Provided is the use of a VLA-4 binding antibody in the manufacture of a medicament for the treatment of a subject at risk of relapsing or progressive multiple sclerosis, wherein the subject has not experienced a clinical episode of focal neurologic deficit and has one or more of the following characteristics: (a) has a plurality of brain lesions or scars greater than or equal to 3 mm in size detectable by cranial scan (b) has serum antibodies against one or both of myelin oligodendrocyte glycoprotein (MOG) and myelin basic protein (MBP) ( c) has increased levels of CSF IgG compared to a negative control and (d) has elevated levels of myelin basic protein (MBP) compared to a negative control.
