participants on Treatment with DRF at 2 Years

Time frame: 2 years

Annualized Relapse Rate (ARR) with DRF

Time frame: At 1 and 2 years

Percentage of Participants Relapsed

Time frame: At 1 and 2 years

Change in Processing Speed Test (PST) Score from Baseline

PST measures mental processing speed. The PST will be assessed using multiple sclerosis performance test (MSPT). The participants will be shown some symbols and corresponding numbers. The participants will be then asked to input the numbers corresponding to the given symbols in empty rows. Higher number of correct responses indicates better cognition

Time frame: Baseline up to 2 years

Change in Score for Each Domain of Quality of Life in Neurological Disorders (Neuro- QoL™) Questionnaire

Neuro-QOL uses a T score which has a mean of 50 and SD of 10, based on the norming sample used. All Neuro-QOL banks and scales are scored such that a high score reflects more of what is being measured.

Time frame: Baseline up to 2 years

Change in Disability, as Measured by Patient Determined Disease Steps (PDDS)

The PDDS has nine ordinal levels ranging between 0 (normal) and 8 (bedridden). Higher scores indicate greater disability.

Time frame: Baseline up to 2 years

Change in Work Productivity and Activity Impairment Due to Multiple Sclerosis (WPAI- MS) Scores from Baseline

The Work Productivity and Activity Impairment (WPAI) questionnaire is a validated instrument to measure impairments in work and activities. The WPAI yields four types of scores: 1. Absenteeism (work time missed) 2. Presenteesism (impairment at work / reduced on-the-job effectiveness) 3. Work productivity loss (overall work impairment / absenteeism plus presenteeism) 4. Activity Impairment. Higher numbers indicate greater impairment and less productivity.

Time frame: Baseline up to 2 years

Number of Participants with Gastrointestinal (GI) Adverse Events (AEs)

An AE is any untoward medical occurrence in a participant administered a pharmaceutical product and that does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal assessment such as an abnormal laboratory value), symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product.

Time frame: Up to 32 months

Number of Participants with AEs Leading to Treatment Discontinuation

An AE is any untoward medical occurrence in a participant administered a pharmaceutical product and that does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal assessment such as an abnormal laboratory value), symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product.

Time frame: Up to 32 months

Number of Participants with Serious Adverse Events (SAEs)

An SAE is any untoward medical occurrence that at any dose results in death, in the view of the investigator, places the participant at immediate risk of death, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, results in a congenital anomaly/birth defect or is a medically important event.

Time frame: Up to 32 months

Number of Participants categorized by the types of actions taken to mitigate GI AEs

The actions taken will include temporary dose reduction, temporary dose interruption, initiation of concomitant GI medication, taking DRF dose with food, permanent discontinuation, or other action.

Time frame: Up to 32 months

Median Absolute Lymphocyte Count (ALC) Over Time

Time frame: Baseline up to 2 years

Percent Change in Median ALC from Baseline

Time frame: Baseline up to 2 years

Number of Participants with Lymphopenia According to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI/CTCAE)Severity Grading

Time frame: Up to 32 months