Comparative Study of High-Efficacy Disease Modifying Treatment of Relapsing Multiple Sclerosis

Inclusion Criteria: * Multiple sclerosis diagnosis and definition of disease course according to the 2017 McDonald criteria * Expanded disability status scale (EDSS) ≤6.5 * Signed written informed consent * Fulfilling criteria for active MS: Treatment naïve relapsing remitting multiple sclerosis (RRMS) patients (never treated, or no DMT the previous 2 years): * 2 relapse previous 12 months OR 1 relapse previous 12 months with severe residual symptoms and EDSS ≥ 3.0 OR 1 relapse previous 12 months AND ≥9 T2 lesions on brain and/or spinal cord MRI AND 1. contrast-enhancing lesion or ≥1 new or enlarging T2 lesion on brain and/or spinal cord MRI previous 12 month Previously treated RRMS patients: * 1 relapse previous 12 months OR * 1 contrast-enhancing lesion or ≥2 new/enlarging T2 lesions on brain and/or spinal cord MRI previous 12 months Exclusion Criteria: * Pregnancy or breast feeding * Lack of effective contraception for women of child-bearing potential (effective contraception include oral contraception, intrauterine devices and other forms of contraception with failure rate \<1%) * Receipt of a live or live-attenuated vaccine within 6 weeks prior to randomization * Known active malignant disease * Severe heart failure (New York Heart Association Class IV) or severe, uncontrolled cardiac disease * Positive test for HIV, hepatitis B or C, or tuberculosis * Negative test for varicella zoster * Lymphopenia grade 2 (0.5 to 0.8 × 10\^9/L) or higher grades of lymphopenia (in case of switching from fingolimod lymphopenia grade 2 can be accepted if lymphocytes are rising markedly compared to on treatment levels) * Neutropenia grade 2 (1.0 to 1.5 × 10\^9/L) or higher grades * Thrombocytopenia grade 2 (50 to 75 × 10\^9/L) or higher grades * Previous treatment with alemtuzumab or hematopoietic stem-cell transplantation * Previous treatment with cladribine, CD20-depleting antibodies, daclizumab or other immune suppressive treatment which is judged to still exert immune suppressive effect by treating physician * Methylprednisolone treatment within 1 month of baseline visit * Findings on the screening MRI judged to preclude participation by the treating physician * Other diseases judged to be relevant by the treating physician * Contraindication to MRI * Known allergy or hypersensitivity to rituximab or ocrelizumab, rituximab, ofatumumab or natalizumab