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(odds ratio [OR], 1.45; p0.0001) and less likely to relapse (OR, 0.75; p0.0001) postindex. Switches were uncommon (~10%) across cohorts. Preindex relapses were associated with increased odds of postindex relapses (OR, 1.73; p0.0001) but not with odds of persistence at 12 months. The 12-month nonpersistence rate was high among all MS patients but lower among oral users. Oral users were also less likely to relapse postindex. Despite the effectiveness of DMTs in reducing relapses, the low persistence, lack of switching to a new