Fingolimod reduces the rate of brain volume loss in patients with relapsing multiple sclerosis (RMS), and this effect is independent of disease status and previous treatment history.

Brain volume is clinically relevant in RMS because it tracks disease progression, and the rate of brain volume loss predicts long-term disability.

Routine measurement of brain volume in RMS could be valuable in informing treatment decisions.

Although reliable, longitudinal measurement of brain volume to determine rate of loss is difficult in routine clinical practice; developments in magnetic resonance imaging analysis are beginning to address the challenges faced.