A retrospective evaluation of the effects of dimethyl fumarate on hematological parameters in patients with multiple sclerosis

Abstract

Aim: Multiple Sclerosis (MS) is a chronic, inflammatory, and demyelinating disease of the central nervous system. Typically seen in young adults, MS progressively leads to neurological impairments and significantly affects the quality of life. The lack of a definitive cure necessitates long-term monitoring and disease-modifying treatments. Dimethyl fumarate (DMF), a disease-modifying agent used in MS treatment, is notable for its antioxidant and anti-inflammatory effects.

Materials and Methods: In the present study, hematological, biochemical, and systemic inflammation parameters in MS patients were retrospectively analyzed before and after DMF treatment. The study aimed to investigate the effects of DMF on peripheral blood parameters and immune indices in MS patients.

Results: DMF treatment resulted in statistically significant decreases in leukocyte, neutrophil, lymphocyte, and platelet counts. Although a significant reduction was detected in creatinine levels, no significant changes were observed in BUN, ALT, AST, sedimentation rate, CRP, eosinophils, basophils, hemoglobin, and monocytes. After DMF treatment, statistically significant increases were observed in PIV, PLR, NLR, MLR, and SIRI. However, these increases likely reflect a mathematical artifact driven by DMF-induced lymphopenia (i.e., reduced lymphocytes in the denominator), rather than true systemic inflammatory activation. Therefore, these indices should be interpreted in the context of absolute cell counts and clinical and radiological findings.

Conclusion: The present study demonstrates that DMF treatment significantly affects peripheral hematological parameters and inflammatory indices. These parameters may serve as practical, low-cost biomarkers for monitoring treatment response in MS patients.