Impact of Natalizumab Versus Fingolimod in Relapsing-Remitting Multiple Sclerosis (RRMS) Participants

This study also includes a Diffusion Tensor Imaging (DTI) sub-study that includes healthy
volunteers. Healthy volunteers will not receive any study medication.

Key Inclusion Criteria for MS Patients:

- Must have a documented diagnosis of relapsing MS (McDonald 2010 Criteria) at study
screening with EDSS score from 0.0 to 5.5.

- If the subject is on Betaseron, Rebif, Avonex, Copaxone, Extavia, Tecfidera, and
Aubagio (BRACE-TA) at study screening:

- He/she must have been on therapy for at least 6 months (unless experiencing highly
active disease), have at least 9 T2-hyperintense lesions on a brain MRI scan, and
have experienced ≥1 relapse within the last 6 months prior to study screening with ≥1
new T1-Gd+ lesion on a brain MRI scan performed ≤6 months prior to study screening or
≥2 new T2 lesions on a brain MRI scan performed ≤6 months prior to study screening,
with comparison made to a T2 MRI scan performed up to 18 months before study
screening

- If the subject has highly active disease, regardless of whether they are
disease-modifying therapy (DMT)-naïve or had previous exposure to Betaseron, Rebif,
Avonex, Copaxone, Extavia, Tecfidera, and Aubagio (BRACE)-TA), they must have had ≥2
disabling relapses in the 12 months prior to study screening and either ≥1 new T1-Gd+
lesion on a brain MRI scan performed ≤6 months prior to study screening or ≥2 new T2
lesions on a brain MRI scan performed ≤6 months prior to study screening, with
comparison made to a T2 MRI scan performed up to 18 months before study screening

Key Exclusion Criteria for MS Patients:

- Diagnosis of Primary Progressive Multiple Sclerosis and/or Secondary Progressive
Multiple Sclerosis.

- History or positive test result at study screening for human immunodeficiency virus
(HIV), hepatitis C virus (HCV) antibody or current hepatitis B infection (defined as
positive for hepatitis B surface antigen [HBsAg] and/or hepatitis B core antibody
[HBcAb]).

- Prior treatment with natalizumab or fingolimod.

- History of or known active malignant disease, including solid tumors and hematologic
malignancies (subjects with cutaneous basal and squamous cell carcinoma that has been
completely excised and considered cured prior to study screening remain eligible).

- History of opportunistic infections or any clinically significant major disease, as
determined by the Investigator.

- A clinically significant infectious illness (e.g., pneumonia, septicemia) within the
1 month prior to study screening.

- History of drug or alcohol abuse (as defined by the Investigator) within 1 year prior
to study screening.

- Prior history of immunosuppressant use (e.g., mitoxantrone, azathioprine,
methotrexate, cyclophosphamide, mycophenolate, cladribine, rituximab), or exposure to
intravenous immunoglobulin (IGIV), monoclonal antibodies, cytokines, growth factors,
soluble receptors, other recombinant products, or fusion proteins in the last 12
months prior to study screening.

- History of myocardial infarction, unstable angina, stroke, transient ischemic attack,
decompensated heart failure in last 6 months.

- Treatment with Class Ia (e.g., procainamide, quinidine, ajmaline, disopyramide) or
Class III (amiodarone, bretylium, dofelitide, sotalol, ibulitide, azilimide)
anti-arrhythmic drugs.

- Concurrent therapy with drugs that slow heart rate (e.g., beta-blockers, heart-rate
lowering calcium channel blockers such as diltiazem or verapamil, or digoxin).

- Hypertension not controlled with prescribed medications.

- History of severe respiratory disease, pulmonary fibrosis or class III or IV chronic
obstructive pulmonary disease.

- The use of live or live attenuated vaccination within 8 weeks of study screening.

Key Inclusion Criteria for Healthy Volunteers:

- Subjects who are generally healthy as demonstrated by physical examination and by
medical history, with no history or evidence of major illnesses, diseases, or
disorders.

- Subjects of childbearing potential must practice effective contraception and be
willing and able to continue contraception for duration of the study.

- History of drug or alcohol abuse (as defined by the Investigator) within 1 year prior
to study screening.

Key Exclusion Criteria for Healthy Volunteers:

- Claustrophobia sufficient to interfere with generating reliable MRI scans.

- History of other major illness including neurological disorders as determined by the
Investigator.

- Presence of a metal device affected by MRI (e.g., any type of electronic, mechanical
or magnetic implant, cardiac pacemaker, aneurysm clips, implanted cardiac
defibrillator) or potential ferromagnetic foreign body (metal slivers, metal
shavings, other metal objects), which would be a contraindication for MRI.

- Women who are currently pregnant or breastfeeding, or who have a positive pregnancy
test result at screening.

NOTE: Other protocol defined Inclusion/Exclusion criteria may apply